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    Hepatic ischemia

    Ischemic hepatitis; Shock liver

    Hepatic ischemia is a condition in which the liver does not get enough blood or oxygen, causing injury to liver cells.

    Causes

    Low blood pressure from any condition can lead to hepatic ischemia. Such conditions may include:

    • Abnormal heart rhythms
    • Dehydration
    • Heart failure
    • Infection
    • Severe bleeding

    Other causes may include:

    • Blood clots in the main artery to the liver (hepatic artery) after a liver transplant
    • Swelling of blood vessels leading to reduced blood flow (vasculitis)

    Symptoms

    If low blood pressure continues for a long time, you may feel weak and lightheaded. However, the period of low blood pressure may be brief and produce no symptoms. Damage to the liver cells usually does not cause symptoms until it affects liver function.

    Blood clots in the liver's main artery may cause abdominal pain.

    Exams and Tests

    The following tests will be done:

    • Blood tests to check liver function (AST and ALT )
    • Doppler ultrasound of the liver's blood vessels

    Treatment

    Treatment depends on the cause. Low blood pressure and blood clots must be properly treated.

    Outlook (Prognosis)

    Patients generally recover if the illness causing hepatic ischemia can be treated. Death from liver failure due to hepatic ischemia is very rare.

    Possible Complications

    Liver failure is a rare but life-threatening complication.

    When to Contact a Medical Professional

    See your health care provider right away if you have persistent weakness or symptoms of shock or dehydration.

    Prevention

    Quickly treating the causes of low blood pressure may prevent hepatic ischemia.

    References

    Hauser SC. Vascular diseases of the gastrointestinal tract. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 145.

    Stevens WE, Patil A. Vascular disease of the liver. In: Feldman M, Friedman LS, Brandt LJ eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 83.

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    • Liver blood supply

      illustration

      • Liver blood supply

        illustration

      A Closer Look

        Tests for Hepatic ischemia

          Review Date: 8/10/2012

          Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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          St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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