Index
It is the result of an anoxic capillary injury that causes vasodilation.
Due to this vasodilation , a large volume of blood can be stored in the organs.
This type of injury is caused in most organs by lack of oxygen , which produces a compensatory mechanism, often useless, such as the widening of the capillaries (blood).
In most cases there is stasis; so the organs begin to undergo a series of processes until tissue death occurs due to lack of oxygen.
Visceral congestion is then an increased amount of blood in the vessels of an organ or a tissue in the body, and it occurs when blood accumulates in the blood vessels because it cannot properly exit an organ.
This type of congestion is also known as passive hyperemia and can affect organs such as the liver, heart and lungs, among others.
Causes of visceral congestion
Visceral congestion is an excess of venous blood and is the result of a distention of a vein due to some obstruction in the outflow of blood.
This condition is commonly due to pressure obstruction of arterial blood flow in one part.
This may be due to a tight bandage, pressure from a tumor, thrombi or emboli, or changes in the wall of the vessel, an obstruction within the veins or capillaries, or a thickening of their walls.
One part becomes cyanotic, swollen, edematous, colder than normal, and its function is less.
The rate of blood flow is reduced. Edema is due to fluid leakage from the blood. If it is severe, the red corpuscles can escape.
Visceral congestion in general is the result of diseases such as:
- Heart failure or ventricular failure.
- Deep venous thrombosis.
- Pneumonia .
- Hepatic vein thrombosis or Budd-Chiari syndrome.
Symptoms of visceral congestion
Visceral congestion of the liver
Visceral congestion leads to centrilobular blood stasis that fills the central vein and surrounding sinusoids.
If congestion develops suddenly and a large amount of blood is retained in the liver, the centrilobular hepatocytes will undergo necrosis.
In chronic passive congestion, hepatocytes die and are replaced by fibrous tissue.
The surface of the liver in such cases has the appearance of a nutmeg.
Fibrosis can progress and the nutmeg liver can develop into cirrhosis.
Visceral congestion of the lungs
Visceral congestion of the lungs is usually a consequence of left heart failure.
It is accompanied by the extravasation of red blood cells in the alveolar spaces. These red blood cells break down and are taken up by macrophages, which can be expectorated as “heart failure cells.”
Macrophages also enter interstitial spaces, where they can die or stimulate fibroblasts to produce collagen.
Visceral congestion of the heart
Prolonged stagnation of blood leads to dilation of the veins (varicose veins) and capillaries.
Red blood cells escape from capillaries and die in the interstitial tissues of the subcutaneous.
Chronic ischemia of the skin prevents the healing of minor traumatic injuries and ulcers form, which due to stasis tend to heal slowly or not at all.
Shortness of breath accompanied by coughing or wheezing and a fast heartbeat are observed.
Diagnosis
A medical history is taken with special emphasis on known underlying diseases, accompanied by a physical examination.
For basic diagnosis, imaging tests such as a Doppler ultrasound, among others, may be recommended.
Treatment of visceral congestion
Visceral congestion itself is not treated, because it is just a sign of an underlying condition. Treatment is carried out by addressing the causes of underlying diseases, such as blood pressure, diabetes, among others, with treatments such as:
- Healthy diet.
- Daily exercise.
- Medications such as angiotensin converting enzyme inhibitors and beta blockers.
- Blood thinners, such as heparin or warfarin .
- Medicines to treat diabetes.
- Medicines to treat liver disease.
Complications
After prolonged visceral congestion, tissues will undergo fatty degeneration due to decreased nutrition, or necrosis and gangrene may even appear.
There may also be some increase in the amount of connective tissue. Pigmentation of leaked hemoglobin is common.
When stasis occurs, blood cells slowly accumulate in the smallest vessels, plasma is exuded, and cells pack closely together.
Alterations of the vasomotor system can cause marked injuries.
If there is good collateral circulation, the area to which the blocked vessel goes may show a very slight change, but if this is not the case, a heart attack may follow.