Ischemic hepatitis

Overview
Ischemic hepatitis (also known as shock liver) is a condition of decreased blood supply to the liver resulting in injury to liver cells (hepatocytes), which occurs in a diffuse fashion.

The decreased blood flow (perfusion) to the liver is usually due to shock or low blood pressure. However, local causes involving the hepatic artery that supplies oxygen to the liver, such as sickle cell crisis and thrombosis of the hepatic artery, can also cause ischemic hepatitis. Patients with ischemic hepatitis are usually very ill.

Blood testing usually shows high levels of the liver transaminase enzymes, AST and ALT, which may exceed 1000 U/L. People who develop ischemic hepatitis may have pain in the right upper part of the abdomen, but they usually feel more unwell because of the serious reason that they developed the ischemia, than due to the ischemic hepatitis itself. Jaundice can occur, but is rare and transient, as is actual loss of function of the liver.

Ischemic hepatitis is related to another condition called congestive hepatopathy or nutmeg liver, which is a backflow condition due to poor drainage of the liver, usually due to heart failure. As a result, the two entities can co-exist.