Causes and Manifestations

Acute liver failure is an inflammatory process causing massive hepatocellular necrosis.

Whilst the numerous causes of acute liver failure are heterogenous, the clinical presentation and general management are the same.


Manifestations of liver dysfunction

Normal function

Pathophysiological manifestations

Carbohydrate metabolism Hypoglycaemia
Protein metabolism Hyperammonemia and toxins causing encephalopathy
Bile secretion Hyperbilirubinaemia causing jaundice
Drug detoxification Drug toxicity
Synthesis and secretion of plasma proteins
  • Clotting factor deficiency causing coagulopathy
  • Hypoalbuminaemia
Clearance of gut bacteria from portal system Systemic infections resulting in sepsis
Sodium and water balance Disruption leads to altered perception of volume status by kidneys and subsequent renal failure