Liver Failure | Symptoms & Causes
What causes acute liver failure?
In many cases, doctors are unable to determine the cause of acute liver failure.
When the cause is known, the most common cause is taking too much acetaminophen, the active ingredient in Tylenol and other cold medications. Acetaminophen can damage the liver after one large dose or after a child takes more than the recommended dose for several days in a row.
Other prescription medications and even some herbal supplements, such as kava, ephedra, skullcap, and pennyroyal, can also cause acute liver failure.
In a small number of cases, acute liver failure is caused by a viral infection such as herpes simplex or Epstein-Barr.
What causes chronic liver failure?
Chronic liver failure occurs when a long-term illness damages the liver. The following liver conditions can lead to chronic liver failure:
- biliary atresia, when a child is born with blocked or damaged bile duct, the tube that bile, fluid produced by the liver, flows through on its way to the intestines
- metabolic liver diseases like Wilson disease in which the body is unable to process copper from food and the copper builds up in the liver.
- chronic viral hepatitis C, which causes the liver to swell and encourages scar tissue to form
What are the symptoms of liver failure?
Jaundice, a yellow discoloration of the skin and eyes, is usually the first and sometimes the only sign of liver disease. Other symptoms include:
- confusion or disorientation
- pain or tenderness in the upper right abdomen
- weakness
- fatigue
- nausea
- vomiting
- dark urine
- easy bleeding
- itching
- small, spider-like vessels visible in the skin
- chills
What are the complications of liver failure?
Liver failure may cause:
- Liver encephalopathy: a drop in brain function caused by the buildup of toxic substances in the blood
- Jaundice: a yellow discoloration of the skin and whites of your child's eyes due to an abnormally high level of bilirubin (bile pigment) in the bloodstream
- Coagulopathy: a bleeding disorder that happens when blood does not clot and can result in excessing bleeding from even a small cut
- Portal hypertension: abnormally high blood pressure in the vein that brings blood from the intestine to the liver (the portal vein), that can cause a distended abdominal cavity (ascites), prominence of abdominal wall veins, or bleeding of the varicose veins at the lower end of the esophagus or the stomach lining
- Ascites: the build up of fluid in the abdominal cavity caused by fluid leaks from the vessels on the surface of the liver and intestine that can make a child feel short of breath
- Hepatomegaly: an enlarged liver that may cause abdominal pain or a feeling of fullness
Liver Failure | Diagnosis & Treatments
How is liver failure diagnosed?
To diagnose liver disease, clinicians typically consider the child’s symptoms and conduct a physical examination. The following tests are often part of the diagnostic process.
Blood tests
A sample of the child's blood may be tested for the following signs of liver disease:
- albumin, a protein made by the liver and found in the bloodstream & lower-than-normal levels are associated with many liver disorders.
- bilirubin, a substance produced by the liver and excreted in the bile. Elevated levels of bilirubin indicate a problem with the liver.
- liver enzymes, elevated levels of liver enzymes can alert physicians to liver damage or injury.
- prothrombin time (PT) test, measures the time it takes for blood to clot. Since blood clotting requires vitamin K and a protein made by the liver, liver cell damage and bile flow obstruction can interfere with proper blood clotting.
Abdominal ultrasound (also called sonography) enables clinicians to view a child's liver function and assess blood flow through various vessels.
Liver biopsy, a procedure that takes a small sample of liver tissue to be examined under a microscope. Besides helping diagnose liver disease, a biopsy can give doctors a better idea of the extent of damage and make decisions about the best treatment for the child.
Computerized tomography scan (CT or CAT scan), a diagnostic imaging procedure, uses a combination of x-rays and computer technology to show a detailed image of internal organs such as the liver. Images from a CT scan is more detailed than an x-ray alone.
How is liver failure treated?
Treatment depends on many factors, including the stage of liver failure and underlying cause. While a healthy liver can recover from damage or illness, acute or chronic liver failure are both severe conditions that often cannot be reversed. In many cases, the only option for a child with liver failure is a liver transplant. Doctors will work with the family to stabilize the child’s condition while they wait for the donation of a healthy liver.
Treatment for a child on a liver transplant wait list may include:
- treating the underlying condition that caused the initial damage
- treating the side effects of liver failure
