Chronic venous congestion if spleen powerpoint

For mbbs undergraduates

1. Chronic venous congestion Dr payal desai

2. Venous congestion Hyperaemia and congestion are the terms used for localised increase in the volume of blood within dilated vessels of an organ or tissue. Acute- rapidly. Chronic- Prolonged and gradual. i . Active hyperaemia / Hyperaemia - Increased volume of blood from arterial and arteriolar dilatation ( i.E. Increased inflow). ii. Venous congestion/Passive hyperaemia - Impaired venous drainage ( i.E. Diminished outflow).

3. Congestion may be acute or chronic, more commonis called chronic venous congestion (CVC). The affected tissue or organ is bluish in colour due to accumulation of venous blood (cyanosis). Obstruction to the venous outflow may be local or systemic. Accordingly, venous congestion is of 2 types- Local venous congestion- results from obstruction to the venous outflow from an organ or part of the body e.G. i . Portal venous obstruction in cirrhosis of the liver Outside pressure on the vessel wall as occurs in tight bandage, plasters, tumours , pregnancy, hernia. Intraluminal occlusion by thrombosis.

4. Systemic (general) venous congestion- Left-sided heart failure (such as due to mechanical overload in aortic stenosis, or due to weakened left ventricular wall a s in myocardial infarction). Right-sided heart failure (such as due to pulmonary stenosis or pulmonary hypertension) .

5. CVC Liver Gross: enlarged liver, tense capsule Cut surface – nutmeg appearance (red and yellow mottled surface)

6. Microscopy Distended central vein and adjacent sinusoids Degenerative changes in hepatocytes Centrilobular fibrosis Peripheral zone shows fatty degeneration

7. CVC spleen Occurs in right heart failure and in portal hypertension from cirrhosis of liver. Grossly- Early stage- slightly to moderately enlarged (up to 250g),in long-standing cases- progressive enlargement and may weigh up to 500 to 1000 g. The organ is deeply congested, tense and cyanotic. Sectioned surface is gray tan.

8. Microscopically- Capsule and trabeculae- Fibrous thickening. Red pulp- enlarged due to congestion and marked sinusoidal dilatation and there are areas of recent and old haemorrhages . Fibrosed Capsule Congested red pulp with areas of hemorrhage

9. Hyperplasia of reticuloendothelial cells in the red pulp of the spleen (splenic macrophages). Congested sinusoid Reticuloendothelial cells

10. Some of haemorrhages overlying fibrous tissue get deposits of haemosiderin pigment and calcium salts- Gamma-gandy bodies or siderofibrotic nodules.

11. Gamma gandy bodies

12. Thank you