Sepsis in the Liver

Laura Webb Lamps, MD

Key Facts

Terminology

Etiology/Pathogenesis

Usually caused by sepsis from underlying bacterial pneumonia or intraabdominal infection

Clinical Issues

Microscopic Pathology

Ductular cholestasis pattern strongly associated with sepsis
- Proliferated bile ductules at perimeter of portal tracts with inspissated bile
Neutrophilic inflammation also common

Hematoxylin & eosin shows proliferated bile ductules at the periphery of the portal tract that contain dense, inspissated bile

(ductular cholestasis).

Hematoxylin & eosin shows canalicular cholestasis

without significant accompanying inflammation. “Pure” cholestasis is common in infants and children.

TERMINOLOGY

Definitions

ETIOLOGY/PATHOGENESIS

Infectious Agents

Systemic infection, usually bacterial
- Most common underlying infectious processes
  - Bacterial pneumonia
  - Intraabdominal suppurative infection
Mechanism uncertain
- Presumably, bacterial endotoxins interfere with normal ductular secretory activity and resorption