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Hepatic ischemia

Ischemic hepatitis; Shock liver

 

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

Causes

 

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

  • Abnormal heart rhythms
  • Dehydration
  • Heart failure
  • Infection
  • Severe bleeding

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 light-headed. 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.

 

Exams 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.

 

Outlook (Prognosis)

 

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

 

Possible Complications

 

Liver failure is a rare but life-threatening complication.

 

When to Contact a Medical Professional

 

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. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 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: Elsevier Saunders; 2010:chap 83.

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  • Liver blood supply

    Liver blood supply

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    • Liver blood supply

      Liver blood supply

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    A Closer Look

     

      Tests for Hepatic ischemia

       
         

        Review Date: 8/11/2014

        Reviewed By: Jennifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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