Liver failure
• Breakdown of liver functions• Inability of the liver to perform its normal function
• Synthetic and metabolic
• Partial/global
• (de)compensated
• Acute LF – without preexisting liver disease
• Chronic LF – with preexisting liver disease
• Acute on chronic LF – sudden necrotising episode
ALF
ALF
ALF
ALF
ALF
ALF
ALF
• Jaundice
• Hepatic foetor
• Fever
• Changed liver size
• Cerebral edema
• Encephalopathy
• Coagulation disorders
• Bilirubin, liver enzymes, renal failure
ALF
• Complications• MOF
• Neurological (encephalopathy)
• Cardiovascular (hypotension)
• Pulmonary (edema)
• Bleeding (coagulopathy)
• Infections (immunosupression)
ALF
ALF
CLF
• Causes• ALD
• NASH
• Chronic hepatitis B, C
• Primary biliary cirrhosis
• Hemochromatosis
• Wilson's disease
• Cardiac cirrhosis
• Autoimmune hepatitis
• Primary sclerosing cholangitis
CLF
• the liver does not function properly due to long-term damage• Hypogonadism (SHBG)
• Fetor hepaticus• Dimethyl sulfide
• Splenomegaly
Jaundice
Ascites
Spider nevi
Palmar erythema
Gynecomastia
Esophageal varices
Caput medusae
CLF
Scores
Scores
Cirrhosis
Cirrhosis
Cirrhosis
Cirrhosis
Cirrhosis
Portal hypertension
Portal hypertension
Hepatorenal syndrome
ALD
NAFLD
NAFLD
NAFLD
NAFLD
NAFLD
NAFLD
ACLF
ACLF