Isolated Hepatic Non-Obstructive Sinusoidal Dilatation, 20-Year Single Center Experience

AIMTo characterize isolated non-obstructive sinusoidal dilatation (SD) by identifying associated conditions, lab-oratory fin-dings, and histological patterns.METHODSRetrospectively reviewed 491 patients with SD between 1995 and 2015. Patients with obstruction at the level of the small/large hepatic veins, portal veins, or right-sided heart failure were excluded along with history of cirrhosis, hepatic malignancy, liver transplant, or absence of electrocardiogram/cardiac echocardiogram. Liver histology was reviewed for extent of SD, fibrosis, red blood cell ext-ravasation, nodular regenerative hyperplasia, hepatic peliosis, and hepatocellular plate atrophy (HPA).RESULTSWe identified 88 patients with non-obstructive SD. Inflammatory conditions (32%) were the most common ca-use. The most common pattern of liver abnormalities was cholestatic (76%). Majority (78%) had localized SD to Zone.. Medication-related SD had higher proportion of portal hypertension (53%), ascites (58%), and median AST (113 U/L) and ALT (90 U/L) levels. Nineteen patients in our study died within one-year after diagnosis of SD, majority from complications related to underlying diseases.CONCLUSIONSignificant proportion of SD and HPA exist without impaired hepatic venous outflow. Isolated SD on liver bio-psy, in the absence of congestive hepatopathy, requires further evaluation and portal hypertension should be rule out.