Ischemic hepatitis

Ischemic hepatitis (also known as shock liver) is a condition of decreased blood supply to the liver resulting in injury to liver cells (hepatocytes), marked by sudden elevation of liver function tests. ^[1] The decreased blood flow (perfusion) to the liver is usually due to shock or low blood pressure. However, local causes involving the hepatic artery that supplies oxygen to the liver, such as sickle cell crisis and thrombosis of the hepatic artery, can also cause ischemic hepatitis. Patients with ischemic hepatitis are usually very ill.

Diagnosis and presentation

Blood testing usually shows high levels of the liver transaminase enzymes, AST and ALT, which may exceed 1000 U/L.^[2] Normal limits for ALT is usually 63 U/L, depending on the lab. These increased lab values are due to the injured hepatocytes leaking out these enzymes into the blood stream.

People who develop ischemic hepatitis may have pain in the right upper part of the abdomen, but they usually feel more unwell because of the serious reason that they developed the ischemia, than due to the ischemic hepatitis itself. Jaundice can occur, but is rare and transient, as is actual loss of function of the liver.

Related conditions

Ischemic hepatitis is related to another condition called congestive hepatopathy or nutmeg liver, which is a backflow condition due to poor drainage of the liver, usually due to heart failure. As a result, the two entities can co-exist.

See also

• Elevated transaminases

References