DR.M.ADINARAYANA RAO M.D.
What is sonographic sympathetic hepatitis?
the Sonographic changes in liver.?
the diseases in which sympathetic hepatitis occur?
clinical significance of sympathetic hepatitis?
differentiate sympathetic hepatitis from true hepatitis?
What is sonographic sympathetic
Changes occur with in liver when
there is inflammation just adjacent to liver & with in draining area
of portal vein without direct involvement of liver by bacteria or
the sonographic changes in liver.?
Changes in the liver are decreased
echogenicity diffusely( graded or uniformly), increased echogenicity of
portal vein walls upto periphery( usually not seen up to periphery), appearance
of echogenic walls for hepatic veins (normally no perceptible walls for
hepatic veins sonographically).
the diseases in which sympathetic hepatitis occure?
Inflammatory changes adjacent
to the liver (Eg: Pyothorax) or in the portal draining area like appendicitis,
intra abdominal abscess, infected diverticulae, Perforation of dueodenum
or pyosalpinx, Gastro-enteritis, hepatic abscess, pancreatitis, Rt.pyelonephritis,peritinitis
How to differentiate
sympathetic hepatitis from true hepatitis?
Size of liver
is normal & Gall bladder is normal in sympathetic hepatitis. No tenderness
are noted Some times in sympathetic hepatitis.Hepatic functional tests
18y male complaining of
pain in the Rt.Iliac fossa, pain, vomiting from last 3days.
Ultrasound findings : Sub costal
view of liver shows decreased echo texture diffusely, portal vein walls
are echogenic seen upto periphery, hepatic vein walls are echogenic. Liver
is normal in size. Gall bladder is normal.
Transverse sectional study of appendix
shows enlarged appendix with echogenic contents in the lumen. Operation
is done. Pus filled appendix is removed.
Example : 2
38 Y male complaining of
cough and Rt.side chest pain.
Subcostal veiw of liver shows decreased
echo texture diffusely, portal vein walls are echogenic seen up to
periphery, hepatic walls are echogenic. Liver is normal in size.
On aspiration, straw colour fluid
is obtained. On analysis 1500 lymphocytes
Patient is on ANTI
TUBERCULOUS TREATMENT and responding well.
32y female complaining of
pain lower abdomen , vomiting, fever.
33y male alcohlic patient presented
with pain at rt.hypochondrium. H/O fever 4days back.
Sub costal view of liver shows decreased
echo texture diffusely, portal vein walls are echogenic seen
up to periphery, hepatic walls are echogenic. Liver is normal in size.
Gall bladder is normal.
On trans vaginal scan Lt.Tube is
dilated with internal echoes.
Example : 5
Portal vein walls seen upto periphery
Rt.lobe of liver shows hypoechoic SOL which is avascular on CFM. Anchovy
saucs like pus aspirated after 5 days
10 years female is suffering with typhoid
& presented with distended abdomen.
viewof liver shows decresed echotextute diffusely & stricking echogenic
portal walls upto peripherally.
HRSG AT RT.IIAC FOSSA & PEVIS shows ascitic fluid with internal echoes.
is perferation of bowel with peritinitis due to typhoid.