Clinical Features

Such liver damage can be potentially life-threatening:

  • Alcoholic hepatitis (AH) can result from prolonged alcohol abuse and presents with non-specific systemic symptoms; and can also cause features of portal hypertension
  • Alcoholic cirrhosis (AC) results in severe liver injury and shrinkage with increased portal hypertension and associated complications as well as decline of liver synthetic function [4]

It is important to remember that alcohol can cause significant damage to the liver and health in general without producing any physical signs or symptoms. A vast majority of patients are diagnosed on routine blood tests.


Early symptoms may be non-specific and thus can require a certain clinical acumen to diagnose. More advanced disease may present with typical signs of liver disease. Sequelae of alcohol abuse may also be the presenting complaint, such as injuries [1].

Clinical history

An open mind is required for all patients, especially within the ED, and alcohol intake should be part of every clinical history, although patients may be unaware that their intake is high or may deny the problem.

Collateral history is often important in these situations.