Diffuse changes in the liver parenchyma

In the human liver there are no pain receptors, therefore, the presence of pathological processes can be detected only through a comprehensive examination. The presence of “diffuse changes in the liver parenchyma” in the history of the disease is not a diagnosis. DIP is observed due to various diseases that contribute to the pathological condition.

Diffuse (mixed) transformations in parenchymal tissues come in several varieties; they appear on the background of hepatitis of any origin, cirrhotic lesions, fatty infiltration, sclerosing cholangitis, etc.

Why there are changes in the liver parenchyma, and what they mean, their types and echo-signs by ultrasound are detailed in the article.

Diffuse changes in parenchymal tissues

Signs of diffuse changes in the liver parenchyma practically do not manifest, pronounced symptoms are observed in patients when the disease is at an advanced stage, it is actively progressing.

The liver is a major gland in the human body. The body includes many liver cells - hepatocytes. Anatomically consists of 2 lobes, which are separated by channels that bring bile secretion, blood vessels.

DIP is not an independent (separate) illness, but the result of anomalous transformations in the organ associated with different pathologies.

The etiology of development is caused by factors, diseases and conditions:

  • Consumption of alcohol products often and in large quantities.
  • Nicotine addiction.
  • Improper diet (consumption of fatty foods, fasting).
  • Genetic pathology.
  • Prolonged use of powerful medicines (antibiotics and drugs with a hepatotoxic effect).
  • Autoimmune disruptions, viral forms of hepatitis.
  • Cirrotic processes.

Diffuse changes in the liver parenchyma occur in people of any age group. On the background of DIP, parenchymal tissues modify their structure. When they are detected on ultrasound a number of additional studies are carried out to determine the exact cause of the disease.

Clinical manifestations

In most clinical pictures, mixed transformations do not manifest in any way; negative symptoms are somewhat less often observed.

  1. Discomfort and heaviness in the area of ​​the projection of the liver, pain rarely occurs.
  2. The weight and discomfort in the right shoulder.
  3. Yellowness of the skin, mucous membranes (not very pronounced).

Ultrasound is performed for the diagnosis. Diffuse transformations are detected not only during primary liver ailments, but also due to system failures - amyloidosis. This is a systemic disease, due to which a specific glycoprotein is deposited in soft tissues and organs, which leads to impaired functionality.

Diseases of the liver and pancreas - the relationship

The pancreas is called the unpaired organ of the gastrointestinal tract, which has no cavity. There are ducts between the liver and the pancreas, so a violation of the functionality of one organ leads to pathologies of another.

If in the history of mixed transformations in two organs, then a person is found to have a metabolic disorder, vascular diseases. He often suffers from acute infections. With a massive lesion symptoms appear in the form of jaundice, discoloration of urine, feces, pruritus.

Abnormal condition of the gland

In the normal state, organ tissues are characterized by a homogeneous structure. When performing ultrasound on the background of DIP, a specialist sees blood vessels with bile ducts, while their density is much higher than normal values.

Transformations of a mixed type in the liver are formed in hemangiomas, disorders of sugar utilization in the body, cirrhosis, hepatosis, obesity, alcohol dependence, tumors, steatohepatosis, hepatitis. Factors provocateurs include parasitic diseases, infections and viruses, starvation.

DIP in children

In a newborn baby, diffuse transformations of parenchymal tissues are a consequence of congenital abnormalities due to infectious processes in the mother’s body during gestation. In children, mixed foci form in the liver due to the use of antibiotics, since they are toxic and have a detrimental effect on the gland.

Structural transformations

Diffuse changes in the liver parenchyma develop not only because of diseases of the gland, but also for illnesses unrelated to the organ. For example, on the background of diabetes mellitus, protein metabolism is disturbed, leading to the formation of deposits in the liver, and mixed abnormalities are found.

With such a picture, during an ultrasound examination, the doctor sees hepatomegaly (an increase in body size), an increased density of the body, and a heterogeneous structure. On the ultrasound, the liver looks bumpy.

Diffuse changes in the liver are moderate, insignificant (unexpressed) and severe (substantial) degree.

Depending on the severity of DIP are:

Variety of changesExplanation
MinorThey are easy to diagnose, characteristic of the initial stages of a number of pathologies of viral or bacterial nature.
ExpressedMost often characterized by edema, hepatomegaly. Usually diagnosed against the background of viral lesions of gland, cirrhosis, diabetes, obesity, tumors of malignant origin.
ModerateA common cause is intoxication caused by drugs, alcoholic beverages.

By the nature of the transformations, mixed changes are:

ClassificationExplanation
Like steatosisUltrasound shows scattered lipid inclusions. With the accumulation of fat, the functionality of the gland is lost, since the hepatocytes are destroyed. Diagnosed in children and adults.
Like hepatosisIn liver tissues, the structure is homogeneous, the blood vessels and ducts are well visualized. Fat accumulates inside the cells, which leads to the destruction of hepatocytes.
Body Fat DegenerationHigh concentration of triglycerides accumulates in the tissues, which violates the functionality of the organ.

Depending on the etiology that provoked a transformation in the gland, it is swelling (edematous), sclerotic, dystrophic and hypertrophic.

Diffuse inhomogeneous

The heterogeneity of the structure is detected during obstruction of the bile ducts, transformation of the connective tissue in the direction of decrease / increase, due to the accumulation of toxins in the liver cells.

Such a transformation is diagnosed in diseases:

  • Calcium salt deposits.
  • Hepatic vein blockage.
  • Viral lesion.
  • Failure of exchanges (with diabetes, excess weight).
  • Cirrotic processes.

Hillocks, fibrous transformations appear in the liver, there is a decrease in the strength of connective tissues, fatty degeneration.

Diffuse-Dystrophic

Due to structural transformations of the parenchyma tissues dysfunction develops. This is usually due to the primary pathologies of the gland.

  1. Hepatitis of any nature (most often).
  2. Intoxication (poisoning by mushrooms, toxic substances).
  3. After application, Halothane is an inhalation medication used before surgery, so that the patient receives anesthesia.
  4. After using drugs.

Tissue degeneration is observed in cirrhotic processes, long-term use of diuretic drugs, drugs with a sedative or sedative effect.

Diffuse transformation of gland canals

The liver includes lobules, in the middle of which lie venous vessels, bile ducts. The main purpose of the biliary ducts - the discharge of bile. Excretory ducts "pierce" the liver, and at the end close.

Mixed changes in the liver canal most often expressed throughout the body, affects the biliary ducts. The pathological process is a consequence of viral, infectious pathologies, excessive consumption of alcoholic beverages, starvation, or the use of fatty, spicy foods in large quantities for a long time.

Body Augmentation and DIP

Hepatomegaly is not a disease, but a condition provoked by various ailments. Iron increases due to the negative impact on the liver of toxic substances, poisons, heavy metals. Diffuse transformation is manifested throughout the tissue, the body protrudes from under the ribs. A palpation gives the patient a lot of discomfort and illness.

Defeat by reactive type

It develops because of diseases of the gastrointestinal tract, chronic pathologies of any localization, due to the prolonged use of medical drugs (for example, hormonal drugs). Along with reactive liver damage, the patient is diagnosed with changes in the pancreas.

Diagnosis and treatment options

Define diffuse transformations by ultrasound. But to identify the source of the problem (primary or secondary disease), additional diagnostic measures are required.

The patient is prescribed laboratory tests - complete blood count and urine, feces, biochemical screening. In the latter case, the doctor is interested in such indicators as alkaline phosphatase, ALT, AST, GGT, the concentration of bilirubin (bound, unbound and total), albumin.

Instrumental examinations include computed tomography, MRI, laparoscopy, biological material sampling (biopsy), fibroscanning (if a cirrhotic lesion is suspected) and other options.

The most rapid and informative method of diagnosis - ultrasound. Before conducting a study, it is recommended that the patient exclude products that contribute to increased gas formation from the menu within a couple of days. During the manipulation, the doctor assesses the condition of the spleen, liver, bile ducts.

  • Increase or decrease in density.
  • Puffiness
  • Hepatocytes increased in volume.
  • Inhomogeneity structure.
  • High concentration of lipid inclusions.
  • Increased connective tissue.
  • Wormholes.
  • Atypical neoplasms.

The echo signs are directly caused by the original source of the disease. After completing all the studies, based on the results, the doctor makes a conclusion - a diagnosis, then prescribed medication.

Drugs for the treatment of DIP:

  1. Hepatoprotectors consisting of components derived from medicinal herbs (Kars).
  2. Essential phospholipids. Good reviews have drugs like Essentiale Forte, Phosphogliv.
  3. Animal medicine (Searepar). Effective remedy Cirepar - cleans the body, protects against the harmful effects of factors.
  4. Amino Acids (Heptor).

The therapeutic strategy is based on the underlying disease. If the cause of mixed transformations in a patient is viral hepatitis, antiviral therapy is prescribed, which lasts for 6 months.

When an infectious process is discovered, antibacterial treatment is carried out. When DIP, provoked by parasitic diseases (echinococcosis, alveococcosis), surgery is required, then antiparasitic treatment is carried out.

When unexpressed diffuse changes in the liver are prescribed only hepatoprotectors, diet according to the table number 5. Additionally, at home, you can use decoctions and tinctures based on medicinal herbs that strengthen the immune status, protect the liver from negative effects, and speed up the recovery of the organ.

Signs of diffuse liver changes

With regard to the pronounced signs with the defeat of the liver tissue, they appear quite rarely.

But sometimes induration can be accompanied by a number of symptoms that a person feels:

After eating, especially fried or spicy, the appearance of a feeling of heaviness.

Bitter taste in the mouth, it is most pronounced in the morning after sleep or after eating.

Feeling of weakness and fatigue, even after small loads.

Nausea, not justified by poisoning.

Irritability and frequent headaches, mood swings.

The most pronounced signs, especially with the progression of certain diseases that lead to serious changes in the liver parenchyma, are: pain in the right hypochondrium, yellowing of the sclera and even the tongue are alarming symptoms. These are the signs that a person can notice and feel, and seek medical help.

Diagnostic methods

The main method to assess the nature of diffuse changes in the liver parenchyma was and remains an ultrasound study. The signs by which the doctor identifies them can be both severe and mild.

To some extent, the diagnosis allows to identify:

All serious diseases previously transferred or occurring at a given time. They leave visible traces on the organ, so the doctor will definitely see these pronounced signs of decomposition of certain parts of the liver.

Moderate signs, as a rule, do not inflict such serious lesions, but are visible on ultrasound and can be caused by viruses, malnutrition, etc.

On ultrasound, the doctor determines the size of each organ lobe, its echogenicity, as well as the clarity of the contours and the homogeneity of the structure.

A competent specialist will immediately see echo - signs of diffuse organ changes, these include:

Fabric heterogeneous structure.

Parenchyma with increased echo density.

The size of the body increased.

Figure blood vessels broken.

In different hepatic lobes, there is a decreased and increased echogenicity.

Seal periportal tracts.

Rapid attenuation of ultrasound.

To diagnose diffuse changes in the structure of the parenchyma of the organ can only competent specialist with knowledge in the field of physiology and anatomy, as it is a complex and time-consuming process. Thanks to modern advances in the field of ultrasound, the possibilities of differential research are greatly expanded. But sometimes such a diagnosis is not enough, since the pathological conditions can be quite serious, and the morphological changes are not very pronounced.

The nature of diffuse changes in the parenchyma of the organ and the reasons for this condition

Depending on the reasons for the diffuse change in the liver, it may be of the following nature:

Fibrous change of the parenchyma. This occurs when, as a result of certain pathological processes in the body, the scar or so-called fibrous tissue begins to grow. Its appearance can be triggered by a number of diseases, for example: alcoholic, toxic, or viral hepatitis, due to congenital pathology, due to parasitic infection. Fibrous changes can also be the result of any disease of another organ that has a direct effect on the liver.

Hypertrophic changes in the parenchyma.

Sclerotic changes of the parenchyma.

That is, due to a number of reasons, changes occurred in the parenchyma of the organ, and additional analyzes are needed to clarify them. The stronger the inflammation, the more pronounced the swelling of the parenchyma will be.

Quite often, such a verdict can be heard in the following diseases:

Diabetes, alcoholism and obesity. The liver in such situations begins to be reborn, grow in size, when conducting research the echogenicity of its structure is several times higher than it should be normal.

In chronic hepatitis, the liver can be significantly increased in size, but diffuse changes are not very pronounced.

If a person has cirrhosis of the liver, then the structure of the organ is completely exposed to diffuse changes, becomes non-uniform, there are many damaged areas, echo is greatly increased.

If a cyst or tumor has grown in the organ, then significant changes will be visible in a certain lobe of the liver.

When a viral infection of the liver parenchyma is modified, but these processes are not global in nature and the body after a certain time independently restored.

Parasites can also cause the parenchyma of the liver to undergo diffuse changes.

Irrational approach to nutrition, consumption of fatty foods rich in calories, as well as alcohol abuse negatively affects the structure of the organ and causes significant changes in its parenchyma.

As it becomes clear, there can be a lot of reasons for the radical changes in the structure of the organ. In order to clarify the diagnosis, additional examinations should be conducted. They include taking blood for analysis: general, biochemical and clinical, serological studies, as well as liver puncture sampling, MRI, angiography, radioisotope scanning.

Treatment of diffuse changes in the liver parenchyma

If we take into account that, as with such a diagnosis, changes in the liver parenchyma do not exist, then the methods of treatment will be aimed at eliminating the disease that caused this transformation. After the cause is identified, the hepatologist will determine the therapeutic regimen and prescribe the appropriate drugs.

As a rule, standard methods of treatment include medication according to a specific scheme:

If the changes were caused by viruses, then antiviral agents will be assigned to reduce their toxic effects on the organ. Etitotropic treatment for hepatitis is reduced to the appointment of certain drugs, depending on its type. And also it is necessary to eliminate additional damaging factors, such as alcohol and other toxins. Often, hepaprotectors capable of “protecting” hepatocytes are prescribed. It can be drugs, both natural origin and synthetic, but also includes amino acids, vitamins and phospholipids.

Phospholipids are able to normalize the structure of the liver cell membrane, reduce hepatocyte necrosis, as a result of which the biochemical indices improve significantly.

Means of natural origin have a stimulating effect on the liver cells, due to which hepatocytes are restored, this effect is also achieved due to the choleretic effects of drugs. The process of digestion improves, the influence of harmful substances entering the body with alcohol, drugs and food is significantly minimized.

The action of synthetic drugs is diverse and extremely difficult, as a rule, they are prescribed for cancer.

Amino acids can normalize the work of the liver and compensate for the lack of necessary compounds.

Vitamins B and E are hepaprotectors and are often prescribed in the general scheme of liver treatment.

In addition to adhering to the treatment regimen, virtually any liver disease that caused its diffuse changes requires following a certain diet. Meals will need to be adjusted in a special way, the doctor will promptly tell you how to do this, but the main recommendations are as follows: elimination of salt, seasonings, spicy, fatty, fried foods. Introduction to the diet of fiber and foods rich in potassium. Naturally, on the nature of the disease, the recommendations will vary in favor of certain products. But alcohol in the treatment of the liver is strictly contraindicated, since in some cases it can not only reduce the effectiveness of the prescribed regimen, but also in combination with certain drugs can be fatal.

If changes in the organ parenchyma are caused only by poor diet and alcohol consumption, then doctors recommend diet table No. 5 according to Pevsner’s classification, where vitaminized and protein foods predominate, as well as dairy products. Depending on the state of the body, with diffuse changes in the liver parenchyma, immunomodulators and some liver dosing are also prescribed.

Prognosis for diffuse changes in the liver parenchyma

Naturally, the prediction of the success of the application of a particular treatment regimen directly depends on the disease that led to diffuse disorders of the liver parenchyma.

If we consider the uncomplicated form of lipomatosis, the majority of chronic hepatitis, as well as changes in the parenchyma due to improper diet and lifestyle, then competent treatment in most cases leads to the fact that the organ begins to function in the same volume, and its disturbed structure is restored. It should be borne in mind that with lipomatosis, a favorable outcome of treatment will directly depend on the area of ​​the liver that was subject to fatty degeneration. As in this case, the recovery of the affected areas is impossible. It will be possible only to normalize the functioning of unaffected organs.

Diseases such as cirrhosis, fulminant forms of hepatitis, and also uncontrolled fatty hepatosis differ in unfavorable prognosis. In these cases, the liver parenchyma changes dramatically, and the organ itself becomes unable to perform its functions. Death is most often caused by intra-abdominal bleeding or the development of serious infectious diseases.

It should be understood that changes in the liver parenchyma of a diffuse nature cannot be groundless. Such a violation of the structure of the body is necessarily preceded by a number of reasons. Depending on those factors or diseases that provoked diffuse transformations in the liver parenchyma, appropriate treatment is prescribed by hepatologists. But in order for the moment not to be missed, it is necessary to undergo ultrasound examinations of qualified specialists at least once a year. The sooner diffuse changes in the liver parenchyma are detected, the more favorable the prognosis for complete recovery is.

Education: A diploma in the specialty “Medicine” was received at the Russian State Medical University. N.I. Pirogov (2005). Postgraduate Studies in Gastroenterology - educational and scientific medical center.

What are diffuse changes in the liver and other parenchymal organs?

Diffuse changes in the parenchyma (epithelial tissue) of the liver are detected by ultrasound. In their pronounced form, we can talk about the presence in the body of the pathological process. In such a situation, a complex clinical examination is required for making and (or) confirming the diagnosis. Anomalies are characterized by changes in the liver tissues, which can occur as a result of both light and severe disruption of the liver.

With diffuse changes in the liver parenchyma, a deformation or thinning of the walls of the parenchyma itself or surrounding tissue is formed, and the integrity and normal functioning of the liver are impaired. Doctors decided to separate the sclerotic, dystrophic and fibrous type of changes in the structure of the liver. Such a classification is determined by structural changes in the cells of the organ, and proper diagnosis of fibrosis is required for subsequent successful treatment.

Having found diffuse changes in the liver parenchyma, it is necessary to conduct additional studies (of all organs of the abdominal cavity) to identify the stage of the process.

Sometimes such manifestations are caused by serious progressive diseases. Diffuse changes in the liver parenchyma can be caused by the following reasons:

  1. Excessive amount of fat in the organs.
  2. Any form and stage of hepatitis.
  3. Autoimmune process in the liver.
  4. Cirrhosis.
  5. Sharp decrease or increase in body weight.
  6. Long course of antibacterial agents.
  7. Alcoholization.

It is important to know that focal or diffuse changes in the liver and pancreas parenchyma can be caused by destructive habits, frequent viral infections, an unbalanced diet, and a polluted environment. The factor causing changes in the liver parenchyma may be heredity. A superficial examination does not provide a complete picture, on the basis of which an accurate diagnosis can be made, therefore a complete examination should be performed with all the necessary tests.


Hepatitis, cirrhosis, etc. can cause fibrosis. View full size

It is important to know that diffuse changes in the liver can form not only in adults, but also The child has, if a:

What are the possible changes in the parenchyma?

Diffuse changes in the liver parenchyma and pancreas are observed quite often. These two organs are unpaired; they form tissues (there is no cavity inside). The organs of the digestive system connect the ducts, therefore, very often when one organ fails, another also suffers. Such changes are manifested as a result of primary and secondary metabolic disorders, vascular pathology, chronic or acute infectious processes.

Disorders of the liver are noticeable in the presence of such symptoms as:

  • yellowness of the eye sclera, skin (jaundice parenchymal),
  • dark urine color
  • light shade of feces.

Itching of the skin when there is a malfunction in the normal functioning of the liver is caused by a large number of bile pigments or in the blood. Pancreatic tissue varies various factors: for example, swelling, excess fatty tissue, growth of pathological tissues, the occurrence of scars on them.

With regard to diffuse changes in the liver and kidneys, such a phenomenon can be recorded after the ultrasound examination and indicates congenital or acquired conditions in which the structure of the organ and its tissues can change.

With such a process, the liver parenchyma can thicken, fluid accumulates in the kidneys, purulent inflammatory processes or thrombosis occur. Sometimes the kidney tissue changes in the presence of stones or fragments of sand in large quantities.

Changes in the liver and spleen affect the entire body. Spleen responsible for the normal circulation of blood and saturated blood flow, for any diseases of this organ, there is general malaise, no appetite, frequent insomnia. If the spleen is broken, the person feels pain and discomfort, a feeling of pressure (if the body is enlarged). Diffuse changes of the spleen can also be made by ultrasound.

Fibrosis Prevention traditionally consists in:

  • proper nutrition
  • maintaining a healthy lifestyle,
  • timely treatment of diseases that can lead to fibrosis.

If diffuse changes in the liver are moderate, then a lifelong intake of the necessary drugs and a therapeutic diet are prescribed. In the case of neglected disease, it is necessary to immediately begin treatment.

The detection of any degree of fibrosis suggests that the liver tissue has undergone changes. As already mentioned, these changes can indicate both the initial stages of the pathological process and the course of a serious illness. Therefore, it is necessary, in addition to ultrasound, to conduct additional diagnostic measures (for example, laboratory and histological studies) to determine the degree of fibrosis and liver damage.

Varieties of ailment

Even minor changes in the parenchyma may be accompanied by disturbances in the pancreas. If this pathology is a consequence of any type of hepatitis, the liver does not perform an antitoxic function. If alcohol or drugs are used with this problem, the outcome can be fatal.

Moderate diffuse changes in the liver are formed under the influence of external factors. It can be:

  • poisoning,
  • unhealthy food
  • viral infections not associated with direct hepatocyte damage.

If symptoms appear, it is recommended to switch to liver diet: remove from the diet salty, fatty, spicy dishes, as well as products with a high content of hard-to-digest protein. Depending on the specific diagnosis, a course of antiviral agents and / or hepatoprotectors may be recommended. If moderate diffuse changes are detected with ultrasound, multivitamins or vitamins B1 and B6 may be prescribed.


With diffuse changes in the liver parenchyma, healthy nutrition and moderate exercise are important.

Marked diffuse changes in the liver are characterized by swelling of the parenchyma. This type of pathological process is observed in diabetes mellitus, overweight, any type of hepatitis, malignant or benign neoplasm. It can be triggered by parasites or viruses, unhealthy diet, alcoholism. Treatment is prescribed after the establishment of the root cause for which the pathology has appeared.

Changes in the parenchyma of a newborn baby can be formed:

  • after suffering pregnant hepatitis
  • or due to congenital abnormalities,
  • they are also sometimes noted after prolonged use of antibiotics, because these drugs aggressively affect the intestinal microflora or liver tissue of the baby.

  1. Since diffuse changes in the body are caused by diseases, their cause is first determined, and treatment begins with its elimination.
  2. Doctors prescribe medication depending on the causes of the disease.
  3. It is recommended to give up bad habits, first of all - from alcohol and smoking.
  4. A reasonable diet and moderate exercise are favorable for restoring the structure of the liver.

The diet is based on the rejection of fatty, salty, spicy dishes. Smoked products and fresh pastries should be avoided. It is recommended to use cottage cheese, fruits, dairy products, vegetable broths, and occasionally boiled fish.

For the prevention of diffuse liver damage should:

    undergo preventive examinations,

  • lead a healthy lifestyle,
  • time to treat concomitant diseases.
  • You can ask a question to the hepatologist in the comments. Ask, do not hesitate!

    The article was last updated: 06/28/2019

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    Factors causing diffuse changes

    Many patients with liver pathologies do not understand what diffuse liver changes are. To understand what this term means, it is necessary to delve into anatomy.

    The liver is a large parenchymal organ that consists of many hepatocytes (liver cells). The gland consists of two lobes, which are separated by bile ducts and blood vessels. As mentioned earlier, DIP is not a specific disease, but a consequence of abnormal processes occurring in the body. So called change and increase in hepatic tissue.

    Causes of diffuse changes in the gland:

    • Excessive alcohol intake.
    • Long smoking.
    • Irrational food.
    • Multifunctional disorders in the body that occur as a result of gene or chromosomal mutations.
    • Long-term use of potent drugs or antibacterial drugs.
    • Metabolic liver disease.
    • Diseases of viral origin.
    • Autoimmune hepatitis.
    • Cirrhosis.
    • Dramatic weight loss or weight gain.

    Both adults and children are subject to diffuse changes due to jaundice, hepatomegaly (enlarged liver) in some diseases.

    DIP signals that liver tissue undergoes changes resulting from minor diseases or severe pathologies.During the diagnosis, it is recommended to investigate not only the liver, but also other organs of the gastrointestinal tract, in order to determine the extent of damage to the gland.

    Often DIP has an erased course, that is, severe symptoms are absent. However, the following signs of diffuse changes in the liver can be distinguished:

    • Moderate painful sensations right under the ribs.
    • Feeling of heaviness or pain in the forearm to the right.
    • Skin and mucous membranes are painted in a yellow shade.

    If the patient has noticed similar symptoms, you should visit a doctor.

    To identify the degree of diffuse organ lesions, an ultrasound is performed. Deviations can occur not only during the initial disease, but also as a result of certain abnormal extrahepatic changes. For example, amyloidosis (damage to the liver and other organs by amyloid). As a result, the liver echostructure will be changed. At the same time, the following echographic signs are observed: hepatomegaly, increased echogenicity of the organ with attenuation in the distant regions, the structure becomes heterogeneous, the ultrasound image has a granular structure, the drawing of vessels is smoothed.

    Pathology of the liver and pancreas

    The pancreas is an unpaired GIT organ that does not have a cavity. Between this organ and the liver are the ducts, therefore, disorders of the function of one organ manifest disorders of another.

    Diffuse changes in both organs can occur for the following reasons:

    • Metabolic disorders.
    • Vascular pathology.
    • Infections with acute or chronic course.

    Extensive damage to the liver and pancreas manifested by yellowing of the skin, eye mucosa, darkening of the urine, discoloration of feces. When the functional disorder of the bile-forming gland occurs, itching of the skin. This is due to the fact that a lot of bile penetrates the blood.

    Pancreatic tissue changes as a result of edema, inflammation, lipomatoz (the appearance of numerous lipomas in the subcutaneous tissue). Also, this process develops due to fibrosis on the background of the inflammatory reaction and metabolic disorders.

    Liver parenchyma lesions

    Normally, parenchymal tissue is a homogeneous, slightly echogenic structure. In diffuse lesions in the parenchyma of the gland during ultrasound examinations in the tissues, vessels with bile ducts are seen, the density of which is increased. Diffuse changes in the liver parenchyma may be associated with serious illnesses or mild disorders of the gland functions. The severity of hepatic tissue edema depends on how severe the inflammation is.

    Diffuse changes in the liver tissue can develop in patients with overweight, cirrhosis, diabetes, alcoholism, cancer, hepatitis, and cystic formations. Helminths, infectious diseases of viral origin, poor nutrition can become provoking factors.

    Changes in the parenchyma of the organ provoke the following symptoms: pain in the head, nausea, weakness, bitter taste in the mouth, mood swings.

    Changes in the structure of the liver

    Diffuse changes in the structure of the liver can occur not only in disorders of the functionality of the organ, but also in diseases not related to the gland. For example, diabetes threatens with protein metabolism disorders, resulting in deposits in the liver.

    In this case, hepatomegaly, diffuse thickening of the liver, and in deep balls tissue becomes heterogeneous. On ultrasound, the heterogeneous structure of the liver looks like small or large areas that have different densities with abnormal metabolic products (proteins, carbohydrates).

    Diffuse heterogeneous lesions

    Heterogeneities in the structure of the organ can occur due to obstruction of the bile ducts, changes in the connective tissue in the direction of increasing or decreasing, accumulation of harmful substances in hepatocytes.

    The diffuse heterogeneous structure of the liver is manifested in cirrhosis, accumulation of calcium salts, obstruction of the hepatic veins, hepatitis, and metabolic disorders in diabetics or overweight people. Then in the liver there are bumps, fibrosis develops or the strength of the connective tissue decreases, stethosis (fatty hepatosis) is manifested. For more information about liver dystrophy by the type of fatty hepatosis, see here.

    As mentioned earlier, pathological processes occur due to errors in nutrition, excessive consumption of alcoholic beverages, etc.

    After the ultrasound, the doctor identifies the cause of the DIP and establishes an accurate diagnosis.

    As a rule, the bile-forming gland is restored by itself, but if left untreated, severe functional impairment occurs.

    Diffuse liver damage

    As a result of pathological changes in the liver, organ dysfunction occurs. Most often, these disorders occur on the background of liver disease.

    Typically, diffuse degenerative lesions provoke hepatitis. Slightly less often, these changes occur after intoxication (by fungi, salts and esters of nitric acid, etc.), the use of halothane (highly active inhalation agent for anesthesia), atofana (a drug). Also, the liver tissue degeneration occurs due to cirrhosis, inappropriate intake of diuretic, hypnotic or sedatives.

    Diffuse transformation of the liver ducts

    The bile-forming gland consists of lobules, in the middle of which venous vessels and bile ducts pass. The main purpose of the bile ducts is the collection of bile. Excretory ducts pass through the entire gland, and their ends are closed.

    DIP affects the entire organ, including the walls of the bile ducts. As in other cases, this process occurs due to exposure to pathogens, alcohol, malnutrition, etc.

    Liver damage in cholecystitis

    DIP in inflammation of the gallbladder often occur.

    Protracted cholecystitis threatens with a prolonged inflammatory process, which is exacerbated from time to time. Pathology is a consequence of another disease. Most often, cholecystitis occurs against a background of motility disorders of the bile ducts or congenital diseases.

    Hepatomegaly and DIP

    The pathology in which the liver is enlarged is hepatomegaly. As a rule, an increase in organ occurs due to intoxication with toxins or poisons. In this case, virtually all hepatic tissue undergoes a diffuse transformation. As a result, the body protrudes from under the ribs (in norm, it is hard enough to feel the gland). In addition, when pressed, the patient feels pain, which indicates that the organ requires immediate therapy.

    Diffusely reactive lesions

    Reactive liver transformation is a pathology that has arisen as a result of diseases of the gastrointestinal organs, chronic diseases of any organs, prolonged use of strong medicines, for example, antibacterial agents. In violation of the functionality of the bile-forming gland develops reactive pancreatitis.

    Such a conclusion with ultrasound allows you to exclude tumors, stones, etc. In addition, using ultrasound can detect focal lesions of tissue density.

    Diffuse lesions are not a separate diagnosis, but a reason to undergo additional diagnosis.

    Liver pathology in children

    In newborns, DIP is diagnosed due to congenital diseases. In addition, pathological processes may occur as a result of infectious diseases in the mother during gestation, for example, hepatitis.

    In children, DIP develops after taking antibacterial drugs. Antibiotics are very toxic and have a detrimental effect on the fragile body of patients in the younger age group.

    If you suspect DIP in a child, it is necessary to conduct a thorough diagnosis: a clinical analysis of blood and urine. If there is a need, the doctor will prescribe a blood test for biochemistry, take cells from liver tissue, or perform laparoscopy (low-impact therapeutic and diagnostic procedure).

    The most common minor diffuse lesions of the body. They occur as a result of mild functional disorders of the liver. The degree of organ damage can be determined using ultrasound and additional diagnostic methods.

    Moderate diffuse changes in the liver develop as a result of intoxication, poor nutrition, infections of viral origin, and so on. When detecting a pathology, it is recommended that the patient adjust the diet. In viral diseases, antiviral drugs are prescribed. If the patient is in serious condition, then he is transferred to the hospital. If the work of the gland is disrupted due to alcoholic beverages or synthetic substances, then plasmapheresis is performed (blood purification). In case of moderate diffuse organ lesions, it is recommended to take multivitamin preparations to increase immunity.

    If diffuse changes are pronounced, then the liver parenchyma swells dramatically. Similar changes occur on the background of diabetes mellitus, fatty hepatosis, chronic hepatitis, cirrhosis, cancer of the gland. In addition, the likelihood of pathology with helminthiasis, viral diseases, malnutrition, alcoholism increases. Treatment is prescribed after a complete diagnosis and identification of the causes of DIP.

    Diagnostic tests

    It is possible to detect the change in the structure of the gland by ultrasound using ultrasound. However, to determine the cause of pathology, it is recommended to conduct additional studies: blood, urine, biopsy (tissue sampling), laparoscopy, CT (computed tomography).

    However, ultrasound is considered the most accessible and effective method of detecting DIP. During the study, you must pay attention to the echographic signs. In this way, the extent of damage to the liver parenchyma and biliary tract can be assessed.

    • Increase the density of the liver.
    • Edema.
    • Increased hepatocyte volume.
    • Heterogeneity heterogeneity.
    • The accumulation of fat cells in the liver.
    • The accumulation of connective tissue.
    • Replacement of normal hepatic fibrous tissue.
    • Accumulation of exchange products.
    • Wormholes.
    • Bleeding
    • Atypical education.

    Zones of diffuse changes in the gland respond with increased, decreased or intense echogenicity.

    Treatment methods

    Diffuse liver disease occurs due to impaired functionality of the liver or other organs of the biliary system. In fact, any disease that a person has suffered has a negative effect on the bile-forming gland, causing minor or moderate diffuse lesions. In any case, the treatment of diffuse changes in the liver is carried out only after finding out the cause of the pathological processes.

    First of all, the patient needs to adjust the menu, stop smoking, alcoholic beverages. If diffuse changes in the liver parenchyma are manifested due to an unhealthy lifestyle, then diet No. 5 should be followed.

    As part of complex therapy, you can apply folk remedies: chicory decoction, plum juice, pumpkin with honey and herbal extracts. The most common treatment used is milk thistle and the root of the gizzard. To prepare the decoction, mix 30 g of dry ingredients and pour a glass of boiling water, after cooling it is filtered and taken in the dosage that the doctor indicated. Also for 4 weeks it is recommended to use 25 ml of olive oil or pumpkin in the morning on an empty stomach.

    Dietary food helps to restore the functionality of the liver and normalizes digestion. The patient should saturate the body with proteins, carbohydrates in the required dosage and reduce the amount of fat. It is recommended to eat warm food and drinks. By observing these rules, the patient will improve his well-being and speed up recovery.

    Diet number 5 includes the following foods, dishes and drinks:

    • honey,
    • Yesterday's pastries (black bread is better),
    • berries and fruits (not sour varieties),
    • fresh juice jelly,
    • weak tea or coffee with the addition of nonfat milk,
    • decoction of the hips,
    • fresh vegetables, fruits, berries,
    • vegetables, raw, boiled, stewed or baked,
    • omelette from protein, boiled soft-boiled egg (no more than 1 yolk per day),
    • soups based on vegetable broth or lean meat,
    • dairy products (low fat content),
    • dietary meats (turkey, veal, chicken, rabbit, etc.),
    • boiled sausages.

    With DIP, the following products should be excluded from the menu:

    • fried foods (goose, duck, fish, pies, eggs),
    • liver, kidneys, lungs, brains, etc.,
    • broth with mushrooms, fatty meat, fish,
    • fresh pastries,
    • okroshka
    • fermented milk products with a high percentage of fat,
    • greasy, spicy food,
    • smoked and canned products
    • cakes and cakes with cream, candy, chocolate, ice cream,
    • green onions, spinach, sorrel, radishes, mushrooms,
    • sausage.

    In addition, you should abandon alcohol and strong tonic beverages (coffee, tea, sweet soda).

    Preventive measures and prognosis

    DIP provoke various factors in order to prevent them, it is necessary to periodically undergo a medical examination, not to contact with toxic substances, to eat properly, to be physically active, to give up bad habits. It is important to treat diseases in time, preventing them from becoming chronic.

    The prognosis for DIP depends on the cause that provoked them. If the structure of the liver has changed due to errors in nutrition, alcoholism or smoking, the prognosis will be favorable when a person changes their lifestyle.

    In other cases, it all depends on the underlying pathology, the degree of damage to the gland and the general condition of the patient.

    Thus, DIPs are the result of other diseases or poor lifestyle choices. To avoid serious consequences, you need to be attentive to your health and consult your doctor if you experience characteristic symptoms. Only timely and proper treatment guarantees recovery.

    Types of diffuse changes and their manifestations

    The following types of violations are distinguished:

    1. Insignificant the change is observed at the initial stages of bacterial, viral inflammation or under the influence of external adverse factors.
    2. Moderate diffuse change of the liver parenchyma occurs with prolonged use of hepatotoxic drugs, alcohol abuse and fatty foods.
    3. Expressed - with hepatitis, cirrhosis, tumors, when, in addition to diffuse changes in the whole organ, local destruction and edema of the liver tissue are detected.

    Causes

    Diseases in which the structure of the body changes:

    • endocrine pathologies: metabolic syndrome in obesity, hypothyroidism, diabetes,
    • chronic hepatitis,
    • fatty degeneration - steatohepatosis,
    • cirrhosis of the liver,
    • tumors: benign, malignant,
    • viral infections
    • parasitic invasion.

    Factors leading to a change in the structure of the liver

    Irrational food. Abuse of products containing animal fats or hydrogenated oil (mayonnaise, chips, pastries, fast food, semi-finished products), leads to an increased load on the liver, which ceases to cope with the utilization of fat, and begins to put them in its parenchyma.

    Chronic alcoholism. The intermediate product of the exchange of ethanol - acetaldehyde, detrimental effect on liver cells. Hepatocytes begin to break down, their place is occupied by fatty inclusions.

    Inactivation of drugs occurs in the liver, many of which (antibiotics, steroid hormones, cardiac glycosides, cytostatics) have a hepatotoxic effect. Destructive processes under the influence of drugs lead to damage of liver tissues in the form of medicinal hepatitis and decrease in the functional activity of the liver.

    Unfavorable environmental conditions. People living near large industrial plants and busy highways increase the risk of liver damage. With long-term intake of harmful substances into the body, metabolic processes in hepatocytes slow down, toxins accumulate, which causes the development of various diseases.

    Psycho-emotional overload. During stress, the adrenaline hormone is released from the adrenal glands. In high concentrations, it adversely affects the function of hepatocytes.

    Symptoms of changes in the hepatic parenchyma

    If changes in the liver proceed according to the type of fatty hepatosis, a compensatory enlargement of the organ develops - hepatomegaly.

    • pains in the right hypochondrium are dull aching in nature,
    • bitter or metallic taste in the mouth,
    • dyspeptic syndrome: nausea, vomiting, constipation, diarrhea,
    • dense brown-yellow coating on the surface of the tongue,
    • deterioration of the skin condition: discoloration (gray, yellowish), swelling, dryness, peeling, itching, rash,
    • cholestasis - jaundice of varying severity, dark urine, discolored feces,
    • reduced immunity, increased tendency to catarrhal diseases,
    • increased sweating. Sweat takes on an unpleasant pungent smell
    • asthenic syndrome: general weakness, severe fatigue, headaches,
    • increased psycho-emotional irritability, mood swings, poor sleep,
    • due to disturbances in the metabolism of hormones in the liver, women develop a malfunction of the reproductive system: menstruation disorder, problems in conceiving a child,
    • appearance of bruises on the skin, vascular "stars", petechiae. Due to the increased fragility of the vessels, various bleedings are possible: nasal, uterine,
    • increased body temperature, not associated with the common cold.

    In childhood, along with the causes of violations in the structure of the liver in adults, genetically determined pathology often comes first:

    • enzyme defects, protein metabolism disorders.
    • congenital fibrosis, multicystosis, cirrhosis of the liver.

    Ultrasound signs of liver disease

    Normally, the photo shows that the structure of the liver is homogeneous with the characteristic fine graininess of the organ. Ultrasound, not reflected from the surface, passes it freely, echo weak intensity. The size and shape of the body is not changed.

    Pathological processes in the liver are sclerotic, hypertrophic or dystrophic.

    Echographic signs of diffuse changes in the liver:

    With fatty hepatosis

    • echo is significantly increased,
    • the form of the body is not changed, the contours are even, indistinct,
    • sometimes there is an increase in size,
    • the structure of the parenchyma is unevenly heterogeneous,
    • depletion of vascular pattern
    • detected foci of reduced echogenicity.

    With a combination of fatty infiltration with fibrous changes (with hepatitis, cirrhosis) on ultrasound, an increase in echogenicity of the surface layers of the parenchyma is combined with the extinction of the echo signal in the deep sections.

    With chronic hepatitis

    • the liver is enlarged, the edge is rounded,
    • the capsule is defined poorly
    • the structure of the parenchyma is heterogeneous heterogeneous,
    • depletion of the peripheral vascular pattern, enhancement of reflected ultrasound from the periportal structures,
    • echo is increased.

    With cirrhosis of the liver

    • the shape of the organ may change, the contours become uneven, the surface is bumpy,
    • hepatomegaly,
    • the pattern of vessels is smoothed
    • expansion of the portal and splenic veins,
    • echo is significantly increased.

    Many pathological processes in the liver tissue for a long time occur without symptoms and are usually diagnosed only by ultrasound. Patients often wonder what a diffuse change is in the liver parenchyma and what should be further taken.

    Watch the video: Diffuse Liver Disease Pt. 1 (January 2020).