ETIOLOGI SIROSIS HATIILHAM SURYO W.1061050190

SIROSIS HATI

NEKROSIS HEPATOSIT KONTINYU

REGENERASI

FIBROSIS*

*peran sel stellata - kolagen

TYPE OF CHIRROSIS1. ALCOHOLIC CHIRROSIS

2. POST HEPATIC & CRYPTOGENIC CHIRROSIS

3. BILIARY CHIRROSIS

4. CARDIAC CHIRROSIS

A) ALCOHOLIC CHIRROSIS

= SIROSIS LAENNECAlkohol Metabolisme di hepar

asetatasetaldehida

as. Ko Atoksik

as. Lemak

Fatty liversteatosis hepatitis sirosis!

B) POST HEPATIC & CRYPTOGENIC CIRRHOSIS

Post hepatic = Post necrotic :Hepatitis B & C--kronisHBV : sex

HCV : transfusi darah

B) TOXIC AND DRUG INDUCEDTOXIC-EX: sp. Amanita dan GalerinaJamur hepatotoksik , dosis letal : 10 mg-nekrosis masifDRUG-EX: TetracyclineDosis IV : > 1.5 mg / hari deposit lemak pada hepar

>> obatwater insolubleHepar water soluble-eksresi di ginjal / bilier

Fase 1 : oksidasi yg dimediasi Sitokrom P450 --- metabolit --- toksikdiikutiFase 2 : glukoronidasi / inaktivasi oleh glutathione

CRYPYOGENIC

= IDIOPATHIC

-AUTO IMUN

-autoantibodi / antibodi terhadap antigen tubuh sendiri

BILIARY CHIRROSIS

BILIARY CHIRROSISPRIMER DAN SEKUNDERPRIMER - ??SEKUNDER:Stasis EmpeduPeriportal necrosissteril/infectedkolangitis

fibrosisakumulasi PMN

CARDIAC CHIRROSIS

CARDIAC CHIRROSISRHFperfusi

Kongestifhepariskemia

nekrosis sentrolobular

fibrosis