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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

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

Other causes may include:

  • Large blood clots in the main artery to the liver (hepatic artery) after a transplant
  • Swelling of blood vessels (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.

Signs and tests

Blood levels of liver enzymes, such as AST and ALT, typically rise 1 - 3 days after the episode of low blood pressure. Levels of another enzyme in the blood, LDH, are also usually high.

Support Groups

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.

Calling your health care provider

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

Complications

Liver failure is a rare but life-threatening complication.

Treatments

Treatment depends on the cause of the low blood pressure. Low blood pressure must be treated so that the liver receives enough blood. The illness causing the problem must also be treated.

Prevention

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

References

Jain R, Thiele D. Gastrointestinal and hepatic manifestations of systemic diseases. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 34.


Review Date: 8/22/2008
Reviewed By: Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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