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Hepatic ischemia


Definition:

Hepatic ischemia is a condition in which the liver does not get enough blood or oxygen, causing injury to liver cells.

Alternative Names:

Ischemic hepatitis; Shock liver

Causes, incidence, and risk factors:

Low blood pressure from any condition can lead to hepatic ischemia. Such conditions may include:

Other causes may include:

  • Blood clots in the main artery to the liver (hepatic artery) after a liver transplant
  • Swelling of blood vessels leading to reduced blood flow (vasculitis)
Symptoms:

If low blood pressure continues for a long time, you may feel weak and lightheaded. However, the period of low blood pressure may be brief and produce no symptoms. Damage to the liver cells usually does not cause symptoms until it affects liver function.

Blood clots in the liver's main artery may cause abdominal pain.

Signs and tests:

The following tests will be done:

  • Blood tests to check liver function (AST and ALT )
  • Doppler ultrasound of the liver's blood vessels
Treatment:

Treatment depends on the cause. Low blood pressure and blood clots must be properly treated.

Expectations (prognosis):

Patients generally recover if the illness causing hepatic ischemia can be treated. Death from liver failure due to hepatic ischemia is very rare.

Complications:

Liver failure is a rare but life-threatening complication.

Calling your health care provider:

See your health care provider right away if you have persistent weakness or symptoms of shock or dehydration.

Prevention:

Quickly treating the causes of low blood pressure may prevent hepatic ischemia.

References:

Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 145.

Stevens WE, Patil A. Vascular disease of the liver. In: Feldman M, Friedman LS, Brandt LJ eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 83.


Review Date: 8/10/2012
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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