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Congestive hepatopathy

Lawrence S Friedman, MD
Section Editor
Sanjiv Chopra, MD, MACP
Deputy Editor
Kristen M Robson, MD, MBA, FACG


The liver's complex vascular supply and high metabolic activity make it particularly vulnerable to circulatory disturbances. The severity and characteristics of hepatic injury depend upon the blood vessels that are involved and the degree to which injury is related to passive congestion or diminished perfusion [1-3].

There are several well-recognized forms of vascular injury to the liver, including Budd-Chiari syndrome, hepatic sinusoidal obstruction syndrome, passive congestion due to heart failure, hepatic infarction, and ischemic hepatitis. Congestive hepatopathy refers to hepatic manifestations attributable to passive hepatic congestion, as occurs in patients with right-sided heart failure. Passive congestion often coexists with reduced cardiac output, making their relative contributions to hepatic injury intertwined. (See "Pathogenesis of liver injury in circulatory failure".)

This topic review will focus on passive congestion with a brief discussion of constrictive pericarditis, while discussions on Budd-Chiari syndrome, hepatic sinusoidal obstruction syndrome, ischemic hepatitis, and hepatic infarction are presented separately.

(See "Budd-Chiari syndrome: Epidemiology, clinical manifestations, and diagnosis".)

(See "Diagnosis of hepatic sinusoidal obstruction syndrome (veno-occlusive disease) following hematopoietic cell transplantation".)

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Literature review current through: Nov 2017. | This topic last updated: Sep 18, 2017.
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