Ischemic Hepatitis or Shock Liver: Causes, Symptoms, Treatment

Ischemic Hepatitis which is also known by the name of Shock Liver is a condition in which there is an injury or insult incurred to the liver as a result of inadequate supply of oxygen and other nutrients to the liver also known as acute hypoperfusion. Ischemic Hepatitis or Shock Liver is different from Hepatic Infarction in which there is ischemic injury due to conditions like thrombosis and the like. Hypotension is basically the primary cause of Ischemic Hepatitis or Shock Liver apart from other conditions like cardiogenic shock sepsis etc., although there have been cases of Ischemic Hepatitis or Shock Liver in people without any known hypotension but in such cases the patients have risk factors for Ischemic Hepatitis or Shock Liver like portal hypertension.

Apart from hypotension other conditions which can cause Ischemic Hepatitis or Shock Liver are extreme respiratory failure, hypoxemia, and severe anemia. It can be stated that all these condition including Ischemic Hepatitis or Shock Liver can be associated with an improper functioning of the heart resulting in decreased distribution of oxygen to the vital organs of the body like the liver.

Classic symptoms of Ischemic Hepatitis or Shock Liver apart from the patient being in a state of shock are nausea, vomiting, anorexia, and general malaise. Individuals with Ischemic Hepatitis or Shock Liver tend to have substantial increase in Liver Function Tests but with prompt treatment the levels of the LFT decreases steadily and get back to normal. Treating Ischemic Hepatitis or Shock Liver depends on the underlying cause but in most cases this condition is self limited and starts to normalize but the prognosis of the patient depends on the cause of Ischemic Hepatitis or Shock Liver.

As mentioned above, hypotension is the root cause of Ischemic Hepatitis or Shock Liver. If a patient has a medical condition that results in hypotension then it can also result in Ischemic Hepatitis or Shock Liver. Some of the conditions which may result in hypotension are:

• Cardiac arrhythmias
• Severe dehydration
• Congestive heart failure
• Infections
• Profuse bleeding due to any cause
• Blood clots in the hepatic artery post a liver transplant
• Vasculitis.

In cases of Ischemic Hepatitis or Shock Liver the presenting symptoms will be those of hypotension and include feelings of weakness and lightheadedness. If the period of low blood pressure or hypotension is only for a brief period of time then there may be no noticeable symptoms. Any damage done to the liver may not be noticeable until it starts affecting the function of the liver which can be seen in liver function tests. Some patients of ischemic hepatitis or shock liver may also experience severe abdominal pain due to clots present in the hepatic artery, especially in patients who have had a liver transplant.

In order to confirm the diagnosis of Ischemic Hepatitis or Shock Liver the following tests may be done:

• LFTs to check for levels of AST and ALT which will be significantly increased in such cases.
• Doppler ultrasound of the blood vessels of the liver

The above two tests along with the symptoms experienced by the patient and presence of hypotension is good enough to definitively diagnose the Ischemic Hepatitis or Shock Liver.

As mentioned above, treatment of Ischemic Hepatitis or Shock Liver is totally dependent on the underlying cause. Hypotension can be treated with medications and increased intake of salt in the diet. Prompt treatment is required for treating hypotension and blood clots as they are the most dangerous of the causes and can result in damaging results. If the underlying cause for Ischemic Hepatitis or Shock Liver is appropriately treated on time then the patient recovers in a few months time. Ischemic Hepatitis or Shock Liver causing death is extremely rare as in some cases liver failure is caused which can prove to be fatal due to Ischemic Hepatitis or Shock Liver. If a patient has consistent low blood pressures then he or she needs to seek treatment right away in order to prevent Ischemic Hepatitis or Shock Liver.