Acute and Chronic Liver Failure

Abstract

For general surgeons, the early recognition of acute liver failure is as important as early referral to a tertiary unit, preferably a liver transplant unit, will facilitate medical management and provide the opportunity for liver transplantation. In Western countries, the most common cause is an overdose of acetaminophen, while in Asia and Africa, the most common cause is viral hepatitis, particularly hepatitis B. In chronic liver disease, the focus is on the management of complications of cirrhosis [decompensated cirrhosis] including bleeding varices, ascites, spontaneous bacterial peritonitis and hepatic encephalopathy. There is also the issue of risks of elective and emergency surgery in patients known to have liver disease including cirrhosis.