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SESSION 6 THEME. Diseases of the liver, gallbladder, biliary ducts and pancreatic gland

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

The overall goal of the lesson. Learn the morphological signs of the manifestations of diseases of the liver, gallbladder, pancreas

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

Specific objectives of the lesson.

The student should know:

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

• morphology of liver failure syndrome;

• complications and outcomes of liver disease;

• causes, developmental mechanisms and morphology of gallbladder and bile duct diseases, their complications and outcomes;

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

The student should be able to:

• determine, by macroscopic and microscopic signs, the nosological affiliation of diseases of the liver, gallbladder, bile ducts and pancreas, carry out differential diagnostics of the forms of diseases and syndromes of these organs;

• assess the causes and mechanisms of development of these diseases, and their functional significance for the organism.


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

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

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

4. Liver cirrhosis, etiology, pathogenesis, morphology, complications and outcomes.

5. Clinical and anatomical characteristics of liver cancer.

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

7. Morphological manifestations of diseases of the exocrine pancreas.


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


1. Acute toxic liver dystrophy - No. 113, (hematoxylin and eosin stain).

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

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

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

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


1. Introduction - 5 minutes.

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

3. Explanations of the teacher - 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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SESSION 6 THEME. Diseases of the liver, gallbladder, biliary ducts and pancreatic gland

    This chapter continues the presentation of the pathology of the digestive system. According to tradition, a number of diseases of the liver and biliary tract, despite their infectious etiology, are not considered in Chapter 14, which deals with 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
    Diseases of the liver, gallbladder and pancreatic
  3. Gallbladder and bile ducts
    As in many other organs and tissues, in the human liver, secretory processes are subject to a certain rhythm. During the day, bile excretion prevails, at night - glycogen production. The effect of the nocturnal decrease in bile secretion, which has a physiological basis, is enhanced even more by biliary dyskinesia (impaired coordination of the smooth muscles of the ducts and the gallbladder, which
  4. Liver, gallbladder and biliary tract
    The liver of a newborn is relatively large, especially its left lobe, to which the spleen is adjacent. Cases of liver disease are rare, more often it is found to be underdeveloped. On the back or on the lower surface of the liver, one can sometimes see congenital cavities, often located in the sagittal direction. If these grooves are significant, the liver is divided into additional lobes.
  5. Diseases of the liver and gallbladder
    With the development of possibilities for diagnosing diseases of internal organs, it has been found that liver disease (hepatopathies) occurs much more frequently than was previously thought, and that many of the uncertain signs of diseases basically have 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
    The liver (hepar) is the largest gland of the human body (Fig. 78). Its mass is about 1500 g. It performs several main functions: the digestive, forms a protein, neutralizing, hematopoietic, metabolizes, etc. The liver is located in the right hypochondrium and in the epigastrium. In shape, it resembles a wedge, has upper and lower surfaces. Upper (diaphragmatic)
  7. Nutrition in diabetes with liver and gallbladder diseases
    Nutrition in the treatment of this disease should improve metabolic processes that are disturbed by diabetes mellitus and diseases of the liver and gallbladder. In the diet of diabetic products are introduced that improve the functioning of the liver, enhancing biliary excretion and contributing to the normalization of intestinal activity. Food that prevents the liver from working is excluded from the diet. It is recommended to include milk in the menu.
  8. Diseases of the liver and biliary system. Hepatitis. Cirrhosis of the liver. Liver cancer. Cholelithiasis.
    1. A woman of 40 years old complains of weakness, jaundice. In history for 2 months. before the disease - blood transfusion. The examination revealed an increase in the liver, an increase in the level of liver transaminases. Conclusion 1. hepatic 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 gallstones and gall bladder
    Diseases of the biliary system are very common. Patients with this pathology in the general population are on average 2, and among women it is almost 10 times more than patients with peptic ulcer. Among the numerous diseases of the biliary tract, it is advisable to isolate predominantly functional disorders (dyskinesias), inflammatory (cholecystitis), and metabolic disorders (cholelithiasis).
  10. Nutrition during exacerbation of liver inflammation and acute inflammation of the gallbladder
    Nutrition is recommended for patients with acute cholecystitis and hepatitis, chronic cholecystitis and hepatitis, cirrhosis of the liver with moderately severe liver failure, gallstone disease, as well as simultaneous damage to the liver and biliary tract, stomach and intestines. Food is cooked on water or steamed, wiped. Excluded are products that enhance the fermentation and rotting processes in
  11. Diseases of the liver and biliary tract
    The main syndromes of diseases of the liver and biliary tract. These include: jaundice, liver failure, portal hypertension, cholestasis, hepatorenal, hepatoencephalic syndromes, hepatic coma, hepatic colic, hepatogenic photosensitization syndrome. Jaundice (icterus) is a clinical laboratory syndrome characterized by hyperbilirubinemia and jaundice, general weakness and
  12. Cyst of the common bile duct
    Synonyms Cyst choledochus. DEFINITION A common bile duct cyst is a congenital dilatation of the bile duct, which in 2-5% of cases causes complete disruption of the bile duct patency and may be the cause of extrahepatic cholestasis. CODE ICDB83.5 Bile cyst. SCREENING ultrasound of the fetus allows you to identify a cyst of the common bile duct (starting from the 19th gestation week). CLASSIFICATION BY
  13. Recommended products for exacerbation of liver inflammation and acute inflammation of the gallbladder
    Recommended: yesterday's wheat bread; soups are cooked on mucous broth with grated cereals, vegetables or on vegetable broths with finely chopped vegetables - potatoes, carrots, zucchini, pumpkin, boiled cereals - rice, semolina, oatmeal cereals, noodles, soups can be added egg-milk mixture, which is prepared a mix of raw eggs with an equal volume of milk, and fill
  14. Gallbladder (problems)
    The gallbladder is a hollow organ that contains bile coming from the liver and does not allow it to flow into the intestine in the intervals between the digestion of food. During food digestion, the gallbladder opens and throws bile through the bile duct into the duodenum. Bile is necessary so that the intestines can absorb fats from food. The most common problem associated with
  15. Atresia of extrahepatic bile ducts
    synonyms Biliary atresia, obstruction of extrahepatic bile ducts. DEFINITION AVZHP - progressive obliteration of the extrahepatic bile ducts, beginning in the period of intrauterine development, with the gradual involvement in the process of intrahepatic biliary system and the formation of biliary cirrhosis. ICD-Q44.2 software code Atresia of the bile ducts. EPIDEMIOLOGY AVZHP - the most common cause
  16. Features of the gallbladder
    The gallbladder is located under the right lobe of the liver and has a spindle-shaped form, its length reaches 3 cm. It acquires a typical pear-shaped form by 7 months, by 2 years it 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 is low in bile acids, cholesterol, salts, many
  17. Cholecystitis (inflammation of the gallbladder)
    Causes Typically, the presence of stones in the gallbladder or its ducts. Pathological thickening of bile as a result of viral infection, dietary errors, abnormal gallbladder structure, overweight, prolonged stressful situation, diseases of the gastrointestinal tract and liver. Symptoms of Pain in the right upper abdomen, fever, fat intolerance, may be temporary
  18. Gallstones
    Causes Metabolic disorders in the liver (bile is supersaturated with cholesterol). More often women are overweight. One of the reasons is considered to be a sedentary lifestyle in combination with errors in the diet (excess fat, fried, spicy and smoked dishes, alcohol). In severe cases, cancer of the biliary tract and gallbladder can occur. Symptoms Soreness to palpation in the right
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