Pathophysiology

Pathophysiology Study Guide

©2018 of 131 7.5 Hepatic/Gallbladder Disorders These are the diseases and disorders of the liver and gall bladder. The liver is a wedge-shaped organ that acts as a chemical factory for the body. Its main function is to break down and excrete toxic substances that help in the processing of vital nutrients, which facilitate the formation of blood clots and stop bleeding. The liver also produces bile, which helps to secrete toxins and waste products out of the body. The gall bladder has a shape like a pear and acts as a storage sac located under the liver. Its main function is to hold bile that is released in the duodenum. The liver and gallbladder are connected with the help of the biliary tract or ducts. Some of the major disorders of the liver and gall bladder are reviewed below. Jaundice Jaundice is a disorder of the liver characterized by a change in the color of the skin, white portion of the eyes, and mucous membranes due to a heightened amount of bilirubin in the blood. Bilirubin is created as the by-product from the natural daily breakdown and destruction of red blood cells in the body. During this activity, the molecule of hemoglobin gets split and the heme portion is separated and converted to bilirubin through chemical reaction. This bilirubin is metabolized by the liver and excreted through the bile. In some cases, this process is disrupted, causing an excess amount of bilirubin in the blood, which leads to jaundice. Causes of jaundice can be identified by finding the problems that disrupt the metabolism activity, which are pre-hepatic, hepatic, and post- hepatic. Pre-hepatic is the phase in which bile is not made in the liver. In this phase, the red blood cells break down and destruct at a faster rate as compared to the ability of the liver to remove it. The conditions that cause this are malaria, crises of sickle cell, spherocytosis, thalassemia, glucose-6-phosphate dehydrogenase deficiency, drugs, and autoimmune disorders. In the hepatic phase, the issues arise within the liver. The liver is incapable of adequatelymetabolizing and excreting bilirubin. The underlying causes include hepatitis, cirrhosis, drugs and toxins, crigler- najjar syndrome, cancer, and Gilbert's syndrome. The post- hepatic phase is characterized by the formation of bile in the liver. The jaundice caused in this phase is known as obstructive jaundice as the underlying causes impairment in the normal drainage of bile from the liver to intestines. The causes, in this case, include gallstones in bile ducts, bile duct carcinoma, strictures of the bile ducts, cholangitis, congenital malformations, pancreatitis, parasites, pregnancy, and newborn jaundice. Viral Hepatitis Viral hepatitis is characterized by the inflammation of the liver, due to viral infection. There are many different species of viruses that can cause inflammation of the liver, like the virus causing mononucleosis and cytomegalovirus. A virus can cause hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. It is not yet clear whether a virus can lead to hepatitis G. The most common of all are hepatitis A, B, and C. The hepatitis virus can cause acute hepatitis, while types B and C have the Achieve Page 116