Acute Liver Failure Flashcards
What is the definition of acute liver failure
Occurs after a severe insult to the liver in a patient with no pre-existing liver disease
How can you classify acute liver failure
Hyperacute
Acute
Subacute
Based on the onset of hepatic encephalopathy
What is hyperacute liver failure
Onset of hepatic encephalopathy with 7 days of onset of symptoms
What is acute liver failure
Onset of hepatic encephalopathy within 8-28 days of onset of symptoms
What is subacute liver failure
Onset of hepatic encephalopathy after 28 days of onset of symptoms
What are some precipitants of acute decompensation of liver disease
Intercurrent infection - spontaneous bacterial peritonitis Acute GI bleed Constipation Drugs - sedatives, diuretics Metabolic abnormalities - hypoglycaemia Major surgery Progression of disease
What are some causes of acute liver failure
Drugs:-
Paracetamol
NSAIDs
Antibiotics - isoniazid, penicillins, erythromycin
Viral:-
Hep A and B
Pregnancy related:-
Acute fatty liver of pregnancy
HELLP - haemolytic anaemia, raised liver enzymes, reduced platelets
Malignancies:-
Lymphoma
Malignant infiltration
Vascular:-
Budd-Chiari syndrome - occlusion of hepatic veins that drain the liver
Ischaemic injury to the liver
Others:-
Wilson’s disease
Autoimmune hepatitis