Nutmeg Liver

Nutmeg Liver

Question 1. Write a brief on nutmeg liver.
Answer:

Nutmeg liver is seen in chronic venous congestion (CVC) of the liver.

• It is called nutmeg because when CVC liver is examined, grossly the cut surface of the liver shows a red and yellow mottled appearance corresponding to a congested center of lobules and fatt peripheral zone respectively.
• It is one of the very characteristic features of diagnosing or getting the clue for CVC liver.

Nutmeg liver pathology

Question 2. Write a short note on thromboembolism.
Answer:

An embolus is a detached intravascular solid, liquid, or gaseous mass that is carried by the blood to a site distant from its point of origin. When emboli represent some part of a dislodged thrombus it is known as thrombo-embolism.

Thromboembolism is of two types, i.e. systemic or arterial and pulmonary.

Systemic or Arterial Thromboembolism

• Systemic thromboembolism refers to emboli, traveling within the arterial circulation.
• Most of them arise from intracardiac mural thrombi, two-thirds of which are associated with left ventricular wall infarcts and another quarter with dilated left atria.
• The remainder largely originates from aortic aneurysms, thrombi on ulcerated atherosclerotic plaques, or fragmentation of valvular vegetation, while only a small fraction is due to paradoxical emboli, venous emboli, tend to lodge primarily in one vascular bed (the lung), arterial emboli can travel to a wide variety of sites; the site of an arrest depends on the point of origin of the thromboembolic and the volume of blood flow through the downstream tissues.
• The major sites for arteriolar embolization are the lower extremities and the brain, with the intestines, kidneys, spleen, and upper extremities involved to a lesser extent.
• The consequences of systemic emboli depend on any collateral vascular supply in the affected tissue, the tissue’s vulnerability to ischemia, and the caliber of the vessel occluded; in general, however, arterial emboli cause infarction of tissues in the distribution of the obstructed vessel.

Causes of nutmeg liver

Venous Thromboembolism

• Venous emboli may arise from the following sources, i.e.
• Deep vein thrombosis of lower legs
• Thrombi in pelvic veins
• Thrombi in veins of upper limbs
• Thrombosis in the cavernous sinus of the brain
• Thrombi in the right side of the heart

The most significant effect of venous embolism is obstruction of pulmonary arterial circulation leading to pulmonary embolism.