Cvc lung, liver and spleen

Chronic Venous Congestion

1. -DR SOWMYA SRINIVAS
CVC LUNG, LIVER AND
SPLEEN

2. HYPEREMIA & CONGESTION
Hyperemia is an increase in volume of blood in a
particular tissue.
Its an “active process” , the increased blood influx
results from arteriolar dilatation.
Congestion, also known as “passive hyperemia”,
results due to stagnation of blood because of venous
obstruction.

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© 2005 Elsevier
Normal

4. a. Active Hyperemia (arterial):a. Active Hyperemia (arterial): is an active process
resulting from increased arterial blood inflow because of
arteriolar dilatation.
- The affected tissue is reddened because of engorgement of
tissues with oxygenated blood.
b. Passive hyperemia (Congestion)b. Passive hyperemia (Congestion) is a passive
process resulting from impaired venous outflow from a
tissue.
- The affected tissue has a red-blue color due to
accumulation of deoxygenated blood.

5. ACTIVE HYPEREMIA
Types:
1. Physiological:
- Hyperemia in skeletal muscles during exercise ,in the gut
following a meal.
2. Pathological: e.g. in acute inflammation.

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© 2005 Elsevier
Hyperemia

7. PASSIVE HYPEREMIA OR
CONGESTION
Definition:
- Increase in venous blood in an organ as result of
obstruction of venous outflow.
- The veins, venules & capillaries in the organ become
passively dilated (passive hyperemia).
Types:
a. Localized
b. Generalized

8. Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 27 June 2005 07:26 PM)
© 2005 Elsevier
Congestion

9. Examples:-
Hyperemia:-
1.Inflammation
2.Blushing – adrenergic stimulation
3.Exercise – increased blood flow to the muscle.
Congestion:-
Obstruction of veins due to thrombi or backward
pressure due to heart failure.

10. Color of hyperemic & congested tissue:-
Hyperemic tissue contains increased amounts of
oxygenated blood & therefore the tissue appears
bright red.
Congested tissue contains increased amounts of
deoxygenated blood & appears blue.
Hyperemic tissue is warm, while congested blood is
cold & clammy.

11. Chronic venous congestion (CVC):-
In CVC there is long standing accumulation of
deoxygenated blood & hence there is damage to the
tissue.

12. Mechanism

HEART FAILURE
left heart failure right heart failure
Pressure into pressure into the
Pulmonary vein systemic venous system
CVC LUNGS CVC LIVER SPLEEN KIDNEY

13. CVC Lung
Causes:-
Left heart failure
Gross :-
The lungs are heavy. Lungs appear brown- BROWN
INDURATION OF LUNGS.

16. CVC Lungs
Micro:-
Rupture of congested vessel results in edema &
hemorrhage.
The alveolar septa appears thickened and fibrotic.
The alveoli are dilated and contain edema fluid and
RBC’s and macrophages.
Lysis of RBC’s releases hemosiderin pigment which
is taken up by macrophages in the alveoli – HEART
FAILURE CELLS.

21. CVC Liver
Causes:-
1.Right heart failure
2.Occlusion of inferior vena cava or portal vein.
GROSS APPEARANCE:-
NUTMEG APPEARANCE – Alternate areas of red &
yellow .

26. CVC Liver (MICRO)
Blood fills up the central vein & sinusoids
around it. Followed by centrilobular hepatocyte
atrophy and necrosis.
In the long standing cases the necrotic area is
replaced by fibrous tissue.
The mid zonal hepatocytes may show fatty
change due to relative hypoxia.
 The areas with blood appears red & areas with
fibrosis appears whitish yellow- NUTMEG
APPEARANCE.

31. CVC Spleen
Causes:-
1.Right heart failure
2.Portal hypertension

GROSS:-
Spleen is enlarged & congested.

34. CVC Spleen (micro)
Red pulp appears congested.
GAMMA GANDY BODIES OR
SIDEROFIBROTIC NODULES :-
Deposits of hemosiderin & calcium salts on fibrous
tissue.

35. Gamma gandy bodies

36. THANK YOU