Ischemic hepatitis

Ischemic hepatitis
Classification and external resources
ICD-10 K72.0
MedlinePlus 000214

Ischemic hepatitis (also known as shock liver) is a condition defined as an acute liver injury caused by insufficient blood flow (and consequently insufficient oxygen delivery) to the liver.[1] The decreased blood flow (perfusion) to the liver is usually due to shock or low blood pressure. However, local causes involving the hepatic artery that supplies oxygen to the liver, such as a blood clot in the hepatic artery, can also cause ischemic hepatitis.

Signs and symptoms

People who develop ischemic hepatitis may have weakness, fatigue, mental confusion, and low urine production (a small percentage-hepatic coma). Jaundice can occur, but is rare and transient, as is actual loss of function of the liver.[2]

Cause

Arrhythmia (ventricular fibrillation)

Ischemic hepatitis can be caused by a number of reasons (that lead to low blood pressure) including:[3]

Mechanism

The mechanism of ischemic hepatitis depends on the etiopathogenetic origin, be it a cardiomyopathy, cardiac tamponade, trauma, or bleeding.[4] Usually ischemic hepatitis reveals itself after a hypotensive event with increase levels of aminotransferase,[5] hypotension is thought to be one of the primary insults in ischemic hepatitis.[6]

Diagnosis

Congestive hepatopathy

Blood testing usually shows high levels of the liver transaminase enzymes, AST and ALT, which may exceed 1000 U/L.[7] It has been found that those who suffer from ischemic hepatitis had significant cardiac disease as well.[8]

As a measure of precaution, paracetamol levels and a toxicology screening should be completed, it is also imperative to be able to exclude the possibility of viral hepatitis.[9]

Ischemic hepatitis is related to another condition called congestive hepatopathy. Congestive hepatopathy includes a number of liver disorders that occur in right-sided heart failure. The medical term congestive hepatopathy is used, however the term cardiac cirrhosis is convention. These two entities can coexist in an afflicted individual.[10]

Treatment

The treatment of ischemic hepatitis is as follows:[11]

See also

References

  1. ↑ Dancygier, Henryk (2009-11-10). Clinical Hepatology: Principles and Practice of Hepatobiliary Diseases:. Springer Science & Business Media. ISBN 9783642045196.
  2. ↑ Liver: A Complete Book on Hepato-Pancreato-Biliary Diseases. Elsevier India. 2009-01-01. ISBN 9788131216743.
  3. ↑ "Hepatic ischemia: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-08-24.
  4. ↑ Sibal, Anupam; Gopalan, Sarath (2015-04-30). Textbook of Pediatric Gastroenterology, Hepatology and Nutrition. JP Medical Ltd. ISBN 9789351527404.
  5. ↑ Lang, Florian (2009-03-19). Encyclopedia of Molecular Mechanisms of Disease: With 213 Tables. Springer Science & Business Media. ISBN 9783540671367.
  6. ↑ Feldman, Mark; Friedman, Lawrence S.; Brandt, Lawrence J. (2010-05-03). Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management, Expert Consult Premium Edition - Enhanced Online Features. Elsevier Health Sciences. ISBN 1437727670.
  7. ↑ Raurich JM, Pérez O, Llompart-Pou JA, Ibáñez J, Ayestarán I, Pérez-Bárcena J (July 2009). "Incidence and outcome of ischemic hepatitis complicating septic shock". Hepatol. Res. 39 (7): 700–5. doi:10.1111/j.1872-034X.2009.00501.x. PMID 19473435.
  8. ↑ Boyer, Thomas D.; Manns, Michael Peter; Sanyal, Arun J.; Zakim, David (2012-01-01). Zakim and Boyer's Hepatology: A Textbook of Liver Disease. Elsevier Health Sciences. ISBN 1437708811.
  9. ↑ Plevris, John; Howden, Colin (2012-04-05). Problem-based Approach to Gastroenterology and Hepatology. John Wiley & Sons. ISBN 9781444346367.
  10. ↑ "Cardiac Cirrhosis and Congestive Hepatopathy: Background, Pathophysiology, Epidemiology".
  11. ↑ Wilson, William C.; Grande, Christopher M.; Hoyt, David B. (2007-02-05). Trauma: Critical Care. CRC Press. ISBN 9781420016840.

Further reading

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