Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Destruction of the underlying reticular framework: The inflammatory mediated destruction of the underlying lobular framework sets the stage for altered regeneration.
• Bridging fibrous septa: Either delicate fibrous septa or broad bands of scar tissue replace substantial portions of the liver parenchyma.
• Regenerative nodules: In the absence of the underlying lobular architecture, attempts at regeneration by the surviving hepatocytes result in useless nodules rather than functional lobules. 
• Disruption of the architecture of the entire liver:
• Parenchymal injury and fibrosis are diffuse.
• Nodularity must be present for diagnosis.
• The fibrosis is irreversible.
• Substantial reorganization of vascular architecture leads to portal hypertension.