Fluminant Hepatic Failure
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GENERAL INFORMATION:
What is it? Fulminant hepatic failure is also called "FHF" or acute liver failure. FHF happens when liver cells are injured and die. These liver cells are replaced by scar tissue instead of normal liver cells. This death of liver cells continues until there are not enough liver cells to do their job. The liver stops working all of a sudden and causes encephalopathy (n-seh-fuh-law-puh-thee) within 2 to 12 weeks. Encephalopathy is when your mind becomes more and more confused. This may cause your behavior to be out of control. With time, you may go into a coma and die.
Where is the liver and what does the liver do? The liver is in the right side of your chest behind your ribs and below your right lung. The liver has several jobs. It makes bile which helps to digest (break down) the food you eat and turn it into energy. The liver also cleans foreign (for-un) things from the body, such as drugs, alcohol, and other chemicals.
Causes: The most common cause of FHF is viral hepatitis. A drug overdose, such as acetaminophen or Tylenol®, may cause FHF. Other causes may be eating some natural products such as some mushrooms or medicinal herbs. Or, you can get FHF if you are exposed to toxic chemicals or poisons. Sometimes it is not known what causes FHF.
Signs and Symptoms:
- Ascites (uh-sih-tees) which is swelling of the abdomen (belly) when too much fluid builds up inside.
- Bruising and bleeding very easily.
- Dark tea-colored urine.
- Light colored stools (BMs).
- Fatigue (feeling tired) and weakness.
- Itchy skin.
- Irritated (upset), confused, and not thinking clearly.
- Jaundice (jon-diss) which is yellow skin, eyes, and gums.
- Loss of appetite.
- Nausea (upset stomach) and vomiting (throwing up).
- Swollen feet and legs. This is called edema.
Care: If the cause is found and can be treated, FHF can be stopped. Liver damage cannot be reversed but symptoms can be lessened and controlled. Most people with FHF will need a liver transplant. Caregivers will treat the symptoms of liver failure while you are waiting for a liver transplant.
- One or more of the following tests may be needed to help caregivers decide on the best treatment plan for you.
- Blood and urine tests.
- Doppler ultrasound.
- Esophagoduodenoscopy (e-saw-fuh-go-du-ah-duh-nah-skuh-p) or "EGD."
- Liver biopsy (bi-op-c).
- Upper GI series.
- CT SCAN
- Blood and urine tests.
- Your treatment may change if your FHF is not being controlled. This is often decided after you have tests. You may have some of the following treatments alone or together.
- Different medicines may be used to treat the side effects of liver failure. Some of these medicines work in the following ways.
- Cleaning the body of toxins that the liver normally removes, such as ammonia.
- Helping the extra fluid in your brain, legs, feet, and abdomen (belly) move back into the blood stream.
- Helping to stop diarrhea and make it easier to eat.
- Lessening bleeding from ulcers.
- Getting rid of extra bile salts that cause skin itching.
- Cleaning the body of toxins that the liver normally removes, such as ammonia.
- Caregivers may put you on a special diet to lessen the protein and sodium you eat and drink. This diet will also make sure you get enough calories for energy.
- Caregivers may put you on vitamins but do not take vitamins without your caregivers OK.
- Paracentesis (pair-uh-sen-t-sis) is a procedure to remove extra fluid from your abdomen (belly) so you can breathe easier.
- Kidney dialysis (di-al-ih-sis).
- Liver transplant.
- Different medicines may be used to treat the side effects of liver failure. Some of these medicines work in the following ways.
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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