Severe acute liver failure

Fulminant hepatic failure or acute liver failure is characterized by an acute alteration of the liver secondary to liver cell death leading to loss of normal brain function (encephalopathy) and impaired coagulation. 

There are multiple causes including viral infections, drugs and medications, natural toxins and different types of diseases.

Symptoms are initially nonspecific: loss of appetite, nausea, vomiting, diarrhea, fever, skin rash. Subsequently, altered mental status (encephalopathy), yellowing of the skin and mucous membranes (jaundice), altered vital signs, failure of kidney function, accumulation of fluid in the abdomen (ascites) and sometimes epileptic seizures may appear.

It is diagnosed by detailed clinical history and physical examination. Complementary examinations such as blood tests, blood and urine cultures, electrocardiogram, chest X-ray and abdominal ultrasound should be performed. 

Treatment is complex and should be performed in a hospital with a Liver Intensive Care Unit whenever possible. The triggering cause should be corrected, and symptoms and coagulation disorders should be treated. It is important to ensure proper nutritional support and correct blood glucose drops.