What is perihilar fibrosis?
Perihilar fibrosis refers to the formation of excessive fibrous tissue in the hilum of the liver.- This region is located at the liver's undersurface, where blood vessels, bile ducts, and nerves enter and exit the organ.
- The fibrotic changes surrounding these structures, the portal triads, can impair their normal functions and lead to various liver problems.
Causes of perihilar fibrosis may include:
1. Chronic inflammation: Long-standing inflammation in the liver, such as in chronic hepatitis B or C infection or autoimmune hepatitis, can lead to perihilar fibrosis.
2. Biliary tract diseases: Conditions that affect the bile ducts, such as primary biliary cholangitis (PBC) or sclerosing cholangitis, can cause progressive perihilar fibrosis.
3. Drug-induced liver injury: Certain medications, including some antibiotics and chemotherapy drugs, can damage the liver and lead to the development of perihilar fibrosis.
4. Alcohol-related liver disease: Excessive alcohol consumption over time can cause alcoholic liver disease, characterized by inflammation, fatty infiltration, and potentially perihilar fibrosis.
5. Metabolic disorders: Metabolic conditions such as hemochromatosis (iron overload) and Wilson's disease (copper accumulation) can cause fibrosis in the perihilar region.
Perihilar fibrosis can lead to several complications:
1. Portal hypertension: The fibrosis in the liver's hilum can obstruct the flow of blood through the portal vein, which increases pressure within the portal system (portal hypertension).
2. Ascites: Elevated portal pressure can lead to the accumulation of fluid in the peritoneal cavity, known as ascites.
3. Variceal bleeding: Portal hypertension can cause collateral vessels (varices) to develop, especially in the esophagus and stomach. These varices may rupture and bleed profusely.
4. Hepatic encephalopathy: Severe liver damage, including extensive fibrosis, can impair the liver's function in detoxifying harmful substances. This can lead to the accumulation of toxins in the bloodstream and affect brain function, causing hepatic encephalopathy.
5. Liver failure: Advanced fibrosis can eventually progress to cirrhosis and liver failure, which is a life-threatening condition.