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LESSON 6 TOPIC. Diseases of the liver, gallbladder, bile ducts, and pancreas

Motivational characteristic of the topic. Knowledge of the pathological manifestations of diseases and syndromes of the hepato-cholecystic-pancreatic zone is necessary for the successful assimilation of this human suffering in clinical departments. In the practical work of the doctor, this knowledge is necessary for the clinical anatomical analysis of sectional cases and liver biopsies.

The general purpose of the lesson. Learn by morphological signs of manifestations of diseases of the liver, gall bladder, pancreas

to recognize the causes and mechanisms of development of these diseases and be able to diagnose and conduct differential diagnosis of the pathological processes underlying them.

The specific objectives of the lesson.

The student must know:

• causes, development mechanisms and pathological anatomy of liver diseases;

• morphology of liver failure syndrome;

• complications and outcomes of liver diseases;

• causes, development mechanisms and morphology of diseases of the gallbladder and bile ducts, their complications and outcomes;

• causes, development mechanisms, and morphological manifestations of non-endocrine pancreatic diseases.

The student must be able to:

• by macroscopic and microscopic signs, determine the nosological affiliation of diseases of the liver, gall bladder, bile ducts and pancreas, conduct differential diagnosis of forms of diseases and syndromes of these organs;

• evaluate the causes and mechanisms of development of these diseases, and their functional significance for the body.


1. Causes, development mechanisms and morphological manifestations of acute hepatosis, its outcomes.

2. Causes, development mechanisms and morphological manifestations of chronic hepatosis, its outcomes.

Viral hepatitis (types A, B, C, D, E), etiology, pathogenesis, morphology, complications and outcomes.

4. Cirrhosis of the liver, etiology, pathogenesis, morphology, complications and outcomes.

5. Clinical and anatomical characteristics of liver cancer.

6. Cholecystitis, causes, clinical anatomical forms, morphological manifestations, complications, outcomes.

7. Morphological manifestations of diseases of the exocrine pancreas.


Macro drugs: 1. Toxic dystrophy of the liver (necrotic variant of viral hepatitis). 2. Small cirrhosis of the liver. 3. Varicose veins of the esophagus. 4. Phlegmonous cholecystitis. 5. Acute pancreatitis (pancreatic necrosis).


1. Acute toxic dystrophy of the liver - No. 113, (stained with hematoxylin and eosin).

2. Portal cirrhosis of the liver - No. 68, (stained with hematoxylin and eosin).

3. Biliary cirrhosis - No. 112 (stained with hematoxylin and eosin).

4. Cholangiocellular liver cancer - No. 227 (stained with hematoxylin and eosin).

Electron diffraction patterns: 1. Portal cirrhosis of the liver. 2. Viral hepatitis. Tables: 1. Toxic dystrophy of the liver. 2. Clinical and morphological forms of viral hepatitis. 3. Cirrhosis of the liver. 4. Gallbladder stones.


1. Introduction - 5 minutes.

2. Determination of the initial level of knowledge - 15 minutes.

3. Teacher's notes - 10 minutes.

4. Independent work of students - 100 minutes.

5. Determination of the final level of knowledge - 15 minutes.

6. Reception of workbooks (albums) - 30 minutes.

7. The conclusion of the teacher - 5 minutes.

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LESSON 6 TOPIC. Diseases of the liver, gallbladder, bile ducts, and pancreas

    This chapter continues the presentation of the pathology of the digestive system. According to traditions, a number of diseases of the liver and biliary tract, despite their infectious etiology, are considered not in chapter 14, devoted to infections, but here. The same applies to diabetes mellitus, a description of which, for reasons of expediency, is included in this
  2. Diseases of the liver, gallbladder and pancreas
  3. Gall bladder and bile ducts
    As in many other organs and tissues, in the human liver, secretory processes are subordinated to a certain rhythm. Bile secretion prevails during the day, glycogen production prevails at night. The effect of a nightly decrease in the secretion of bile, which has a physiological basis, is enhanced even more with biliary dyskinesia (a violation of the coordinated work of the smooth muscles of the ducts and gallbladder, which has
  4. Liver, gall bladder and bile ducts
    The liver of the newborn is relatively large, especially its left lobe, to which the spleen is adjacent. Cases of agenesis of the liver are rare, they are more often found to be underdeveloped. On the back or on the lower surface of the liver, you can sometimes see congenital notches, often located in the sagittal direction. If these depressions are significant, the liver is divided into additional lobes.
  5. Diseases of the liver and gall bladder
    With the development of possibilities for diagnosing diseases of internal organs, it was found that liver disease (hepatopathy) is much more common than previously thought, and that many vague signs of disease are based on hepatosis. Due to the importance and variety of functions, the liver is endowed with a natural ability for high regeneration. Therefore arising under the influence of different
  6. LIVER. Gallbladder
    The liver (hepar) is the largest gland of the human body (Fig. 78). Its mass is about 1500 g. It performs several main functions: digestive, forms protein, detoxifies, hematopoietic, metabolizes, etc. The liver is located in the right hypochondrium and in the epigastrium. In shape, it resembles a wedge, has an upper and lower surface. Upper (diaphragmatic)
  7. Nutrition for diabetes with diseases of the liver and gall bladder
    Nutrition in the treatment of this disease should improve metabolic processes that are disturbed by diabetes and diseases of the liver and gall bladder. Products that improve liver function, enhance bile secretion, and help normalize intestinal activity are introduced into the diet of a diabetic. Foods that impede liver function are excluded from nutrition. It is recommended to include milk and
  8. Diseases of the liver and biliary system. Hepatitis. Cirrhosis of the liver. Liver cancer. Cholelithiasis.
    1. A 40-year-old woman complains of weakness, jaundice. A history of 2 months. before the disease - blood transfusion. An examination revealed an increase in the liver, an increase in the level of hepatic transaminases. Conclusion 1. liver steatosis 3. obstructive jaundice 2. Botkin’s disease 4. acute viral hepatitis 2. Viral hepatitis C is characterized by 1. high frequency of chronicity 2. parenteral transmission 3.
  9. Diseases of the biliary tract and gallbladder
    Diseases of the biliary system are very common. Patients with this pathology in the general population are on average 2, and among women - almost 10 times more than patients with peptic ulcer. Among the numerous diseases of the biliary tract, it is advisable to single out mainly functional disorders (dyskinesias), inflammatory (cholecystitis), and metabolic (gallstone
  10. Nutrition for exacerbation of liver inflammation and acute gallbladder inflammation
    Nutrition is recommended for patients with acute cholecystitis and hepatitis, chronic cholecystitis and hepatitis, liver cirrhosis with moderate liver failure, cholelithiasis, as well as with simultaneous damage to the liver and biliary tract, stomach and intestines. Food is cooked in water or steamed, wiped. Excluded foods that enhance fermentation and rotting in
  11. Diseases of the liver and biliary tract
    The main syndromes of liver and biliary tract diseases. These include: jaundice, liver failure, portal hypertension, cholestasis, hepatorenal, hepatoencephalic syndromes, hepatic coma, hepatic colic, hepatogenic photosensitization syndrome. Jaundice (icterus) is a clinical and laboratory syndrome characterized by hyperbilirubinemia and jaundice, general weakness and
  12. Common bile duct cyst
    Synonyms of Cyst of the common bile duct. DEFINITION A cyst of the common bile duct is a congenital expansion of the bile duct, which in 2-5% of cases causes a complete violation of the patency of the bile duct and can cause extrahepatic cholestasis. CODE FOR ICBC83.5 Gall cyst. Screening an ultrasound of the fetus allows you to identify a cyst of the common bile duct (starting from the 19th week of gestation). CLASSIFICATION By
  13. Recommended products for exacerbation of liver inflammation and acute gallbladder inflammation
    Recommended: yesterday’s wheat bread; soups are prepared on a mucous broth with grated cereals, vegetables or on vegetable broths with finely chopped vegetables - potatoes, carrots, zucchini, pumpkin, boiled cereals - rice, semolina, oatmeal, noodles, and egg-milk mixture can be added to soups, which is prepared mix raw eggs with an equal volume of milk, and season
  14. Gall bladder (problems)
    The gall bladder is a hollow organ that contains bile coming from the liver and prevents it from flowing into the intestine in between meals. During the digestion of food, the gallbladder opens and expels bile through the bile duct into the duodenum. Bile is necessary so that the intestines can absorb fats from food. Most common problem related
  15. Extrahepatic bile duct atresia
    synonyms Biliary atresia, obstruction of extrahepatic bile ducts. DEFINITION OF AVS is a progressive obliteration of the extrahepatic bile ducts, which begins during the period of intrauterine development, with the gradual involvement of the intrahepatic bile system and the formation of biliary cirrhosis. CODE ICD-Q44.2 Atresia of the bile ducts. EPIDEMIOLOGY AID - the most common cause
  16. Features of the gallbladder
    The gall bladder is located under the right lobe of the liver and has a fusiform shape, its length reaches 3 cm. It acquires a typical pear-shaped form by 7 months, by 2 years reaches the edge of the liver. The main function of the gallbladder is the accumulation and secretion of hepatic bile. The bile of a child is different in composition from the bile of an adult. It has few bile acids, cholesterol, salts, a lot
  17. Cholecystitis (inflammation of the gallbladder)
    Causes: As a rule, the presence of stones in the gallbladder or its ducts. Pathological thickening of bile as a result of a viral infection, errors in diet, abnormal structure of the gallbladder, overweight, prolonged stressful situation, diseases of the gastrointestinal tract and liver. Symptoms Pain in the upper right abdomen, fever, fat intolerance, may be temporary
  18. Gallstones
    Causes Impaired metabolism in the liver (bile is oversaturated with cholesterol). Overweight women get sick more often. One of the reasons is a sedentary lifestyle combined with errors in the diet (excess fat, fried, spicy and smoked foods, alcohol). In complex cases, cancer of the biliary tract and gall bladder can occur. Symptoms Soreness on palpation in the right
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