Liver failure Symptoms and Signs

In the course of liver failure, it have complex and diverse clinical symptoms because many organs involved. Acute onset, the rapid progress of this disease, common liver failure symptoms and signs is:

1. In Onset of 8 weeks, can occur hepatic encephalopathy, neuropsychiatric symptoms;
2. no signs of chronic liver disease;
3. At the same time, clinical manifestations is serious liver dysfunction;
4. conventional biochemistry and hematological tests showed liver cell dysfunction, an early increase in ALT, prothrombin extended time;
5. have hepatitis history or exposure to drugs, history of toxic-induced liver damage;
6. liver examination showed large liver cell necrosis.

Early symptoms of Acute liver failure, fulminant hepatic failure

1. Jaundice: There are three characteristics:
1) after the jaundice rapidly deepen in the short term, such as total bilirubin> 171μmol / L, liver function at the same time other manifestations of serious harm, such as bleeding tendency, prothrombin time, ALT increase and so on. If only deep jaundice, no other serious hepatic dysfunction, showing for the intrahepatic cholestasis;
2) jaundice lasted for a long time, the general dynamics for the deepening jaundice, sustained, three stages of regression, if the 2 ~ 3 weeks of jaundice is not to reclaim, prompted serious condition;
3) the emergence of the disease without jaundice improved, the general rules of acute jaundice hepatitis, when jaundice appears, the gradual improvement of appetite, reduce nausea and vomiting. Such as jaundice symptoms after 1 week without improvement, to be alert for severe hepatitis.

2. Continued low-grade fever: in early disease may have low-grade fever, jaundice after the temperature dropped to normal. With jaundice accompanied by persistent low-grade fever, suggesting that liver cell necrosis or endotoxemia.

3. weakness, fatigue, loss of appetite, and even unable to take care of themselves.

4. Gastrointestinal symptoms: frequent nausea, vomiting, hiccup, abdominal distention significantly, intestinal paralysis.

5. Hemorrhage: plaque deposition, such as the skin, purpura, epistaxis, gingival bleeding, a small number of upper gastrointestinal bleeding, suggesting that coagulation dysfunction, liver failure.

6. Ascites rapidly: because of the longer half-life of albumin (2 weeks), generally in the disease after 2 to 3 weeks only hypoalbuminemia, duration more than 2 to 8 weeks have ascites more.

7. To reduce the liver, liver bad, flapping wing-like tremor, muscle hypertonia, pyramidal tract symptoms positive, such as ankle clonus, suggesting that severe liver damage.

9. Increased heart rates, low blood pressure, and endotoxemia or internal bleeding.

The late symptoms of Acute liver failure, fulminant hepatic failure:

In the course of the late liver failure, mainly occur hepatic encephalopathy, and the following symptoms:

1. Cerebral edema: when ankle clonus, pyramidal tract symptoms, there was cerebral edema, or conjunctival edema, mydriasis fixed, slow breathing, irregular rhythm, showing optic disc edema are manifestations of brain edema.

2. Clotting dysfunction and bleeding: bleeding site to the skin, gum, nasal, conjunctival and mucosal common.
1) the quality and quantity of platelet abnormalities: FHF than normal platelet small, electron microscopy shows that vacuolization, pseudopodium, serosal fuzzy. No hepatic encephalopathy normal platelet. Due to bone marrow suppression, hypersplenism, intravascular coagulation was consumed, can induce thrombocytopenia.
2) synthesis of coagulation factors obstacles: the plasma coagulation factors were all reduced, particularly in extrahepatic factor Ⅶ synthesis, rather than increased. Significantly prolonged prothrombin time.
3) DIC with local secondary fibrinolysis: plasma activation of plasma endothelin and its material are reduced, and fibrin / fibrinogen degradation products increased.

3. Infection: The most common respiratory tract infections, other elements of the urinary tract infection, for G-bacteria, G + cocci, and anaerobic bacteria may also have fungal infection.

4. Renal failure: FHF abnormal renal function at 70%, accounting for half of acute tubular necrosis. Have a high urine sodium, urine and tubular necrosis isotonic. With liver cell necrosis, endotoxemia, diuretics applied inappropriately, gastrointestinal bleeding caused by low blood volume and low blood pressure and other factors. Renal failure reported cause of death in FHF in the first place, it is worth noting.

5. Electrolyte acid-base disorders: hyponatremia, hypocalcemia, hypomagnesemia, hypokalemia, respiratory alkalosis, low Xie alkalosis and metabolic acidosis and so on.

6. Other: hypoglycemia, hypoxemia, pulmonary edema, arrhythmia, and portal hypertension, such as acute pancreatitis.