Liver & intrahepatic bile ducts

Vascular disorders

Vascular disorders-general

Deputy Editor-in-Chief: Debra L. Zynger, M.D.
Raul S. Gonzalez, M.D.

Topic Completed: 25 January 2021

Minor changes: 26 January 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Vascular disorders[title] liver

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez R. Vascular disorders-general. website. Accessed December 3rd, 2021.
Definition / general
  • Vascular disorders affecting the liver can be systemic or localized and have intrinsic or extrinsic causes
  • Intrinsic causes:
  • Extrinsic disorders include heart failure, causing congestive hepatopathy
  • Normal liver is resistant to ischemia due to dual blood inflow (hepatic artery and portal vein)
  • Cirrhosis also causes vascular remodeling, though it is not generally considered a vascular disorder (J Hepatol 2014;61:912)
Microscopic (histologic) description
  • Inflow abnormalities often cause ischemic necrosis
  • Outflow abnormalities often cause sinusoidal dilation
  • Most other histologic changes depend on the causative disease
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.

Ischemic necrosis

Sinusoidal dilatation

Sample pathology report
  • Liver, biopsy:
    • Liver parenchyma with prominent zone 3 sinusoidal dilation (see comment)
    • Comment: The findings are most consistent with outflow obstruction (e.g. congestive hepatopathy). Trichrome and iron stains are unremarkable.
Board review style question #1
Which of the following is true about vascular disorders involving the liver?

  1. Hepatic artery thrombosis only affects native livers
  2. Inflow abnormalities often cause sinusoidal dilation
  3. Outflow abnormalities often cause portal vein thrombosis
  4. The liver’s dual blood flow makes it resistant to ischemia
Board review style answer #1
D. The liver’s dual blood flow makes it resistant to ischemia

Comment Here

Reference: Vascular disorders-general
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