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Acute Hepatic Congestion

  • Acute Hepatic Congestion is an acute consequence of right heart failure. Initially, congestion affects the areas surrounding the terminal hepatic venule where blood usually exits the classically-conceived hepatic lobule] or in Zone III of the acinus-model of the hepatic lobule (See: Hepatic Histology). Thus a "Centrilobular Pattern" of congestion emerges characterized by distention of sinusoidal capillaries. Reduced blood flow through the liver also leads to hypoxia which manifests as degeneration of hepatocytes. However, because hepatocytes surrounding the terminal hepatic venule (i.e. Zone III in the liver acinus model) are the last cells to receive oxygenated blood, these cells are most prone to degeneration resulting in a "Centrilobular Pattern" of hepatocyte degeneration. Hepatocytes adjacent to the portal tracts may develop some lipid droplets representative of damage falling short of outright degeneration.