Passive congestion

Many patients have underlying liver disease with liver function abnormalities. It may be difficult to determine superimposed drug-induced liver injury in patients with viral hepatitis, passive congestion of the liver from heart failure, fatty liver... 

The significance of ammonia in clinical disease was broadened markedly when it was discovered that ammonia poisoning might be the mechanism of the cerebral symptoms associated with chronic heart failure. It has been known for a long time that the mental symptoms associated with heart failure could not be correlated with the oxygen supply to the brain, which remains, in most cases, adequate. The work of A. N. Bessman (B4) demonstrated that the ammonia content of the blood was elevated in heart failure, probably due to the chronic passive congestion of the liver which prevented the liver from removing the normally formed ammonia from the portal system. When the blood ammonia fell, the mental symptoms of heart failure were relieved. This has been confirmed by Calkins and Delph (Cl), who studied twenty-six cases of heart failure and found the blood ammonia to be elevated only in the two patients who had mental symptoms. 

Fig. 39.3 Chronic passive congestion with centroacinar parenchymal atrophy and fibrosis (HE)...

Hepatic hyaline globules associated with passive congestion. Arch. Pathol. Lab. Med. 1988 112 510-513... 

Hepatic 25 [ILB] (all with chronic passive congestion one with mild centrilobular fibrosis) ... 

Mouse (B6C3F1) 103 wk 5d/wk 6hr/d Resp Hepatic 100 (acute passive congestion of the lungs) 100 (hepatocellular degeneration) Mennear et al. 1986 NTP 1986... 

Congestion of the lungs was reported in rats exposed intermittently to tetrachloroethylene at 1,600 ppm, but not 800 ppm, for 13 weeks (NTP 1986). Thrombosis and squamous metaplasia were observed in the nasal cavity of rats exposed intermittently at >200 ppm for 103 weeks (Mennear et al. 1986 NTP 1986). In mice exposed intermittently to tetrachloroethylene at > 100 ppm for 103 weeks, acute passive congestion of the lungs was observed (Meimear et al. 1986 NTP 1986). 

In cardiac failure, chronic passive congestion develops. The red cells that accumulate in the interalveolar sinusoids are phagocytized by the epithelial cells from the lining of the alveolar wall or in histiocytes. Again, after hemoglobin is degraded, stainable iron pigment accumulates in the alveolar cells. The iron-loaded alveolar cells are called heart failure cells. When expectorated with the mucus secreted by the bronchi, these cells cause the brownish discoloration observed in sputum of old cardiac patients. 

Generalized hepatic dysfunction (hepatitis, cirrhosis, cancer, metastasis, chronic passive congestion etc.)... 

Animals are less sensitive than humans. When exposed to CS, animals pass through an excitatory phase, after which they usually lie passively. Animals exposed to CS show severe congestion of the blood vessels In the lungs. "With concentrations approaching those that might occur In riots, neither Illness nor lung damage is demonstrable."... 

Valla, D.C. Hypoxic hepatitis-passive hver congestion in heart disease (in French). Gastroenterol. Clin. Biol. 2003 27 (Suppl.) 33-40... 

Table V-l. Properties of Active Hyperemia and Congestion (Passive Hyperemia)...

As the passive lung congestion develops into a chronic condition, more pigment accumulates and the lung becomes fibrotic. At autopsy, the organ is smaller... 

---