10-13-2007, 03:54 PM
Infarct
Blockage of intra-hepatic blood vessels by tumor or vasculitis can result in infarcts of the liver.
Another important cause of hepatic infarcts is sickle cell disease.
Pathogenesis
¢Blockage of arterial blood flow results in anoxic cell injury and the development of an infarct.
¢Blockage of the portal vein does not usually result in an infarct because the portal artery continues to provide the liver cells with oxygen,
Epidemiology
¢Liver infarcts are rare because of the dual blood supply.
General Gross Description
¢Blockage of the intrahepatic artery can result in typical wedge shaped pale infarcts.
¢Occlusion of the portal vein does not result in an infarct because of the hepatic arterial blood supply.
¢However, an area of mottled discoloration may be seen, referred to as an infarct of Zahn.
General Microscopic Description
¢Infarcts due to occlusion of the hepatic artery are characterized by coagulative necrosis of the liver cells, followed by infiltration by inflammatory cells, resorption of tissue and the development of a scar.
Clinical Correlation
¢May present as pain the upper right quadrant.