Hepatic ischemia

Alternative names
Ischemic hepatitis; Shock liver

Definition
Hepatic ischemia is a deficiency of blood or oxygen supply to the liver that causes injury to liver cells.

Causes, incidence, and risk factors

Low blood pressure resulting from any condition - including heart failure, abnormal heart rhythms, dehydration, severe bleeding, and infection- can lead to hepatic ischemia.

Symptoms

If the low blood pressure continues for an extended period, the patient may feel weak and lightheaded. However, the period of low blood pressure may be brief and produce no symptoms at the time. The damage to the liver cells is generally without symptoms as well.

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. Another enzyme in the blood, LDH, is also usually quite elevated.

Treatment

Treatment depends on the cause of the low blood pressure, which must be addressed to keep the liver’s blood supply stable.

Expectations (prognosis)

Patients generally recover if the underlying illness can be treated. Death from liver failure as a result of hepatic ischemia is very rare.

Complications

Liver failure is a possible but rare complication that can lead to death.

Calling your health care provider

See your health care provider urgently if you have persistent weakness or signs of shock or dehydration.

Prevention

Prompt treatment of underlying causes of low blood pressure may prevent hepatic ischemia.

Johns Hopkins patient information

Last revised: December 3, 2012
by Levon Ter-Markosyan, D.M.D.

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