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Published on: August 7, 2012
Current concepts in ischemic hepatitis
Joseph M Lightsey1, Don C Rockey
1Department of Internal Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Ischemic hepatitis, a liver injury from poor blood flow, is linked to heart disease and critical illness. Treatment focuses on the underlying cause of low blood pressure to improve outcomes.
Area of Science:
- Hepatology
- Cardiology
- Critical Care Medicine
Background:
- Ischemic hepatitis is a liver injury often seen in critically ill patients.
- It is frequently associated with cardiovascular disease, circulatory, or respiratory failure.
- A 'two-hit' mechanism involving systemic hypoperfusion and ischemia is proposed.
Purpose of the Study:
- To define ischemic hepatitis and its comorbidities.
- To review its pathophysiology, clinical presentation, course, and outcomes.
- To explore potential therapeutic strategies.
Main Methods:
- Literature review of ischemic hepatitis.
- Analysis of studies on pathophysiology and clinical presentation.
- Examination of treatment and outcome data.
Main Results:
- A strong link exists between cardiovascular disease and ischemic hepatitis risk.
- Hepatic congestion may predispose the liver to hemodynamic injury.
- Ischemic hepatitis can lead to acute liver failure and is associated with high mortality.
Conclusions:
- Ischemic hepatitis is a complication of critical illness stemming from hemodynamic disturbances.
- Treatment targets the underlying cause of hypotension.
- Predicting mortality and improving outcomes remain areas for further research.
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