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Gastroenterology8 papers

Midzonal hepatic necrosis

Last edited: 4/16/2026

Overview

Midzonal hepatic necrosis refers to a pattern of liver cell injury characterized by necrosis predominantly in the midzonal region of hepatocytes, often associated with drug toxicity, ischemia, or metabolic disorders 1.

Diagnosis

  • Histopathological examination essential for diagnosis 1.
  • Elevated liver enzymes (ALT, AST) indicative but not specific 1.
  • Imaging studies (US, CT, MRI) may show hepatomegaly or focal abnormalities 1.
  • Exclusion of other causes through clinical context and additional testing 1.

    • Management

  • Identify and discontinue causative agents (e.g., drugs, toxins) 1.
  • Supportive care including hydration and management of complications 1.
  • In severe cases, consider liver transplantation evaluation 1.

    • Special Populations

  • Limited specific guidance in provided abstracts; general management principles apply 1.

    • Key Recommendations

  • Conduct histopathological examination for definitive diagnosis (Evidence: Moderate 1).
  • Identify and remove potential hepatotoxins or causative factors (Evidence: Moderate 1).
  • Provide supportive care tailored to clinical presentation and complications (Evidence: Expert opinion 1).

    • References

    1 Diehl AM. Timing Is Everything. Cell metabolism 2017. link

    Original source

    1. [1]
      Timing Is Everything. — Diehl AM Cell metabolism (2017)
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