Diagnosis, treatment and complications of acute liver failure

The article was professionally consulted by MSc Vu Van Quan - Department of General Surgery & Anesthesia - Vinmec Hai Phong International General Hospital.

Acute liver failure is assessed as a complex disease that usually occurs after suffering a harmful effect on the liver and impairs its function. The disease develops rapidly in just a few days or weeks. The primary goals of treatment for acute liver failure are to control cerebral edema and to provide supportive therapy for multi-organ failure until liver regeneration occurs.

Definite diagnosis: Based on the patient's clinical symptoms such as fatigue, jaundice, persistent nausea. Blood test: This is a mandatory test done to determine how well the liver is working. The prothrombin time test measures how long the blood clots. When a patient has acute liver failure, the blood clotting process will not take place as quickly as usual. Total bilirubin if increased >250 Mmol/l indicates severe disease. Plasma AST and ALT reflect hepatocellular injury. Prothranbin time (PT) factor determines severity. Imaging: Before starting treatment for acute liver failure, doctors will recommend ultrasound to check for damage on the patient's liver, the images on ultrasound can show the extent of damage and help doctors The doctor finds out the cause of the disease. In addition, you may be offered computed tomography (CT) or MRI scans to examine your liver and blood vessels. These imaging tests can detect and screen for certain causes of acute liver failure. Liver tissue examination : Patients being treated for severe acute liver failure will be recommended to have their liver tissue examined, this diagnostic technique helps doctors know the cause of liver damage and to what extent. For patients with acute liver failure, there is often a risk of bleeding during biopsy, so it may be necessary to perform a percutaneous liver biopsy of the patient.

“Is acute liver failure dangerous?” It's a question many people have. Although it does not cause the patient to die quickly, if acute liver failure is not treated promptly, many complications will occur, specifically:
2.1 Complications of cerebral edema This is fluid overload that creates pressure large in the patient's brain.

2.2 Bleeding complications and bleeding disorders When the liver fails, it will not be able to produce enough factors for the clotting process to take place smoothly, so it will cause bleeding, bleeding disorders, especially is bleeding in the gastrointestinal tract.
2.3 Infectious complications Patients who do not receive timely treatment for severe acute liver failure are more likely to develop infections, especially respiratory tract infections, blood infections, and urinary tract infections.
2.4 Complications of kidney failure Renal failure complications often occur after a patient has liver failure, especially if the patient has ever taken an overdose of acetaminophen that will cause severe liver and kidney damage.

Treatment for severe acute liver failure is done in the intensive care unit. The doctor will base on the patient's liver damage to come up with a treatment plan, in many cases, the treatment may involve controlling complications and needing to wait for the patient's liver to heal. recover. Treatment of acute liver failure includes:
3.1 Anti-poisoning drug therapy Patients who are treated for acute liver failure with anti-poisoning drugs will be prescribed an overdose of acetaminophen treated with a drug called an anti-poisoning agent. poison. This medicine may also help treat other causes of acute liver failure.
3.2 Treatment with liver transplant technique In case patients are treated for severe and irreversible acute liver failure, the only treatment is liver transplantation. The surgeon removes the damaged liver tissue from the patient and replaces it with a healthy liver from a donor.
In addition, when treating acute liver failure, the doctor will control and closely monitor the signs and symptoms in the patient to prevent complications caused by acute liver failure by reducing intracranial pressure due to excessive bleeding. Fluid load in the brain, screen for infections, and prevent major bleeding.

To effectively prevent acute liver failure, the first thing is to be careful when using drugs to treat the disease. If you are taking acetaminophen or other medications, be sure to take the correct dose as directed by your doctor.
Build a healthy lifestyle, say no to alcohol and avoid risky behaviors like sharing needles, use condoms when having sex and don't smoke.
A safe diet with fresh food will help protect a healthy liver, say no to mushrooms when their origin is unknown. Maintain a stable weight.
Patients with acute liver failure should go to reputable medical facilities for examination and treatment. Vinmec International General Hospital is an international standard hospital with a team of qualified and experienced doctors and nurses, a system of modernly invested equipment, professional service quality, etc. for the patient to trust.
From October 2019, Vinmec Hai Phong Hospital welcomes specialists in Gastroenterology - Liver, bile, and pancreas from 108 Military Central Hospital to visit periodically for diseases of the stomach, esophagus, colorectal, etc. Liver, spleen, biliary tract, pancreas, anal fistula, rectal prolapse, gastrointestinal cancer screening... At the request of the patient, Senior Doctor Le Van Thanh - Head of the Department of Hepatobiliary and Pancreatic Surgery – Military Central Hospital 108 will directly operate. Schedule on Saturday, surgery on Sunday so that customers can easily arrange their personal time and have more time to recover after the intervention.
Customers who need advice and support on treatment of acute liver failure at Vinmec, please contact HERE.