Contents
Congestive hepatopathy, also known as nutmeg liver and chronic passive congestion of the liver, is liver dysfunction due to venous congestion, usually due to congestive heart failure.

Clinical features
- Sense of fullness and tenderness in the right hypochondriac region
- Gastrointestinal catarrh
- Vomiting of blood
- Jaundice
- Light or clay-colored stool
- Bile coloured urine
- Ascites, followed later by generalised oedema
- Due to portal obstruction
- Enlarged and tender liver
Complications
- Severe and longstanding hepatic congestion,
- Fibrosis (cardiac cirrhosis)
Diagnosis
Investigations
- Electrocardiogram (EKG)
- Diagnostic paracentesis
Imaging
- RUQ-USG + Doppler studies (of portal vein and hepatic veins & artery)
- Echocardiograph (ECG)
- CT-scan
- Dilatation of the IVC and hepatic veins
- Retrograde hepatic venous opacification shortly after IV contrast injection
- Heterogeneous hepatic enhancement due to stagnant blood flow

Histopathology
- Perisinusoidal fibrosis
- Hepatic venule dilation
- Dilation of the sinusoids in zone III (centrilobular)

Management
Treatment of underlying cause