Diffuse liver changes consequences. What does diffuse change in the liver and pancreas mean? Diffuse reactive liver changes

This is not a diagnosis, but disturbances in the structure of the liver, which indicate hidden pathological processes. Medicine does not consider such changes to be a disease, but they must be treated so as not to bring the organ to a state incompatible with life.

What are diffuse changes in the liver parenchyma

This organ is made up of tissue called parenchyma. It is formed mainly from liver cells - hepatocytes, which renew old or dead areas of tissue. The liver is completely regenerated in about a year and a half. If diffuse (that is, affecting the entire organ) changes are detected in it, then more often this means an increase in parenchymal tissue, less often - its decrease. Such violations can be either minor or large-scale.

Even a banal flu does not leave its mark on the liver, but it, as a rule, gets off minimal changes in the parenchyma. Another thing is severe diffuse lesions after hepatitis of any kind, chronic alcohol poisoning or giardiasis. If scar (fibrous) tissue begins to grow in an organ, it will significantly increase in volume and undergo irreversible structural changes.

Signs and symptoms of hepatomegaly

The liver does not complain for a long time about the difficult conditions of its existence. Organ misfortunes are discovered only by chance during an ultrasound due to completely different patient complaints. Often there is an enlargement of the liver - hepatomegaly, as a result of which the structure of the organ begins to degrade. The density of the parenchyma becomes increased, and its echogenicity is many times higher than normal, that is, ultrasound is reflected from the parenchyma at a much higher speed.

With diffuse changes, the enlarged organ is easily detected by palpation, and this diagnostic procedure causes pain to the patient. If such changes do not occur in acute form, a person may not experience it. But as the pathology progresses, the symptoms of hepatomegaly become more obvious. Appears:

heartburn;
halitosis;
nausea;
yellow tint, itchy skin;
ascites (fluid in abdominal cavity).

Moderate

Signs of minor liver degradation are common. If they appeared in it, then they are also present in the pancreas. An ultrasound diagnostician determines the presence of moderate diffuse lesions in the liver by increased density tissue, heterogeneity of its structure, distortion of the pattern of blood vessels. Parenchyma compaction and other echo signs of pathology can manifest themselves through a feeling of discomfort after a fatty meal, a bitter taste in the mouth, headaches, fatigue, irritability.

According to the type of fatty hepatosis

The liver reacts to metabolic disorders and intoxication of the body in a very unique way: its cells accumulate fat. Over time, steatosis or fatty infiltration develops, simply - obesity of the organ. The disease is insidious in that it has no symptoms and is often detected by chance during an ultrasound examination of the abdominal cavity. Sometimes a person feels nauseous, weak, tired, and drowsy. Then inhibition may appear in his movements, and monotony in his speech. More later than man jaundice, ascites, dizziness, and convulsions occur.

Reactive changes in the liver parenchyma in a child

Functional immaturity of the stomach and intestines in children, the toxic effects of worms often lead to the development reactive hepatitis, that is, caused not by liver pathologies. This disease either has no symptoms or is manifested by mild malaise, digestive disorders, low-grade fever, emotional decline. At adequate treatment diffuse abnormalities can restore liver activity completely.

Pronounced diffuse changes

When the liver is poisoned by various poisons so severely that it is no longer able to neutralize them, its disintegration begins - cirrhosis. If on early stages diffuse-focal degeneration, the organ increases in volume, then at a later stage it decreases and shrinks. Its echostructure is diffusely heterogeneous, and its echogenicity is very high. The patient is persistently haunted by pain in the right hypochondrium and right shoulder; his tongue, sclera and skin under his eyes are jaundiced.

Treatment methods

The main treatment for diffuse lesions in the liver consists primarily of eliminating their causes: obesity, alcohol abuse, taking medications that are toxic to this organ, etc. Amino acids, vitamins E and group B improve the condition of the organ. To ensure that liver cells are restored, hepatologists (or therapists) prescribe medications:

Essentiale forte N;
Phosphogliv;
FanDetox;
Heptral;
Result Pro;
Gepabene.

According to indications, courses of treatment with antibiotics, antivirals, anthelmintics and choleretic drugs. Operative methods Treatments are used when it is necessary to remove stones and tumors in the liver. Patients are prescribed diet table No. 5 with a ban on fatty, spicy and smoked foods. Salty, sweet, sour food, alcohol and soda are also prohibited. Priority is given to lean varieties of meat and boiled fish, dairy dishes and soups, cereals and vegetables.

When receiving an ultrasound report from a doctor, many records raise the question “what is this” and changes in the liver diffuse type, like the pancreas, is no exception. Such a statement clearly refers to pathological conditions of organs, which frightens most people.

A-priory diffuse changes in the liver, as in other organs, this is an increase in the parenchyma (functional elements and tissues) of the organ, that is, significant changes in size. Speaking about what diffuse changes are in a given organ, they imply disturbances in tissue consisting of hepatocytes - healthy cells liver.

Such disorders are usually diagnosed by ultrasound, although palpation of the organ can detect changes in its size. Echo signs of diffuse changes include a decrease in echogenicity during ultrasound examination, obvious fluctuations in size outside the normal range, and a heterogeneous structure of the epithelium. With age, a number of disorders are considered normal, and this is necessarily taken into account by the diagnostician, but in most cases such a conclusion indicates the presence of diseases of various kinds.

Causes of diffuse changes

Almost everything existing diseases These two organs cause diffuse changes in the parenchyma of the pancreas and liver. Among the most common reasons:

Irregularities in the liver are a reason to examine the pancreas, which may also be affected. What exactly is primary is usually impossible to say right away, but treatment will still be required integrated approach, therefore diagnostics need to be done jointly.

Sources of diffuse changes in the pancreas and liver can also be:

pancreatitis of any form;
diabetes;
lipomatosis;
fibrosis.

Congestion in the biliary tract, due to poor circulation, due to alcoholism and smoking, lead to the same consequences. Violations may result stressful situations and irrational menu.

The normal structure of the liver is homogeneous and weakly echogenic, you can see through it bile ducts and large vessels, the echo signs of which are clearly visible on ultrasound. If the structure of the liver tissue is changed, this means that we're talking about about diffuse changes in the liver. Such organ damage can indicate both very minor changes in the body and quite serious diseases, focal lesions that threaten human life.

Ultrasound can help determine the level of diffuse changes that have become noticeable additional examinations- blood biochemistry, liver biopsy, clinical researches pancreas, as well as diagnosis of other organs located in the neighborhood.

Diffuse changes in the liver parenchyma is a rather superficial term that hides a dozen diseases. But let's still figure out what this definition means. The main types of diffuse changes that the liver structure undergoes can be diagnosed by ultrasound. These include hepatitis, lipid infiltration, chronic hepatitis. The severity of the inflammatory process directly correlates with the size of liver edema. In this case, echogenicity is reduced, and the level of sound conductivity increases. A special place is occupied by focal liver lesions - tumors and cysts.

If we classify diffuse changes in the liver parenchyma, its ducts and vessel walls depending on the nature of the changes, then we can talk about fibrous, sclerotic, dystrophic, edematous, hypertrophic liver damage.

Diffuse changes in the liver parenchyma can also be divided into mild (moderate) and severe:

The first include diffuse changes in the liver according to the type fatty liver disease, stagnant cirrhosis, metastases.
Pronounced diffuse changes in the liver imply that the patient has sarcoidosis, liver cirrhosis (not congestive), an abscess, or toxic fatty hepatosis.

Causes

As noted above, diffuse changes in the liver parenchyma are not a specific disease, but a generalized name for a symptom of one of several possible ailments. Consequently, there are many reasons for the occurrence of such a condition. In fact, all the “harmful things” that we eat in one way or another are reflected in the liver, the state of its ducts, the walls of the main vessels - this is clearly made clear by the echostructure on ultrasound.

On average, every third resident of our country who smokes tobacco and drinks alcohol at least once a week has a rather heterogeneous liver structure. But this condition may be due to other reasons. For example, if before the ultrasound you were treated with antibiotics for several weeks, then most likely the ultrasound will reveal a heterogeneous echostructure of the liver. In addition, the doctor may suspect that the heterogeneous echostructure of the liver is caused by stagnation of bile in the ducts. In this case, the doctor will refer you to additional tests, and, most likely, biochemistry will show an increase in bilirubin levels.

The structure of the pancreas is normally heterogeneous; the tissues in it have quite different densities and perfectly reflect ultrasound on ultrasound. This property internal organs called "echogenicity". Doctors also often talk about “studying the echostructure.” Disturbances in the functioning of the pancreas can lead to changes in the echostructure.

At reduced level echogenicity is most often referred to as inflammatory processes in an organ - acute or chronic pancreatitis, A increased level indicates fibrosis or lipomatosis.

If echo signs of diffuse changes indicate an increased level of density of tissue and ducts, then it is quite possible that we are talking about the replacement of pancreatic tissue with tissue of adipose or connective origin. Sometimes the echogenicity is increased, but focal lesions are not detected, there are no special changes in the liver ducts and vascular walls - this condition may be due to age-related changes or previous illnesses.

Features of diffuse changes in the liver and pancreas in a child

As is known, the pancreas is affected quite a large number of external factors- these are metabolic disorders, genetically inherited characteristics and diseases, intestinal diseases, as well as hormonal changes. An enlarged pancreas during a child's examination should be a signal for parents to full examination abdominal cavity of the child - liver, its ducts, echo - studies of other internal organs. Of course, you also need a certain diet for the child and an examination that will reveal possible focal lesions of the internal organs. Under no circumstances should you panic, but you also cannot ignore these changes - this means exposing the child to enormous risk.

A competent doctor will immediately prescribe blood tests - both serological and biochemical. In addition, the child will need to undergo computed tomography organs abdominal area and in some cases - even a puncture, which will allow sampling of material for histology. The correctness of the chosen treatment and diet will depend on the completeness of the examination.

Treatment of diffuse changes in the liver and pancreas

In fact, diffuse changes in themselves do not require treatment, since they are only a manifestation of certain pathologies. Treatment is necessary for the tissues of the liver and pancreas, as a rule, we are talking about rehabilitation therapy. The first step in treatment is to determine the cause of the condition. After all, further strategy and tactics of therapy depend on it.

In the event that diffuse changes in the tissues of the liver and pancreas, as well as other abdominal organs are caused by in the wrong way patient's life, too fatty foods, frequent use alcoholic drinks, then the first thing to do is change your diet and eliminate bad habits.

Believe me, if you refuse to change this lifestyle, not a single “magic” pill will help you. Along with significant changes in nutrition (diet No. 5), an increase in sleep and rest time, the patient is advised to take hepatoprotectors. These drugs restore the liver by increasing the rate of division of healthy organ cells. By the way, the diet of patients with varying degrees damage to the liver, its ducts and blood vessels comes down to the well-known “table No. 5”.

Diffuse changes in the liver. What is it, signs and treatment. Changes in the liver parenchyma can be caused by some diseases, including fatty degeneration, alcoholic hepatitis of any type, various metabolic liver diseases.

A weakly echogenic, homogeneous structure of the liver tissue is the norm. IN in this case Blood vessels and bile ducts, which have increased echogenicity, should be visible. If diffuse changes in the parenchyma occur, this leads to a complete change in the liver tissue. Such changes may indicate minor functional changes, and about very severe lesions, in which the liver tissue will be a highly echogenic structure. To determine the extent of changes, additional laboratory research liver, biliary tract, duodenum, pancreas. It may be necessary to examine other digestive organs.

Changes in the liver parenchyma can be caused by some diseases, including fatty degeneration of any type, various metabolic diseases of the liver. Fatty degeneration of the liver leads to an increase in its size and increased echogenicity of the structures. If the changes are minor, then it is similar to chronic hepatitis, which occurs for numerous reasons, including viral infections and. to install the real reason diseases, careful additional research is needed.

Diffuse changes in the liver parenchyma can be detected ultrasonic method research. They arise not only when primary disease liver, but also with some pathological extrahepatic changes. For example, diabetes mellitus can lead to. In this case, during echography, the sizes of all lobes of the liver will be increased, the echogenicity of the liver tissue will also be increased, but in deep sections attenuation will be observed, heterogeneity of the structure will appear in the form of an increase in the graininess of the image, and a slight smoothing of the pattern of blood vessels will occur. Also with such pathological changes, such as hemosiderosis, galactosemia, von Willebrand disease, metabolic disorders, etc. There are nonspecific changes in the echographic picture. This is primarily the formation of a heterogeneous structure of the parenchyma. Heterogeneity manifests itself in the form of large or small areas of decreased and increased echogenicity. In such areas, accumulations of pathological metabolic products can be found, which include carbohydrates, glycogenoids, proteins, etc. In some cases, differential diagnosis with multiple small-focal liver lesions is necessarily carried out. Nevertheless, a puncture biopsy can most successfully resolve this issue. Ultrasound examination is a painstaking and in-depth process that requires extensive knowledge in the field of physiology, anatomy and ultrasound examination liver. IN Lately possibilities differential diagnosis expanded and deepened, thanks to the improvement of ultrasonic equipment. However, the level of ultrasound equipment is not always sufficient for staging accurate diagnosis. In this case, further research is needed diffuse diseases parenchyma.

The liver is the organ that does not make itself known for a long time in case of illness. Most often they are discovered during ultrasound diagnostics. And quite often in the extract you can find a small but frightening note - diffuse changes in the liver parenchyma. Don't panic, first you should try to understand what this phrase means. There is no such diagnosis as “diffuse changes in the liver parenchyma”. The recording can only mean that certain processes are occurring in the organ that caused such a condition. But why this happened needs to be determined with the help of various types of research.

Diffuse changes can be a symptom of the following diseases:

any hepatitis

sclerosing cholangitis

autoimmune hepatitis

To understand what we are talking about, you 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, when the doctor says that the parenchyma has diffuse changes, he means transformation of the liver tissue. Thus, minor deviations may be a consequence of previous viral disease. But there are also severe lesions, so it is necessary to carry out additional research, which will allow us to identify the full depth of liver damage. But in any case, diffuse changes in the liver parenchyma cannot be ignored, and identifying the causes that led to similar condition is the key to successful treatment.

Signs of diffuse liver changes

As for pronounced signs of damage to the liver tissue, they appear quite rarely.

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

After eating, in particular fried or spicy food, a feeling of heaviness occurs.

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

Feeling weak and increased fatigue, even after light loads.

Nausea not due to poisoning.

Irritability and frequent headaches, abrupt change moods.

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

The main method for assessing the nature of diffuse changes in the liver parenchyma was and remains ultrasound examination. The signs by which the doctor determines them can be either pronounced or moderate.

To some extent, diagnostics can reveal:

All serious illnesses, previously transferred or occurring in this moment time. They leave noticeable marks on the organ, so the doctor will definitely see these pronounced signs of decomposition of certain areas of the liver.

Moderate signs, as a rule, do not cause such serious damage, but are noticeable on ultrasound, and can be caused by viruses, poor diet, etc.

Using an ultrasound, the doctor determines the size of each lobe of the organ, its echogenicity, as well as the clarity of the contours and uniformity of the structure.

A competent specialist will immediately see diffuse changes in the organ from the echo, these include:

Fabric of heterogeneous structure.

Parenchyma with increased echo density.

The size of the organ is increased.

Drawing blood vessels broken.

In different hepatic lobes, decreased and increased echogenicity is noted.

Consolidation of periportal tracts.

Rapid attenuation of ultrasound.

Only a competent specialist with knowledge in the field of physiology and anatomy can diagnose diffuse changes in the structure of the parenchyma of an organ, since this is a complex and labor-intensive process. Thanks to modern advances in the field of ultrasound, the possibilities of differential research have been significantly expanded. But sometimes such diagnostics alone are not enough, since 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 that caused this condition

Depending on the reasons that caused diffuse changes in the liver, it may be of the following nature:

Hypertrophic nature of parenchyma changes.

Sclerotic changes in the parenchyma.

Swelling.

That is, due to a number of reasons, changes in the parenchyma of the organ have occurred, and additional tests must be carried out to clarify them. How more inflammation, the more noticeable the swelling of the parenchyma will be.

Quite often, a similar verdict can be heard in diseases of the following nature:

Diabetes mellitus, alcoholism and obesity. Liver in similar situations begins to degenerate, increase in size; during the study, the echogenicity of its structure is several times higher than it should be normally.

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

If a person has cirrhosis of the liver, then the structure of the organ completely undergoes diffuse changes, becomes heterogeneous, there are many damaged areas, and echogenicity is significantly increased.

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

At viral infection The liver parenchyma changes, but these processes are not global in nature and the organ recovers on its own after a certain time.

Irrational approach to nutrition, consumption rich in calories fatty foods, 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 many reasons that caused radical changes in the structure of the organ. In order to clarify the diagnosis, additional examinations should be carried out. They include taking blood for analysis: general, biochemical and clinical, serological studies, and liver puncture, MRI, angiography, and radioisotope scanning are also possible.

Treatment of diffuse changes in the liver parenchyma

If we take into account that there is no change in the liver parenchyma as such a diagnosis, then treatment methods will be aimed at eliminating the disease that caused such a transformation. After the cause is identified, the hepatologist will determine therapeutic regimen and prescribe appropriate medications.

As a rule, standard treatment methods include taking medicines according to a certain scheme:

If the changes were caused by viruses, then antivirals, designed to reduce their toxic effect on the organ. Etitotropic treatment for hepatitis comes down to the prescription of certain medications, depending on its type. It is also necessary to eliminate additional damaging factors, such as alcohol and other toxins. Hepaprotectors are often prescribed that can “protect” hepatocytes. These could be drugs like natural origin, and synthetic, this also includes amino acids, vitamins and phospholipids.

Phospholipids are able to normalize the structure of the liver cell membrane, reduce necrosis of hepatocytes, as a result of which biochemical parameters are significantly improved.

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

Action synthetic drugs varied and extremely complex; as a rule, they are prescribed for cancer.

Amino acids help normalize liver function and replenish the deficiency of compounds it needs.

Vitamins B and E are hepaprotectors and are often prescribed for general scheme liver treatment.

In addition to following the treatment regimen, almost any liver disease that causes diffuse changes requires following a certain diet. The diet will need to be adjusted in a special way, the doctor will advise you how to do this correctly, but the main recommendations boil down to the following: exclusion of salt, seasonings, spicy, fatty, fried food. Introduce fiber and potassium-rich foods into the diet. Naturally, depending on the nature of the disease, recommendations will vary in favor of certain products. But alcohol is strictly contraindicated in liver treatment, since in some cases it can not only reduce the effectiveness of the prescribed regimen, but also in combination with certain drugs lead to death.

If changes in the parenchyma of an organ are caused only by poor nutrition and alcohol consumption, then doctors recommend dietary table No. 5 according to the Pevzner classification, where fortified and protein food, and dairy products. Depending on the condition of the body, with diffuse changes in the liver parenchyma, immunomodulators and some liver preparations are also prescribed.

Prognosis for diffuse changes in the liver parenchyma

Naturally, the prognosis for the success 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 chronic hepatitis, as well as changes in the parenchyma due to poor nutrition and lifestyle, then competent treatment in most cases, it leads to the fact that the organ begins to function in the same volume, and its damaged structure is restored. It should be taken into account that in case of lipomatosis, a favorable treatment outcome will directly depend on the area of the liver that was susceptible to fatty degeneration. Since in this case, restoration of the affected areas is impossible. It will only be possible to normalize the functioning of the unaffected lobes of the organ.

Diseases such as cirrhosis, lightning forms hepatitis, as well as uncontrolled fatty hepatosis. In these cases, the liver parenchyma changes dramatically, and the organ itself becomes unable to perform its functions. Death most often occurs due to intra-abdominal bleeding or the development of severe infectious diseases.

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