Acute Liver Disorders: Causes, Presentations, and Management

Acute liver disorders can have various causes such as drugs, viruses, ischemia, autoimmune conditions, and more. The presentations of acute liver disease can include abnormal liver tests, jaundice, liver impairment, and even liver failure. Management involves removing and treating the underlying cause, monitoring and support, with outcomes that usually resolve but can occasionally lead to death or the need for a liver transplant.

• Acute Liver Disorders
• Liver Disease
• Hepatology
• Liver Failure
• Management

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1. Acute Liver Disorders Will Gelson Consultant Hepatologist Addenbrooke s Hospital April 2020

2. Principles Causes Presentations Management Prognosis Principle of acute liver disease Insult Normal liver Liver injury Inflammation (hepatitis) Necrosis

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. Principles Causes Presentations Management Prognosis Summary Principles Clinical presentations Causes Management Prognosis

16. Principles Causes Presentations Management Prognosis Questions and Wiki william.gelson@addenbrookes.nhs.uk Hepatology wiki Power point files https://easternliver.net