The liver is the organ that has not long declared itself in the event of illness. Most often they are detected during the ultrasound diagnosis. And quite often in the statement you can find a small, but frightening record - diffuse changes in the liver parenchyma. Do not panic, for a start you should try to understand what this phrase means. As such, the diagnosis of “diffuse changes in the liver parenchyma” does not exist. A record can only mean that certain processes occur in the body, causing a similar condition. But because of what happened, you need to determine it with the help of research of a different nature.
Diffuse changes can be a symptom of such diseases:
To understand what is being said, one should know that the parenchyma is not a shell, but a collection of the most important elements responsible for the functioning of the organ. The liver consists entirely of parenchymal tissue, which, in turn, is formed from certain cells - hepatocytes.
Therefore, speaking of the fact that the parenchyma has diffuse changes, the doctor involves the transformation of the liver tissue. So, minor deviations can be the result of a viral illness. But there are also heavy lesions, so it is imperative to conduct additional studies that will allow to extract the entire depth of the liver lesion. But in any case, diffuse changes in the liver parenchyma should not be ignored, and identifying the causes that led to such a condition is the key to successful treatment.
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.
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 body 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.
Diffuse changes in the liver is a term indicating a variety of degree of organ damage. In contrast to local, focal disturbances of the structure, they suggest the spread of pathological changes to the entire liver tissue (parenchyma). The causes and nature of morphological changes in the liver depend on the specific disease
They are not functional, always caused by changes in the cellular structure, hepatic bile ducts, and vessels. Diffuse changes in the structure of the liver can only be identified in vivo by echo signs during an ultrasound examination. Much less - in the histological analysis of the removed organ. The changes are detected by pathologists in people who died from severe liver disease.
How does the anatomical structure of the liver manifest on ultrasound?
In a working liver there is a rational lobular structure. Arterial and venous vessels are suitable inside each lobule, in addition, the blood circulation is maintained by intraplate (sinusoidal) and interlobular (inside connective tissue septa) capillaries.
The influx of blood into the liver cells (hepatocytes) of substances that need to be processed, the outflow - delivers useful ingredients to all internal organs, removes slags. Slices are prism shaped. Scientists suggest the existence of a diffusion mechanism for plasma penetration into hepatocytes through the vascular wall.
Each hepatocyte secretes the developed bile into a special diverting duct, which, enlarging and merging with others, reaches the gallbladder. In parallel with the venules lie the intrahepatic bile ducts, which merge in each lobe, then both into a single hepatic bile duct, which flows into the choledoch. Thus, part of the bile is “discharged” bypassing the gallbladder.
You can see and evaluate what each structural unit means only under a microscope. For diagnostics, it is important to determine the state of the functional usefulness of the apparatus of the hepatocytes and their surrounding tissues. Great help is provided by the study of the ability of reflection of ultrasonic waves, obtained by echographic signs. They reveal undoubted areas of liver damage or diffuse spread.
What are the ultrasound signs of diffuse disorders?
Sound waves pass through a healthy liver without lingering or reflecting, since its density represents a homogeneous mass. On the screen, the echostructure looks like a uniformly dark (homogeneous) zone, it is called hypoechoic.
Vessels and ducts appear in strips of an even darker shade (anechoic), although the walls form a light contour, as they are capable of reflecting sound. This principle allows you to see the direction and size of the portal vein, bile duct.
Various changes in the structure, deposition of biochemical substances, microelements, replacement of the parenchyma with scar tissue lead to a change in the echogenicity of the tissue. Transformations cause an increase in the echogenicity property and the liver on the monitor becomes bright (medical specialists say “bright liver”).
Diffuse changes in the liver parenchyma can manifest themselves in an unequal dark shade of different areas, "grit". It depends on the heterogeneous manifestations of various sites of inflammation, metabolic changes. To correctly assess the degree of hypoechoicity, the doctor simultaneously looks at the right kidney and focuses on the dark shade of its parenchyma.
On ultrasound, you can see a dense cirrhotic tissue emanating from the connective tissue septa, the replacement of a healthy parenchyma by the products of vital activity of the body (fatty inclusions, deposits of copper, iron).
By the nature of the picture, suggestions are made about the causes of hyperechogenicity. For example, in infectious diseases (viral hepatitis), vascular changes predominate, experts call the general appearance of the liver a “snowstorm” or a “starry sky”.
To clarify the diagnosis, the patient needs to compare the results, study the symptoms and the course of the disease. Identification of diffuse changes in the liver parenchyma will require a detailed examination with a comparative analysis of the clinical and biochemical signs of various diseases, and immunological reactions.
Morphological causes of disturbance of the echo structure
The signs of diffuse changes in the liver detected by the echoscopic method do not reflect true histological abnormalities, but the accumulated experience of functional diagnostics allows us to isolate and target doctors to certain causal connections of the lesion of the parenchyma. There are the following options for changes.
Metabolic - always associated with metabolic pathology. This is facilitated by: hereditary diseases, hormonal changes, unhealthy diet. The group of diseases includes: Gaucher disease, glycogenosis, diabetes mellitus, fructose intolerance, tyrosinemia, hereditary hepatolentic insufficiency or Wilson-Konovalov disease (damage to the liver, brain accumulated copper), galactosemia, fatty infiltration with impaired fat metabolism.
Infectious - inflammation of the parenchyma in viral hepatitis (acute and chronic), miliary tuberculosis, mononucleosis (caused by Epstein-Barr virus), AIDS, brucellosis, cytomegalovirus infection, some helminth infections, fungal diseases.
Toxic - occur when toxic substances act on the liver tissue (alcohol, nicotine addiction, effects of steroid therapy, cytotoxic drugs, radiation exposure, antibiotics, poisoning with heavy metal salts, products with a high content of trans fats, free radicals).
Malignant tumors - in the case of extensive dissemination (seeding). Chronic heart failure due to venous stasis of blood in the liver and portal vein system. Autoimmune - hereditary and acquired diseases of an allergic nature.
Among the diffuse changes in the liver of an exchangeable nature, the following states can be distinguished in more detail. Steatosis (synonym for fatty infiltration) - as a part of hepatocytes, fatty inclusions gradually accumulate, cells break down and form cysts. It has been established that violations by the type of fatty infiltration arise under the influence of the accumulation of a significant amount of triglycerides, which the liver cells are not able to process.
Deposits of intermediate substances - iron (hemochromatosis, complicated blood transfusion, the effects of hemolytic anemia), copper (Wilson-Konovalov disease), hyaline (alcoholic cirrhosis). Changes can be both focal and diffuse. Detected in people of different ages, including children. Non-alcoholic steatosis is more commonly found in people who are overweight.
According to the type of morphological changes, the structure of the liver changes in the direction of:
- swelling and swelling of the parenchyma (depending on the severity of the inflammatory process),
- hardening (replacement for scar tissue),
- hypertrophy (proliferation of structural elements),
Such changes may alternate and cause exacerbations or remission of the disease, but they speak of pathology, even if they are not well defined. The initial stage of the disease on the ECHO-signs can not be seen. Non-expressed symptoms do not reflect the degree of disruption of the structure of the liver parenchyma.
Causes of pathology in childhood
Diffuse changes in the liver of a newborn baby are suspected with prolonged severe jaundice, hepatomegaly, splenomegaly. Ultrasound allows you to exclude or confirm the diagnosis. The changes are usually associated with a congenital metabolic disorder, mother-borne diseases during pregnancy (hepatitis, the toxic effect of drugs).
If the child needs to be treated, doctors choose antibiotics with a minimal damaging effect on the liver, check the individual sensitivity of the body. Any allergic manifestations, diathesis, affect the structure of the liver cells.
Ultrasound Examination Forms
Description ultrasound doctor builds on the basis of his experience. The distinctive shades and forms of liver disease are interpreted by the doctor in appearance, the degree of change in echogenicity. The conclusion about diffuse changes can be formulated with the following phrases:
The more pronounced are the echo signs, the brighter the picture of the disease and the more severe the clinical course. Inflammation of the pancreas, an organ highly dependent on the functioning of the liver cells and the biliary system, often joins the liver. In the "Conclusion" the doctor must indicate an increase in the size of the liver, spleen, condition of the gallbladder and ducts (stones, permeability, anatomical contractions), the walls of large vessels.
“Diffuse inhomogeneous changes” emphasize the varying degree of disturbance in the echogenicity of individual parenchyma areas. Such damage to the structure of the liver is associated with the accumulation of calcium, iron, copper in cells, an uneven cirrhotic process, obstruction of the intrahepatic bile ducts, tumors, tuberculosis, and parasitic infections.
The sign of heterogeneity can be regarded as a positive point, indicating the safety of the compensatory capabilities of the body. For doctors and patients, this suggests the feasibility of using all available therapies.
Heterogeneous nodular changes (granulomas) in 30% of cases cause drugs. These include: Allopurinol, carbamazepine, alpha methyldopa, sulfonamides, isoniazid, quinidine, procainamide. "Diffuse dystrophic changes" - occur with various diseases of organs and systems that are accompanied by loss of protein, vitamins, complete exhaustion of energy reserves.
They often accompany chronic blood diseases, anemia, but can also be the outcome of viral hepatitis, the result of damage to the liver itself (mushroom poisoning, nitro compounds, sedative drugs), and overdose of diuretic drugs.
With cirrhosis of the liver
Signs of cirrhosis with ultrasound are divided into basic and indirect. The main factors are: an increase in size, an uneven lower edge, a multitude of hyper and hypoechoic small areas due to the replacement of healthy cells with connective tissue, a thickening of the portal vein walls and a deterioration in the visibility of the vascular contours. Among the indirect signs: portal hypertension is indicated by an increase in the diameter of the splenic and portal veins, an enlarged spleen, the presence of fluid in the abdominal cavity (ascites).
Diffuse changes in the liver are sometimes detected simultaneously with an enlarged kidney, dilated pelvis, inflammation, renal artery thrombosis, and stones in the urinary tract. The connection of the two organs is ensured by mutual "revenue" in violation of the removal of slag substances, the accumulation of metabolic products. Therefore, in case of liver failure, the kidneys are affected and vice versa.
For diseases of the spleen
The spleen - the main lymph node of the body, is responsible for blood circulation, immunity. It is affected along with the liver with an increase in pressure in the portal vein system. Blame the possibility of dropping blood and increasing the load. Ultrasound detects hepato- and splenomegaly. Treatment of cirrhosis, prompt additional bypass of the blood flow helps to restore the function of the spleen.
Treatment of diffuse changes in the liver
Therapy is prescribed by a doctor depending on the specific type of disease. The conclusion of a diffuse liver damage is not a diagnosis, therefore, it does not have a specific treatment.
This information is taken into account for inclusion in the assignment scheme:
- diet food in accordance with table No. 5 (exclusion of all irritating spicy, fatty, fried foods, seasonings, clear schedule, balance in weight of a person, fasting days),
- recommendations on lifestyle changes and habits (exclusion of any alcohol, smoking, compulsory walks, exercise),
- antiviral or antiparasitic treatment, anti-TB drugs, choleretic drugs,
- the most suitable hepatoprotectors, vitamins,
- popular recommendations.
Having received the conclusion of an ultrasound study with incomprehensible phrases, you should not try to decipher it yourself or turn to non-professionals. The diagnosis will be correct only after additional functional tests showing the quality of the liver, identifying the specific causes of pathology.
Diffuse changes in the liver are not an independent disease. The change is characterized by an increase in the main liver tissue - the parenchyma. An increase in parenchyma can be sclerotic, hypertrophic, fibrous and dystrophic. Changes in liver tissue is a symptom of a number of diseases. To determine the cause of diffuse changes in the liver and the severity of the organ damage, it is necessary to undergo a thorough examination.
Causes of parenchyma increase
The main cause of liver failure is the presence of diseases that gradually progress. Also, among the main causes leading to a change in the liver, experts point out:
- obesity, fatty degeneration,
- various types of hepatitis
- cirrhosis of the liver,
- a dramatic change in body weight
- regular medication,
- autoimmune diseases.
People are subject to diffuse changes in the liver regardless of gender and age. Such a change can occur in children, here it can develop against the background of jaundice or some diseases.
Poor environmental situation, poor diet, bad habits can provoke changes in the structure of the liver. Also one of the factors is heredity. Determine the cause, establish an accurate diagnosis and prescribe an effective treatment after a thorough examination of the patient.
Symptoms of diffuse changes in the liver
In the initial stages, changes in the liver are practically asymptomatic. In most cases, the person does not pay attention to mild nausea or weak pain in the right side. Often, diffuse changes in the liver are detected by ultrasound, when diagnosing another disease, for example, if the pancreas hurts, the symptoms may be similar.
Symptoms in more severe cases appear as follows:
- constant pain on the right side under the ribs,
- yellow color sclera,
- discoloration of the tongue and skin around the eyes to yellow,
- right shoulder pain.
Diagnosis of liver changes
The main method for determining changes in the liver is ultrasound diagnosis of the organ. When examining the liver with this method, you can accurately determine its size, degree of deviation from normal size, see enlarged lymph nodes, tubercles and irregularities.
The results of the study will help the specialist to make an accurate diagnosis and prescribe treatment.
Additionally, the doctor may prescribe additional studies:
- full blood count
- X-ray examination
- blood test for all types of hepatitis.
At the initial stage of changing the structure of the liver, prophylactic treatment is possible, including the transition to proper nutrition, getting rid of bad habits, playing sports.
The change in the average degree is reversible with a strict diet and medication or folk remedies. In severe cases, medical intervention and long-term treatment is a must.
Signs of liver changes in various diseases
Various signs of liver changes detected by ultrasound indicate the presence of various diseases that caused these changes. Diffuse changes in the liver are usually characterized by a decrease in the echogenicity of the organ. Increasing its level indicates the formation of seals in the liver.
- Signs of Fat Dystrophy
With this disease, a large number of lipids accumulate in the liver cells and its ability to function in a normal manner decreases. Fatty degeneration is usually a concomitant disease in diabetes, metabolic disorders and obesity.
Diffuse changes in the liver in this disease are expressed by the following symptoms:
- increasing the size of the body
- changing its shape,
- the liver is not deformed when the sensor is pressed on it,
- visible clear drawing of the veins of the organ,
- the picture obtained in the diagnosis of rough and dense.
- Signs of cirrhosis
The manifestation of symptoms in cirrhosis by ultrasound depends on the severity of the disease. With cirrhosis, an increase and increase in the connective tissue of the liver occurs. For this disease, the most characteristic signs are:
- in the initial stages of the disease - the liver increases in size. In the later stages of the disease, there is a decrease in the size of the liver, up to a significant wrinkling,
- the surface of the liver is uneven,
- the degree of echogenicity is high.
- Liver pathology in case of a child’s illness
In a child, as in an adult, diffuse liver changes may be due to obesity and the occurrence of cirrhosis. Also her condition is influenced by genetic and congenital diseases, namely:
- heart failure caused by congenital heart disease,
- infections transmitted from mother to child during gestation,
- tumors with metastases,
- liver tumors
- disorders of metabolic processes in the body.
Treatment of diffuse liver changes
Treatment of changes and restoration of liver function should begin with eliminating the causes of it. The method of treatment is selected based on the type of disease. If the change in the liver is caused by prolonged alcohol consumption, medication or obesity, then it is enough to eliminate these factors. After this begins the restoration of the liver. For this purpose, preparations containing hypoprotectors that restore the tissues of an organ are used.
In other cases, surgical or conservative treatment is used. Surgery is used in severe cases of liver changes:
- liver swelling,
- liver cyst,
- portal hypertension.
In other cases, use of drug treatment.
For any diseases that cause a change in the structure of the liver, you must follow a strict diet and abandon certain foods. For the patient, the main products on the table should be boiled fish and meat, low-fat dairy products, crackers, soups, vegetables, cereals, boiled eggs, as well as non-sweet tea and compote.
When recovering the liver, the patient is not recommended to eat fatty broths, meat and fish, smoked products, sweets, mushrooms and legumes.
It should be noted that the diet can reduce the manifestations of changes in the liver, but its full function can only be restored with the help of medications.
Liver treatment by folk methods
The procedure of cleansing the liver causes a good effect and relief to the patient.As a result, the body is reduced, its structure becomes more uniform, the pain in the right side decreases. You can do the cleaning only in the absence of any contraindications from the doctor. By the way, herbal therapy of the pancreas and liver can be combined, and it will be an excellent complex.
To clean the liver, oats, corn stigmas, lingonberry leaves, fennel, birch buds, rosehip, mint are used. These plants are used both together and separately in the form of decoctions.
When a problem with the liver is necessary to include in the patient's diet food rich in vitamins of group B. A large amount of this vitamin is contained in the apricot kernel. Enough to eat up to 10 cores per day to provide the body with a daily rate of vitamin B.
A good way to restore the liver is honey infused in a pumpkin. To obtain it, you need to take a small pumpkin, remove the seeds and pulp from it and fill it with honey. Put for three weeks in a dark place. After three weeks, the honey must be drained into a glass container and refrigerated. Honey must be taken three times a day for a teaspoon.
When treating folk remedies, be patient and do not interrupt treatment. To restore liver function may require more than one course of admission funds. However, a positive result will be guaranteed after the completion of the first course of treatment with folk remedies.
The liver is the organ that does not signal a disease for a long time. In most cases, pathologies of the gland appear during ultrasound diagnosis. When confronted with a record of "diffuse liver changes" in a medical record, many patients panic because they do not understand what this means. However, DIP (diffuse liver changes) is not a diagnosis. This record indicates various pathologies in the organ that provoke a similar condition. Various studies will help identify them.
DIPs can signal cirrhosis, hepatitis, sclerosing cholangitis, etc. Much depends on the degree of transformation of the liver tissue. Minor changes indicate viral disease. With severe abnormalities, we are talking about more serious pathologies, so it is necessary to conduct a thorough study to determine the extent of damage to the bile-forming gland.
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.
- 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.
Take this test and find out if you have liver problems.
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.
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.
- 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.
- Atypical education.
Zones of diffuse changes in the gland respond with increased, decreased or intense echogenicity.
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, 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:
- 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,
- 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,
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 come into contact with toxic substances, to eat right, 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.