Clinical Case Database / Category: Case Based Discussion

A case of fulminant liver failure

Publication details

Shyam Menon MBBS, MRCP, Alan Bohan MBBChBAO, MD, MRCPI, HDipHRM
Foundation Years Journal, volume 1, issue 3, p.98 (123Doc Education, London, June 2007)

Abstract

A 75-year-old retired miner with diffuse pulmonary fibrosis presented to the medical assessment unit with a 24-hour history of confusion and agitation. He had been admitted to the hospital 4 weeks before with chest pain. Acute cardiac and respiratory caused were excluded and he was discharged from the unit on Paracetamol, 1g 6-8 hourly as required. Examination demonstrated jaundice, asterixis and Grade III hepatic encephalopathy. He had no stigmata or signs of chronic liver disease or its complications.

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Authors

Shyam Menon MBBS, MRCP

SpR in Gastroenterology
Department of Gastroenterology
University Hospital North Staffordshire
Stoke-on-Trent

Alan Bohan MBBChBAO, MD, MRCPI, HDipHRM (Corresponding author)

Consultant Hepatologist
Department of Gastroenterology
University Hospital North Staffordshire
Stoke-on-Trent

References

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2.  Ellis A,Rhodes A,Jackson N et al. Acute Liver Failure (ALF) in a specialist intensive care unit ; a 7 year experience. Crit Care 1998;2(S1):50

3.  Jalan R. Acute Liver Failure;current management and future prospects. JHepatol 2005 42(S1):S115-23

4.  Damme PV, Tormes G, Beutels P et al. Hepatis B in Europe:a preliminary economic evaluation. Vaccine 1995;13:S54-7

5.  Davenport A, Will EJ Dawson AM et al. Changes in intracranial pressure during hemofitration in oliguric patients with grade IV encephalopathy. Nephron 1989;53:142-46

6.  Rolando N, Gimson A, Wade J et al.Prospective controlled trial of selective enteral and parenteral antimicrobial regimes in fulminant hepatic failure. Hepatology 1993;17:190-201

7.  Chapman RW, Forman D, Peto R et al.Liver Transplantation for Acute Hepatic Failure. Lancet 1990;335:32-5

8.  O’Grady J, Alexander G, Hayllar K et al. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 1989;97:439-45

9.  Jalan R, Olde SW, Hayes PC et al. Ammonia-induces brain oedema and intracranial hypertension in acute liver failure; inflmmation, ammonia and cerebral blood flw. J Hepatol 2004;41:613-20

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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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