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Ischemic Hepatitis

By

Whitney Jackson

, MD, University of Colorado School of Medicine

Last full review/revision May 2020| Content last modified May 2020
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Topic Resources

Ischemic hepatitis is damage throughout the liver caused by an inadequate blood or oxygen supply.

  • Heart or respiratory failure may reduce the blood flow or oxygen supply to the liver.

  • People feel nauseated and vomit, and the liver may be tender and enlarged.

  • Doctors may do imaging tests to look for the cause.

  • Doctors treat the condition that is reducing blood flow to the liver.

In ischemic hepatitis, liver cells are damaged or die because the liver does not receive enough blood or oxygen.

Ischemic hepatitis differs from other types of hepatitis. Usually, “hepatitis” implies inflammation of the liver, which can have many causes, most commonly a virus (as in hepatitis A or B Overview of Hepatitis Hepatitis is inflammation of the liver. (See also Overview of Acute Viral Hepatitis and Overview of Chronic Hepatitis.) Hepatitis is common throughout the world. Hepatitis can be Acute (short-lived) read more ). However, in ischemic hepatitis, the liver is not inflamed. Rather, liver cell death (necrosis) occurs. The term hepatitis is used because technically, it refers to any disorder in which liver enzymes called aminotransferases leak from damaged liver cells into the blood.

Causes of Ischemic Hepatitis

Ischemic hepatitis develops when the liver’s requirements for blood, oxygen, or both are not being met.

Decreased blood flow throughout the body is the most common cause for such unmet needs. Blood flow may be decreased by the following:

Decreased oxygen levels in the body, as may result from prolonged, severe respiratory disorders, can also cause ischemic hepatitis.

Blocked blood vessels can cause hepatic ischemia but only when both the hepatic artery and the portal vein are narrowed or blocked. Ischemia does not develop when only one of these blood vessels is narrowed or blocked because the liver receives blood from both the hepatic artery and portal vein, and the blood vessel that is not blocked continues to supply the liver with blood.

The most common cause of blocked blood vessels is a blood clot. (Blockage by a blood clot is called thrombosis.) Blood clots in the hepatic artery can have many causes, such as the following:

Symptoms of Ischemic Hepatitis

Diagnosis of Ischemic Hepatitis

  • Liver blood tests and blood-clotting tests

  • Sometimes imaging tests

Doctors suspect ischemic hepatitis when results of liver blood tests (done to determine how well the liver is functioning and whether it is damaged) and/or blood clotting tests are abnormal in people who have a condition that can cause the disorder.

Treatment of Ischemic Hepatitis

  • Treatment of underlying condition

Doctors focus on treating the condition that is reducing blood flow to the liver. If blood flow can be restored, ischemic hepatitis commonly resolves.

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