What are the signs and symptoms of acute liver failure?

Updated: Jun 13, 2019
  • Author: Gagan K Sood, MD; Chief Editor: BS Anand, MD  more...
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Acute liver failure is a broad term that encompasses both fulminant hepatic failure and subfulminant hepatic failure (or late-onset hepatic failure). The term fulminant hepatic failure is generally used to describe the development of encephalopathy within 8 weeks of the onset of symptoms in a patient with a previously healthy liver. The term subfulminant hepatic failure is reserved for patients with liver disease for up to 26 weeks before the development of hepatic encephalopathy.

Signs and symptoms of acute failure may include the following:

  • Encephalopathy

  • Cerebral edema: May lead to signs of increased intracranial pressure (ICP) (eg, papilledema, hypertension, bradycardia)

  • Jaundice: Often present but not always

  • Ascites: Potential for hepatic vein thrombosis with rapid development in the presence of fulminant hepatic failure accompanied by abdominal pain

  • Right upper quadrant tenderness: Variably present

  • Change in liver span: May be small due to hepatic necrosis or may be enlarged due to heart failure, viral hepatitis, or Budd-Chiari syndrome

  • Hematemesis or melena: Due to upper gastrointestinal (GI) bleeding

  • Hypotension and tachycardia: Due to reduced systemic vascular resistance

See Presentation for more detail.

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