A report on Ammonia and Hepatic encephalopathy

Ball-and-stick model of the diamminesilver(I) cation, [Ag(NH3)2]+

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

Ball-and-stick model of the tetraamminediaquacopper(II) cation, [Cu(NH3)4(H2O)2](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.

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.

Micrograph showing liver cirrhosis, a condition that often precedes hepatic encephalopathy. Trichrome stain.

Ammoniacal Gas Engine Streetcar in New Orleans drawn by Alfred Waud in 1871.

The X-15 aircraft used ammonia as one component fuel of its rocket engine

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.

The world's longest ammonia pipeline (roughly 2400 km long), running from the TogliattiAzot plant in Russia to Odessa in Ukraine

Hydrochloric acid sample releasing HCl fumes, which are reacting with ammonia fumes to produce a white smoke of ammonium chloride.

Production trend of ammonia between 1947 and 2007

Main symptoms of hyperammonemia (ammonia reaching toxic concentrations).

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.

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

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

3 related topics with Alpha

Cirrhosis

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Impaired liver function caused by the formation of scar tissue known as fibrosis due to damage caused by liver disease.

Person with cirrhosis and associated pain in the right upper region of the abdomen

Hepatitis C viral particles and the liver

Caudate lobe hypertrophy on ultrasound due to cirrhosis

Hepatofugal (non-forward) flow in portal vein

Liver cirrhosis on CT imaging of the abdomen in transverse view

Micrograph showing cirrhosis, trichrome stain

Cirrhosis deaths per million persons in 2012

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>

Histopathology of steatohepatitis with mild fibrosis in the form of fibrous expansion (Van Gieson's stain)

Histopathology of steatohepatitis with moderate fibrosis, with thin fibrous bridges (Van Gieson's stain)

Histopathology of steatohepatitis with established cirrhosis, with thick bands of fibrosis (Van Gieson's stain)

Trichrome stain, showing cirrhosis as a nodular texture surrounded by fibrosis (wherein collagen is stained blue).

Micronodular cirrhosis, with diffuse areas of pallor.

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
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900–1000
>1000

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

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.

Liver

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Major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth.

The liver, viewed from above, showing the left and right lobes separated by the falciform ligament

The liver, viewed from below, surface showing four lobes and the impressions

Shape of human liver in animation, with eight Couinaud segments labelled

CT scan showing an adult liver in the axial plane.

Adult ultrasound showing the right lobe of the liver and right kidney.

After resection of left lobe liver tumor

Maksalaatikko, a Finnish liver casserole

19th century drinking scene in Kordofan, home to the Humr tribe, who made a drink from giraffe liver. Plate from Le Désert et le Soudan by Stanislas d'Escayrac de Lauture.

alt=3D Medical Animation Still Shot Depicting parts of liver|3D Medical Animation Still Shot Depicting parts of liver

thumb|right|Diagram of liver, lobule, and portal tract and their inter-relations

Axial CT image showing anomalous hepatic veins coursing on the subcapsular anterior surface of the liver.<ref name="Sheporaitis">{{cite journal|pmid=9843288|year=1998|last1=Sheporaitis|first1=L|last2=Freeny|first2=PC|title=Hepatic and portal surface veins: A new anatomic variant revealed during abdominal CT|volume=171|issue=6|pages=1559–1564|doi=10.2214/ajr.171.6.9843288|journal=AJR. American Journal of Roentgenology}}</ref>

Maximum intensity projection (MIP) CT image as viewed anteriorly showing the anomalous hepatic veins coursing on the anterior surface of the liver

A CT scan in which the liver and portal vein are shown.

MDCT image. Arterial anatomy contraindicated for liver donation

MDCT image. Portal venous anatomy contraindicated for liver donation

MDCT image. 3D image created by MDCT can clearly visualize the liver, measure the liver volume, and plan the dissection plane to facilitate the liver transplantation procedure.

Phase contrast CT image. Contrast is perfusing the right liver but not the left due to a left portal vein thrombus.

The liver converts ammonia into urea as part of the ornithine cycle or the urea cycle, and the urea is excreted in the urine.

Hepatic encephalopathy is caused by an accumulation of toxins in the bloodstream that are normally removed by the liver.

Hyperammonemia

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Hyperammonemia is a metabolic disturbance characterised by an excess of ammonia in the blood.

Hyperammonemia is one of the metabolic derangements that contribute to hepatic encephalopathy, which can cause swelling of astrocytes and stimulation of NMDA-receptors in the brain.