Liver Disease Secondary to Intestinal Failure

Table 4

Histopathological findings and pathophysiology of intestinal failure associated liver disease (IFALD).

IFALD stage	Events	Mediators/factors	Parenchymal changes	References
Early stage	Steatosis: abnormal accumulation of lipids in hepatocytes	Tumor necrosis factor α (TNF-α) Fas ligands (Fas-L)	Activation of caspase pathway that leads to cell damage	[38–41]
Intermediate stage	Steatohepatitis: release of reactive oxygen radicals and other proinflammatory mediators causing cellular membrane dysfunction and increased mitochondrial permeability	Oxydative damage of cellular and membrane lipids	Inflammation involving hepatic and perihepatic cells (steatohepatitis) Cellular dysfunction causing cholestasis	[42–44]
Advanced stage	Hepatocytes ballooning, bile duct proliferation, and cirrhosis	Oxygen radicals and proinflammatory mediators causing hepatocyte death or apoptosis	Irreversible scarring of the liver tissue (cirrhosis)	[42–46]