Hepatic veno-occlusive lesions and other histopathological changes of the liver in severe alcoholic hepatitis - A comparative clinicohistopathological study of autopsy cases

Background: The clinicopathological features of veno-occlusive lesions (VOL ) in the liver were studied in 18 autopsy cases of severe alcoholic hepatit is (sALH). All the cases were heavy drinkers and died of liver failure or v ariceal rupture. Methods: We performed histological evaluation by examining stained sections of liver blocks from each case. The severity of VOL was compared with the clinical findings and histopathological changes of alcoholic liver diseases (ALD). Results: Clinically, as the severity of VOL increased, the amount of ascite s observed during autopsy increased significantly (p = 0.001) and the time from hospitalization to death was significantly longer (p < 0.05). The peri pheral leukocyte count tended to increase and the serum bilirubin level inc reased significantly (p < 0.05) with increased VOL severity, after we exclu ded one case that was complicated by acute respiratory distress syndrome an d bacterial endocarditis. Histopathologically, the appearance of Mallory bo dies increased significantly as VOL became more severe (p < 0.05), but the VOL severity did not correlate with sinusoidal neutrophil infiltration. Fat ty degeneration tended to be milder as VOL increased in severity although t he difference was not significant, whereas bile retention tended to be more marked. Conclusions: We conclude that investigation of VOL is clinicopathologically important when assessing the pathophysiology and severity of sALH.