Ischemic hepatitis: Difference between revisions
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==Background== | ==Background== | ||
Also known as shock liver | [[File:Liver vascular anatomy.png|thumb|Liver vascular anatomy.]] | ||
[[File:Biliary system multilingual.png|thumb|Bile duct and pancreas anatomy. 1. Bile ducts: 2. Intrahepatic bile ducts; 3. Left and right hepatic ducts; 4. Common hepatic duct; 5. Cystic duct; 6. Common bile duct; 7. Sphincter of Oddi; 8. Major duodenal papilla; 9. Gallbladder; 10-11. Right and left lobes of liver; 12. Spleen; 13. Esophagus; 14. Stomach; 15. Pancreas: 16. Accessory pancreatic duct; 17. Pancreatic duct; 18. Small intestine; 19. Duodenum; 20. Jejunum; 21-22: Right and left kidneys.]] | |||
*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== | ==Clinical Features== | ||
*Critically ill patient, may not be able to report symptoms | |||
*Findings can include: | |||
**[[Weakness]], malaise | |||
**[[RUQ pain|Abdominal discomfort]] | |||
**[[Jaundice]] | |||
**[[hepatic encephalopathy|Encephalopathy]] | |||
**[[Liver disease induced coagulopathy|Coagulopathy]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Acute hepatitis causes}} | |||
==Evaluation== | ==Evaluation== | ||
*[[LFTs]] | |||
**AST, ALT > 1000s | |||
**Elevated bilirubin | |||
**Elevated alk phosphatase | |||
*INR | |||
**[[liver disease induced coagulopathy|Coagulopathy]] | |||
*Consider acetaminophen level | |||
*Acute [[viral hepatitis|hepatitis panel]] | |||
==Management== | ==Management== | ||
*Treat underlying [[shock]] | |||
==Disposition== | ==Disposition== | ||
*Admit | |||
==See Also== | ==See Also== | ||
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<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] [[Category:Critical Care]] | ||
Revision as of 23:12, 13 November 2024
Background
Bile duct and pancreas anatomy. 1. Bile ducts: 2. Intrahepatic bile ducts; 3. Left and right hepatic ducts; 4. Common hepatic duct; 5. Cystic duct; 6. Common bile duct; 7. Sphincter of Oddi; 8. Major duodenal papilla; 9. Gallbladder; 10-11. Right and left lobes of liver; 12. Spleen; 13. Esophagus; 14. Stomach; 15. Pancreas: 16. Accessory pancreatic duct; 17. Pancreatic duct; 18. Small intestine; 19. Duodenum; 20. Jejunum; 21-22: Right and left kidneys.
- 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:
Differential Diagnosis
Causes of acute hepatitis
- Acetaminophen toxicity (most common cause of acute liver failure in the US[1])
- Viral hepatitis
- Toxoplasmosis
- Acute alcoholic hepatitis
- Toxins
- Ischemic hepatitis
- Autoimmune hepatitis
- Wilson's disease
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.