広範な肝小葉中間帯および周辺帯壊死をおこした心奇形乳児の１剖検例

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  • An autopsy case of diffuse midzonal and periportal hepatocerllular necrosis developed in newborn with congenital heart disease.

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A rare case of diffuse midzonal and periportal hepatocellular necrosis developed in a 2-month-old male with congenital heart disease was reported. Coagulative hepatocellular necrosis was seen in all midzonal areas and around 67% of the portal triads and 320% of the central veins of the whole liver. In the present case, the simultaneous appearance of hepatic necrosis and multiple organ failure suggests that endotoxaemia, in addition to severe hypoxaemia induced by congenital heart disease, related to the development of the hepatic necrosis, because a major cause of multiple organ failure is endotoxaemia. In the present case, endotoxaemia was implyed by a decrease in platelets and leukocytosis. The peculiar hepatic necrosis in the present case may be formed by confluence of enlarged focal necrotic areas and survival of the hepatocytes around the portal triads and the central veins fortunately kept blood supply, because it is known that hypoxaemia enhances the endotoxininduced hepatic injury.

収録刊行物

  • 肝臓

    肝臓 29 (11), 1516-1520, 1988

    一般社団法人　日本肝臓学会

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