A report on Hepatic encephalopathy, Cirrhosis and Ammonia

Micrograph of Alzheimer type II astrocytes, as may be seen in hepatic encephalopathy
Cross-section of human liver with cirrhosis
Ball-and-stick model of the diamminesilver(I) cation, [Ag(NH3)2]+
Ball and stick model of ammonia; one nitrogen atom with three hydrogen atoms. Accumulation of ammonia in the bloodstream is associated with hepatic encephalopathy.
Person with cirrhosis and associated pain in the right upper region of the abdomen
Ball-and-stick model of the tetraamminediaquacopper(II) cation, [Cu(NH3)4(H2O)2](2+)
Micrograph of Alzheimer type II astrocytes, as may be seen in hepatic encephalopathy
Hepatitis C viral particles and the liver
Jabir ibn Hayyan
Micrograph showing liver cirrhosis, a condition that often precedes hepatic encephalopathy. Trichrome stain.
Caudate lobe hypertrophy on ultrasound due to cirrhosis
This high-pressure reactor was built in 1921 by BASF in Ludwigshafen and was re-erected on the premises of the University of Karlsruhe in Germany.
Hepatofugal (non-forward) flow in portal vein
A train carrying Anhydrous Ammonia.
Liver cirrhosis on CT imaging of the abdomen in transverse view
Liquid ammonia bottle
Micrograph showing cirrhosis, trichrome stain
Household ammonia
Cirrhosis deaths per million persons in 2012
Ammoniacal Gas Engine Streetcar in New Orleans drawn by Alfred Waud in 1871.
No fibrosis, but mild zone 3 steatosis, in which collagen fibres (pink–red, arrow) are confined to portal tracts (P) (Van Gieson's stain)<ref name="BoydCain2020">{{cite journal | vauthors = Boyd A, Cain O, Chauhan A, Webb GJ |title=Medical liver biopsy: background, indications, procedure and histopathology |journal=Frontline Gastroenterology |volume=11 |issue=1 |year=2020 |pages=40–47 |issn=2041-4137 |doi=10.1136/flgastro-2018-101139 |pmid=31885839 |pmc=6914302}} -"This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license"</ref>
The X-15 aircraft used ammonia as one component fuel of its rocket engine
Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (Van Gieson's stain)
Anti-meth sign on tank of anhydrous ammonia, Otley, Iowa. Anhydrous ammonia is a common farm fertilizer that is also a critical ingredient in making methamphetamine. In 2005, Iowa used grant money to give out thousands of locks to prevent criminals from getting into the tanks.
Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (Van Gieson's stain)
The world's longest ammonia pipeline (roughly 2400 km long), running from the TogliattiAzot plant in Russia to Odessa in Ukraine
Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (Van Gieson's stain)
Hydrochloric acid sample releasing HCl fumes, which are reacting with ammonia fumes to produce a white smoke of ammonium chloride.
Trichrome stain, showing cirrhosis as a nodular texture surrounded by fibrosis (wherein collagen is stained blue).
Production trend of ammonia between 1947 and 2007
Micronodular cirrhosis, with diffuse areas of pallor.
Main symptoms of hyperammonemia (ammonia reaching toxic concentrations).
Pale macronodules of cirrhosis.
Ammonia occurs in the atmospheres of the outer giant planets such as Jupiter (0.026% ammonia), Saturn (0.012% ammonia), and in the atmospheres and ices of Uranus and Neptune.
Cirrhosis leading to hepatocellular carcinoma
Disability-adjusted life year for cirrhosis of the liver per 100,000 inhabitants in 2004. no data <50 50-100 100-200 200-300 300-400 400-500 500-600 600-700 700-800 800-900 900–1000 >1000

The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver.

- Hepatic encephalopathy

More serious complications include hepatic encephalopathy, bleeding from dilated veins in the esophagus, stomach, or intestines, and liver cancer.

- Cirrhosis

More than 40% of people with cirrhosis develop hepatic encephalopathy.

- Hepatic encephalopathy

Hepatic encephalopathy (HE) occurs when ammonia and related substances build up in the blood. This build-up affects brain function when they are not cleared from the blood by the liver. Symptoms can include unresponsiveness, forgetfulness, trouble concentrating, changes in sleep habits, or psychosis. One classic physical examination finding is asterixis. This is the asynchronous flapping of outstretched, dorsiflexed hands. Fetor hepaticus is a musty breath odor resulting from increased dimethyl sulfide and is a feature of HE.

- Cirrhosis

Liver dysfunction, such as that seen in cirrhosis, may lead to elevated amounts of ammonia in the blood (hyperammonemia).

- Ammonia

Hyperammonemia contributes to the confusion and coma of hepatic encephalopathy, as well as the neurologic disease common in people with urea cycle defects and organic acidurias.

- Ammonia
Micrograph of Alzheimer type II astrocytes, as may be seen in hepatic encephalopathy

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