Principles and Management of Acute Liver Disorders by Consultant Hepatologist
This presentation discusses the principles, causes, presentations, management, and prognosis of acute liver disorders, with a focus on insult to the normal liver leading to liver injury, inflammation, and necrosis. It covers causes such as drugs, viruses, ischemia, autoimmune conditions, Budd-Chiari syndrome, and Wilson's disease. Presentations include abnormal liver tests, jaundice, liver impairment, and different stages of liver failure. The management involves removing and treating the underlying cause, monitoring and supporting the patient, and the possibility of resolution or progression to death or liver transplantation.
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Acute Liver Disorders Will Gelson Consultant Hepatologist Addenbrooke s Hospital April 2020
Principles Causes Presentations Management Prognosis Principle of acute liver disease Insult Normal liver Liver injury Inflammation (hepatitis) Necrosis
Principles Causes Presentations Management Prognosis Causes of acute liver disease Insult Normal liver Drugs (paracetamol) Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Liver injury Inflammation (hepatitis) Necrosis
Principles Causes Presentations Management Prognosis Presentations of acute liver disease Abnormal liver tests Liver enzymes, jaundice Liver Injury Liver impairment Hyperacute Enceph < 1/52 Liver failure Acute 1-4/52 Subacute 4-24/52
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of acute liver disease Remove and treat cause Paracetamol Viruses Ischaemia Autoimmune Budd chiari Wilson s disease Monitor/support Usually resolves Occasionally leads to death or liver transplantation
Principles Causes Presentations Management Prognosis Management of Acute Liver Failure Acute liver failure is a multisystem disorder Na balance ICP measures Fluid balance Inotropes Fluid balance Haemofiltration Electrolyte correction Early haemfiltration Liver transplantation Glucose Ventilation Blood products Broad spectrum antimicrobials Fluid balance Inotropes https://easternliver.net
Principles Causes Presentations Management Prognosis Progosis of Acute Liver Failure Creatinine, INR, bilirubin, encephalopathy, pH, lactic acidosis http://odt.nhs.uk/pdf/liver_selection_policy.pdf
Principles Causes Presentations Management Prognosis Summary Principles Clinical presentations Causes Management Prognosis
Principles Causes Presentations Management Prognosis Questions and Wiki william.gelson@addenbrookes.nhs.uk Hepatology wiki Power point files https://easternliver.net
