title: "Acute Liver Failure"
Acute Liver Failure
Key Facts
Acute liver failure is new liver injury with INR ≥1.5 and encephalopathy in a patient without pre-existing cirrhosis.
Paracetamol (acetaminophen) overdose is a leading cause of acute liver failure in many settings.
Overview
This article covers definition, common causes, and initial ED priorities.
Definition
- Acute liver injury (days–weeks) without chronic liver disease
- Coagulopathy (INR ≥1.5) + any degree of encephalopathy
Common causes
- Paracetamol toxicity
- Viral hepatitis
- Ischaemic hepatitis (“shock liver”)
- Drug-induced liver injury (DILI)
ED priorities
- ABCs, glucose, temperature, haemodynamics
- Treat the cause early (e.g., NAC for paracetamol)
- Early senior/ICU involvement; consider transplant centre referral for severe cases
Sources
- CC Bible
- Local toxicology guidance
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Related Topics
See also: Paracetamol Overdose, Approach to the Poisoned Patient