Todayโs path rounds are on ๐ง๐ฎ๐ญ๐ฆ๐๐ ๐ฅ๐ข๐ฏ๐๐ซ, more scientifically known as ๐๐ก๐ซ๐จ๐ง๐ข๐ ๐ฉ๐๐ฌ๐ฌ๐ข๐ฏ๐ ๐๐จ๐ง๐ ๐๐ฌ๐ญ๐ข๐จ๐ง! This was a suggestion!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐ฎ๐ญ๐ฆ๐๐ ๐ฅ๐ข๐ฏ๐๐ซ refers to a specific pattern we can see in the liver at necropsy, where the liver takes on the appearance of a nutmegโs cut surface. This is a very characteristic sign of ๐๐ก๐ซ๐จ๐ง๐ข๐ ๐ฉ๐๐ฌ๐ฌ๐ข๐ฏ๐ ๐๐จ๐ง๐ ๐๐ฌ๐ญ๐ข๐จ๐ง, however does not tell you much about the actual cause of the congestion.
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Any species can get this!
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
The basic underlying problem leading to passive congestion is increased pressure in the ๐ก๐๐ฉ๐๐ญ๐ข๐ ๐ฏ๐๐ข๐ง๐ฌ, which go from the liver to the circulation. This causes the blood in the liver to become ๐๐จ๐ง๐ ๐๐ฌ๐ญ๐๐ (not flowing) because it simply canโt push against the pressure in its normal outflow vessel. This is almost always caused by some kind of heart issue, specifically issues affecting the right side of the heart, as it regulates the pressure within veins.
At the microscopic level, the blood in the liver tends to accumulate around the ๐๐๐ง๐ญ๐ซ๐ข๐ฅ๐จ๐๐ฎ๐ฅ๐๐ซ ๐ณ๐จ๐ง๐๐ฌ (around the hepatic veins), making these areas strikingly red. Elsewhere in the liver, the ๐ก๐๐ฉ๐๐ญ๐จ๐๐ฒ๐ญ๐๐ฌ (cells of the liver) become swollen and take on a lot of fat, making these areas pale tan. This colour contrast produces the characteristic pattern we see at necropsy. Neat!
๐๐ก๐จ๐ญ๐จ๐ฌ
1) What a nutmeg looks like! Who knew?
2) A nutmeg liver next to a nutmeg.
3-6) Examples of nutmeg liver.
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Photos 1 and 2 courtesy of Noahโs Arkive.
Photos 3-6 courtesy of University of Calgary Diagnostic Services Unit.
