Concept of the clinical stages of acute hepatic failure

Serial medical diagnostic imagings were performed on 15 patients with acute hepatic failure to compare liver size and clinical picture. In patients showing hepatatrophy at the onset of coma, the interval between the onsets of disease and coma was long, ascites and edema supervened, high total bilirubin and low glutamic pyrubic transaminase levels tended to be found, and prothrombin time did not respond to treatment. All of these patients died. Based on liver size changes in patients who survived acute hepatic failure, acute hepatic failure was assumed to be classified into swelling, reduction, and recovery stages. The shorter the interval between the onsets of disease and coma, the earlier coma and prolonged prothrombin time occurred before hepatatrophy. In acute hepatic failure, signs of hepatic failure develop with various histological pictures and it is very important to institute the treatment before the liver is atrophied.