Acute cholestasis, hepatic failure, and fatty liver in the alcoholic

Three alcoholic patients are described who presented with acute cholestasis and liver cell failure. In each patient the liver biopsy showed severe fatty change with cholestasis, but without typical alcoholic hepatitis. There was no evidence of extra-hepatic biliary obstruction, although one patient had chronic pancreatitis. Two of the three patients died of hepatic failure, but the third recovered and has remained well while abstaining from alcohol.