key terms

alcoholic liver disease

liver injury resulting from alcohol abuse

amebic hepatic abscess

an abscess that develops from a parasite that grows in the colon and invades the liver via the portal vein

anastomosis

the surgical connection between 2 structures

arteriovenous fistula

an abnormal passageway between an artery and a vein

autoimmune disorders

disorders in which the body’s immune system attacks and destroys healthy tissues and/or organs

autosomal dominant polycystic kidney disease

• an inherited disease that results in the development of renal, liver, and pancreatic cysts typically late in life

• AKA adult polycystic kidney disease

bare area

the region of the liver not covered by peritoneum

Beckwith–Wiedemann syndrome

• a growth disorder syndrome synonymous with enlargement of several organs, including the skull, tongue, and liver

• children with this disorder are prone to several childhood cancers, including within the liver and kidney

biloma

• a collection of bile within the abdomen

• can be intrahepatic or extrahepatic in location

Budd-Chiari syndrome

the occlusion of the hepatic veins, with possible coexisting occlusion of the IVC

caput medusae

recognizable dilation of the superficial veins of the abdomen

cavernous hemangioma

the most common benign liver tumor

cholangitis

inflammation of the bile ducts

cirrhosis

condition defined as hepatocyte death, fibrosis and necrosis of the liver, and the subsequent development of regenerating nodules

conjugated bilirubin

• the water soluble form of bilirubin that is excreted into the intestines in bile and excreted in stool

• AKA direct bilirubin

contrast-enhanced (liver) ultrasound

sonographic imaging that includes the injection of a contrast agent through IV to better enhance the borders of liver lesions and to analyze those lesions for possible signs of malignancy

Couinaud classification

system used to separate the liver into 8 surgical segments and used to describe functional liver anatomy

Cruveilhier-Baumgarten syndrome

characterized by cirrhosis, portal HTN, and dilation of the umbilical and paraumbilical veins

cystic fibrosis

genetic disorder linked with the development of scar tissue accumulation within the lungs, liver, pancreas, kidneys, and/or intestines

diaphragmatic slip

a pseudomass of the liver seen on sonography resulting from hypertrophied diaphragmatic muscle bundles

dysentery

infection of the bowel which leads to diarrhea that may contain mucus and/or blood

echinococcal cyst (hydatid cyst)

a liver cyst that develops from a tapeworm that lives in dog feces; the tapeworm originates from the parasite Echinococcus granulosus

Epstein-Barr virus

virus responsible for mononucleosis and other potential complications

facial telangiectasia

• dilated or broken vessels located near the surface of the skin on the face that appears as threadlike red lines

• AKA spider veins

falciform ligament

ligament that attaches the liver to the anterior abdominal wall

fatty liver

• a reversible disease characterized by deposits of fat within the hepatocytes

• AKA hepatic steatosis

fetor hepaticus

• bad breath secondary to end-stage liver disease and the liver’s inability to filter toxins

• often accompanies cirrhosis, portal HTN, and hepatic encephalopathy

focal fatty infiltration

manifestation of fatty liver disease in which fat deposits are localized

focal nodular hyperplasia

a benign liver mass composed of a combination of hepatocytes and fibrous tissue that typically contains a central scar

gastroesophageal junction

the junction between the stomach and the esophagus

Glisson capsule

the thin fibrous casing of the liver

gynecomastia

enlargement of the male breast

hematemesis

vomiting blood

hematoma

localized collection of blood

hemochromatosis

an inherited disease characterized by disproportionate absorption of dietary iron

hemopoiesis

the formation and development of blood cells

hepatic candidiasis

a hepatic mass that results from the spread of fungus in the blood to the liver

hepatic encephalopathy

a condition in which a patient becomes confused or suffers from intermittent loss of consciousness secondary to the overexposure of the brain to toxic chemicals that the liver would normally remove from the body

hepatic jaundice

• jaundice resulting from the liver’s inability to conjugate bilirubin

• may be caused by conditions such as viral hepatitis, toxins, cirrhosis, and liver cancer

hepatitis

inflammation of the liver

hepatocellular adenoma

a benign liver mass often associated with the use of oral contraceptives

hepatocellular carcinoma

the primary form of liver cancer

hepatofugal

blood flow away from the liver

hepatoma

the malignant tumor associated with hepatocellular carcinoma → primary liver cancer

hepatomegaly

enlargement of the liver

hepatopetal

blood flow toward the liver

hepatorenal syndrome

the development of renal impairment and possible renal failure because of chronic liver disease

hepatosplenomegaly

concurrent enlargement of the spleen and liver

hyperbilirubinemia

elevated levels of serum bilirubin

hyperlipidemia

abnormally high levels of fats within the blood

hypovolemia

decrease blood volume

inferior vena cava web

• rare condition characterized by obstruction of the inferior vena cava by membranous or fibrous bands

• can cause obstruction of the hepatic veins leading to Budd–Chiari syndrome

jaundice

• broad clinical term referring to the yellowish discoloration of the skin, mucous membranes, and sclerae

• found with liver disease and/or biliary obstruction

kernicterus

brain damage from bilirubin exposure in a newborn with jaundice

Kupffer cells

specialized macrophages within the liver that engulf pathogens and damaged cells

ligamentum teres

• ligament that forms part of the edge of the falciform ligament of the liver, connecting the liver to the umbilicus

• a remnant of the left umbilical vein

• AKA round ligament of the liver

ligamentum venosum

• remnant of the fetal ductus venosus

• appears as a hyperechoic linear ligament between the caudate lobe and the left lobe of the liver

lipoma

a benign fatty tumor

liver fibrosis

the development of scar tissue within the liver as a result of the lover repeatedly trying to repair itself

liver hilum

• the area of the liver where the common bile duct exits the liver and portal vein and hepatic artery enter the liver

• AKA porta hepatis

low-resistance flow

a flow pattern that characteristically has antegrade flow throughout the cardiac cycle

malaise

feeling of uneasiness

malignant degeneration

the deterioration of a benign mass into a malignancy

mass effect

the displacement or alteration of normal anatomy that is located adjacent to a tumor

metabolic syndrome

condition that includes hypertension, hyperglycemia, excessive body fat around the waist, elevated cholesterol, and nonalcoholic fatty liver disease

monophasic

vascular flow yielding a single phase

necrosis

death of tissue

palmar erythema

reddening of the palms

periportal cuffing

an increase in the echogenicity of the portal triads as seen in hepatitis and other conditions

pneumobilia

air within the biliary tree

portal hypertension

the elevation of blood pressure within the portal venous system

portal triads

an assembly of a small branch of the portal vein, bile duct, and hepatic artery that surround each liver lobule

portal vein thrombosis

the development of a cloth within the portal vein

posthepatic jaundice

elevation in bilirubin caused by an obstruction of bile flow, typically by wither a gallstone lodged in the biliary tract or pancreatic mass

prehepatic jaundice

when the liver cannot process the amount of hemolysis of the RBCs, resulting in a buildup of circulating bilirubin in the bloodstream

pseudocirrhosis

nodular appearance of the liver caused by multiple metastatic tumors

pseuodmass

false mass

purpura

blood spots under the skin that may appear purple

pyogenic liver abscess

a liver abscess that can result from the spread of infection from inflammatory conditions such as appendicitis, diverticulitis, cholecystitis, cholangitis, and endocarditis

quadrate lobe

the medial segment of the left lobe

recanilization

the reopening of canals or pathways

Riedel lobe

a tongue-like extension of the right hepatic lobe

sequela

an illness resulting from another disease, trauma, or injury

serpiginous

twisted or snake-like pattern

shear wave elastography

elastography technique that utilizes a standard ultrasound transducer with elastography technology to obtain information about the stiffness of tissue as in the case of liver fibrosis or cirrhosis

situs inversus

condition in which the organs of the abdomen and chest are on the opposite sides of the body

spider nevi

a cluster of vessels noted on the skin that have a web-like pattern

splanchnic circulation

• blood flow to the major gastrointestinal organs including the stomach, liver, spleen, pancreas, and small and large intestines

• consists of the celiac artery, superior mesenteric artery, and inferior mesenteric artery

splenomegaly

enlargement of the spleen

starry sky sign

the sonographic sign associated with the appearance of periportal cuffing in which there is an increased echogenicity of the walls of the portal triads that may be associated with hepatitis

steatohepatitis

a type of fatty liver disease that causes inflammation of the liver

total bilirubin

obtained by adding unconjugated and conjugated bilirubin

total parental hyperalimentation

procedure in which an individual receives vitamin and nutrients through a vein, often the subclavian vein

transient elastrography

• imaging technique that utilizes a special transducer to assess the liver and other organs for signs of fibrosis and cirrhosis

• used to measure the stiffness of tissue

transjugular intrahepatic portosystemic shunt (TIPS)

the therapy for portal hypertension that involves the placement of a stent between the portal veins and hepatic veins to reduce portal systemic pressure

triphasic

vascular flow yielding three phases

unconjugated bilirubin

• the non–water soluble form of bilirubin that travels to the liver via the bloodstream

• eventually converted to conjugated bilirubin by the liver

• also referred to as indirect bilirubin

von Gierke disease

• condition in which the body does not have the ability to break down glycogen

• AKA glycogen storage disease type 1

von Hippel–Lindau disease

an inherited disease that includes the development of cysts within the liver, pancreas, and other organs

Wilson disease

a congenital disorder that causes the body to accumulate excess copper