*Metabolic liver diseases

  1. Fatty liver(nutritional)

    Nutritional fatty liver is characterized by the yellowish color change on liver surface which represents fatty change of liver parenchyma itself. Liver becomes enlarged, and has a dull margin. The liver surface is usually smooth if the cause of the disease is mere nutritional. Since fatty change is prominent in centrilobular zones rather than perilobular in most instances, yellowish spots on liver surface are located centrilobularly.








  2. Hemochromatosis

    The dark reddish brown color of liver surface is characteristic in hemochromatosis. The liver surface of this case shows granular change, suggesting the presence of a fine nodular formation in liver histology.




  3. Wilson's disease

    The liver in the non-cirrhotic stage of Wilson's disease is usually enlarged, and shows the characteristic spotty pigmentation. These spots are believed to be caused by cupper deposition in liver parenchyma.




    The magnified laparoscopic picture of liver surface observed in the case presented above. A terminal portal branch is seen in the middle of the picture. Spotty pigmentation is obvious at the left upper corner.





    Coarsely nudular liver surface with blue-gray color spots is characteristic in the cirrhotic stage of Wilson's disease.

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Third Department of Internal Medicine, NIIGATA UNIVERSITY School of Medicine
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