Hepatic ischemia
Ischemic hepatitis; Shock liverHepatic ischemia is a condition in which the liver does not get enough blood or oxygen. This causes injury to liver cells.
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Causes
Low blood pressure from any condition can lead to hepatic ischemia. Such conditions may include:
- Abnormal heart rhythms
- Dehydration
- Heart failure
- Infection, especially sepsis
- Severe bleeding
Other causes may include:
- Blood clots in the main artery to the liver (hepatic artery) after a liver transplant
- Inflammation of blood vessels, leading to reduced blood flow (vasculitis)
- Burns
- Heat stroke
- Having a sickle cell crisis
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Symptoms
The person may have altered mental status due to reduced blood flow to the brain. Other symptoms may include:
- Loss of appetite
- Feeling of general discomfort
- Jaundice
Damage to the liver cells most often does not cause symptoms until it affects liver function.
Blood clots in the liver's main artery may cause abdominal pain.
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Treatment
Treatment depends on the cause. Low blood pressure and blood clots must be treated right away.
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Outlook (Prognosis)
People generally recover if the illness causing hepatic ischemia can be treated. Death from liver failure due to hepatic ischemia is very rare.
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Possible Complications
Liver failure is a rare, but fatal complication.
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When to Contact a Medical Professional
Contact your health care provider right away if you have persistent weakness or symptoms of shock or dehydration.
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Prevention
Quickly treating the causes of low blood pressure may prevent hepatic ischemia.
References
Korenblat KM, Berk PD. Approach to the patient with jaundice or abnormal liver tests. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 138.
Nery FG, Valla DC. Vascular diseases of the liver. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 85.
Williams MJ, Gordon-Walker TT. Hepatology. In: Penman ID, Ralston SH, Strachan MWJ, Hobson RP, eds. Davidson's Principles and Practice of Medicine. 24th ed. Philadelphia, PA: Elsevier; 2023:chap 24.