Pattern of Necrosis in Acute Viral Hepatitis

Abstract

Of 170 patients with biopsy-documented acute viral hepatitis, 52 exhibited zones of hepatic necrosis and collapse that bridged adjacent portal triads or central veins (or both), a lesion classified as subacute hepatic necrosis (SHN). Whereas the clinical course in the 118 patients with the classic type of spotty necrosis (CH) was relatively benign, 19 per cent of those with SHN lesions died, and cirrhosis developed in 37 per cent. Ascites, edema and hepatic coma, which occurred in approximately a quarter of the SHN patients, were the only clinical manifestations that clearly distinguished between the two groups.