Ischemic hepatitis
Background
- Also known as shock liver
- Condition where the liver is injured acutely due to lack of blood flow for any number of reasons.
- Occurs frequently secondary to shock
Clinical Features
- Critically ill patient, may not be able to report symptoms
- Findings can include:
- Weakness, malaise
- Abdominal discomfort
- Jaundice
- Encephalopathy
- Coagulopathy
Differential Diagnosis
Causes of acute hepatitis
- Acetaminophen toxicity (most common cause of acute liver failure in the US[1])
- Viral hepatitis
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Hepatitis D
- Hepatitis E
- HSV
- Epstein-Barr virus
- Varicella zoster virus
- Toxoplasmosis
- Acute alcoholic hepatitis
- Toxins
- Ischemic hepatitis
Evaluation
- LFTs
- AST, ALT > 1000s
- Elevated bilirubin
- Elevated alk phosphatase
- INR
- Consider acetaminophen level
- Acute hepatitis panel
Management
- Treat underlying shock
Disposition
- Admit
See Also
External Links
References
- Ostapowicz G, Fontana RJ, Schiodt FV, et al. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med. 2002 Dec 17; 137(12): 947-54.
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