MANIFESTATIONS OF LIVER DISEASE:

QUESTIONS:
1. What the alternative or concomitant response to injury caused by extrahepatic or
intrahepatic obstruction to bile flow?
Answer: Cholestasis

RATIONALE:
Substances that are normally excreted in bile, such as conjugated bilirubin,
cholesterol, bile acids, and trace elements, accumulate in serum.

Extrahepatic obstruction, bile pigment may be visible in the intralobular bile ducts or
throughout the parenchyma as bile lakes or infarcts.

In Intrahepatic cholestasis, an injury to hepatocytes or an alteration in hepatic

physiology leads to a reduction in the rate of secretion of solute and water.

Likely causes include alterations in enzymatic or canalicular transporter activity,

permeability of the bile canalicular apparatus, organelles responsible for bile secretion, or
ultrastructure of the cytoskeleton of the hepatocyte

. The end result can be clinically indistinguishable from obstructive cholestasis

2. What is the term for when the lower edge of the right lobe of the liver extends
downward?
Answer: Riedel lobe

TRIVIA:
The liver span increases linearly with body weight and age in both
sexes, ranging from approximately 4.5-5.0 cm at 1 wk of age to approximately
7-8 cm in boys and 6.0-6.5 cm in girls by 12 yr of age. The lower edge of the
right lobe of the liver extends downward (Riedel lobe) and can normally be
palpated as a broad mass in some people.