According to "Medical Surgical Nursing" the liver performs more than 400 functions, which makes it an extremely vital organ. Destruction of liver tissue eventually results in liver failure. This disease progresses over time and complications may arise as a result of severe liver failure. Many complications relate to the structure and function of the liver. Although there are several common signs of advanced liver failure, not all occur with every liver failure patient.
Ascites
Ascites refers to the accumulation of fluid in the abdominal cavity. According to the University of Maryland Medical Center, ascites results in distension of the abdomen. Ascites buildup causes abdominal pressure, bloating, tightness of the skin, pain and shortness of breath. Fluid may also build up in feet and legs due to water and sodium retention caused by abdominal ascites.
Portal Hypertension and Bleeding
Portal hypertension is high blood pressure within the portal vein of the liver. The increase in pressure is caused by a blockage in the blood flow through the liver. Increased pressure in the portal vein causes blood to back up into the veins in the stomach, esophagus and intestines, causing them to become engorged with blood. These dilated veins run the risk of rupture, and patients with liver failure have an increased risk of hemorrhage. Liver failure also prevents the absorption of vitamin K, which is necessary for clotting. Without enough vitamin K, the risk of internal bleeding further increases.
Hepatic Encephalopathy
The liver filters and cleans many toxins both ingested and produced in the body. When liver failure occurs, the liver becomes unable to perform this function properly. Toxins, in particularly ammonia, build up in the blood stream and cause several changes to thought processes. This condition is known as hepatic encephalopathy. The University of Maryland Medical Center list symptoms to include confusion, drowsiness, impaired judgment, loss of consciousness, personality changes, and possible coma and/or death.
Cholestasis and Jaundice
Cholestasis refers to the impaired flow of bile to and from the liver. Bile is produced by the liver and then stored in the gallbladder where it is later released to help digest food in the intestines. This backup of bile causes several symptoms associated with liver failure. Cholestasis symptoms include jaundice, or yellowing of the skin and whites of the eyes, pale-colored bowel movements, dark urine, bleeding, chills, itchy skin, spider veins and pain.
Hepatorenal Syndrome
Hepatorenal syndrome describes sudden kidney failure in the patient with advanced liver failure. This syndrome occurs in patients with no previous problems with the kidneys. According to the American Academy of Family Physicians, the exact cause of this syndrome remains unknown, but it is thought to occur due to the impaired blood flow resulting from liver failure. Hepatorenal syndrome damage is usually irreversible and may require the need for dialysis to sustain life.
References
- University of Maryland Medical Center: Liver Disease
- American Acadmey of Family Physicians: Cirrhosis and Chronic Liver Failure Part II
- "Medical Surgical Nursing"; Ignatavicius, D. MSN, Workman, L. PhD.; 2002
