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유행성 Virus간염의 임상상과 간침생검 조직상에 관한 연구 제3편 급성 Virus간염의 후유증 및 합병증에 관한 연구 : STUDIES ON CLINICAL, LABORATORY AND HISTOLOGICAL FINDINGS OF' LIVER BIOPSY IN EPIDEMIC VIRAL HEPATITIS Part III: Studies on Complications and Sequelae of Acute Hepatitis

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서울대학교 의과대학
Seoul J Med, Vol.1 No.2, pp. 49-78
The complications and sequelae of viral hepatitis
were studied in 143 acute cases and 15 chronic
cases. utilizing a correlation of the clinical picture
with laboratory findings and serial liver biopsies.
Of the 143 acute cases studied. 98 cases underwent
serial biopsies. 45 cases had a single biopsy. Of
the 98 cases studied by serial biopsies: 19 cases had
histologic findings consistent with cholangiolitic
change. 79 cases had histologic findings of hepatocellular
damage. 15 cases of chronic hepatitis were
studied by single biopsy. The following results
were observed.
1. In 43.6% of these patients with acute viral
hepatitis. there was no histologic clearance within
3 months after the onset of illness. Differently
from acute phase, this prolonged histological findings
were mainly fibrosis. mononuclear cell infiltration.
and cholangiolitic change around the portal
areas. There were rarely noted fatty metamorphosis.
2. Of the 87 cases of acute ·hepatitis. 10 cases
(11.4%) showed evidence of recurrent or relapsing
phases of the disease. The histologic picture of
the latent stage which followed the initial attacn:
was mainly that of arrested cholangiolitic involvement
with no evidence of healing. Only in one
case. there was histologic evidence of reactivation
during a relapsing stage_ Of the 10 cases. 2 cases
showed complete healing. 1 case progressed into
a chronic hepatitis with portal cirrhosis. 7 cases
had a persistence of the cholangiolitic changes in
final outcome.
3. Of the 98 cases studied 1:>y serial biopsies. in
19 cases significant histologic pattern Was that of cholangiolitic damage. Comparing with hepatocelular
hepatitis, clinically nausea, vomiting, itching
sensation and hepatomeg.dy were remarkable; in
laboratory findings a slight leukocytosis, positive
urine bilirubin, increased direct reactive serum
bilirubin and abnormal retention of BSP were
more striking; histologically bile stasis, bile duct
proliferation and inflammatory cellular infiltration
(especially neutrophils) were remarkable in the
patients of cholangiolitic damage. of this group, 11
cases showed persistent cholangiolar involvement
and 3 of these 11 cases progressed to cirrhosis_
4. Viral hepatitis combine with liver distosomiasis
and cholecystitis showed every characteristic
clinical, laboratory and histologic findings of cho
langiolitic type_
5. Of these 98 cases studied by serial biopsies, 79
cases were characterized by hepatocellular changes
Of this group, 18 cases showed marked portal
fibrosis and 4- of these 18 cases progressed to
portal cirrhosis.
6. The cases of chronic hepatitis studied were
15 cases. 6 of these had mild splenomegaly, 4 of
these had slight hepatomegaly, 6 of these had
persistent jaundice. All of these cases had active
viral hepatitis persisting for more than one year
as proven by needle biopsy.
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