Ischemic hepatitis

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Ischemic hepatitis
Other namesIschemic hepatopathy , Shock liver
Histopathology of shock liver, showing its hallmark[1] pathologic finding centrilobular necrosis but viable periportal hepatocytes. H&E stain. The necrotic hepatocytes have barely discernible nuclei.
SymptomsMental confusion[2]
CausesHeart failure, Infection[3]
Diagnostic methodDoppler ultrasound, Blood test[3]
TreatmentResuscitation(acute), Stabilize underlining illness(chronic)[4]

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

hepatic artery that supplies oxygen to the liver, such as a blood clot in the hepatic artery, can also cause ischemic hepatitis.[medical citation needed
]

Signs and symptoms

People who develop ischemic hepatitis may have weakness, fatigue, mental confusion, and low urine production (

hepatic coma. Yellow discoloration of the skin (jaundice) can occur, but is rare and temporary, 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.[6] Usually ischemic hepatitis reveals itself after a hypotensive event with increased levels of aminotransferases.[7] Because of this, hypotension is thought to be one of the primary insults leading to ischemic hepatitis.[8]

Diagnosis

Congestive hepatopathy

Blood testing usually shows markedly high elevations of both liver transaminase enzymes, AST and ALT, which may exceed 10,000 U/L.[9] It has been found that those who suffer from ischemic hepatitis had significant cardiac disease as well.[10]

As a measure of precaution, paracetamol levels and a toxicology screening should be completed to evaluate for possible toxin-mediated injury; it is also imperative to be able to exclude the possibility of acute viral hepatitis.[11]

Related conditions

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 affected individual.[12]

Treatment

The treatment of ischemic hepatitis is as follows:[13]

See also

References

  1. PMID 29868133
    .
  2. ^
    ISBN 9788131216743
    .
  3. ^ a b c "Hepatic ischemia: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-08-24.
  4. ISBN 9780323529570
    . Retrieved 2 January 2018.
  5. ISBN 9783642045196
    .
  6. ISBN 9789351527404
    .
  7. ISBN 9783540671367
    .
  8. ISBN 978-1437727678
    .
  9. S2CID 20312771
    .
  10. ISBN 978-1437708813
    .
  11. ISBN 9781444346367
    .
  12. ^ "Cardiac Cirrhosis and Congestive Hepatopathy: Background, Pathophysiology, Epidemiology". 2018-06-28. {{cite journal}}: Cite journal requires |journal= (help)
  13. ISBN 9781420016840
    .

Further reading

External links

Scholia has a topic profile for Ischemic hepatitis.
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