Acute liver failure

Fulminant hepatic failure or acute liver failure is characterised by an acute liver disorder secondary to the death of liver cells that leads to the loss of normal brain function (encephalopathy) and coagulation disorder.

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

The symptoms are initially non-specific: loss of appetite, nausea, vomiting, diarrhoea, fever, skin rash. Later, mental state alteration (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.

It is diagnosed by taking a detailed medical history of the patient and performing a full physical examination. Complementary testing should be done for its study: blood tests, blood and urine cultures, electrocardiogram, chest X-ray and abdominal ultrasound.

Treatment is complex and must be carried out in a hospital with a  liver-specific intensive care unit whenever possible. The triggering cause must be fixed, treating the symptomatology and coagulation disorders as well. It is important to ensure a correct nutritional support as well as treating the glucose levels decrease.