Liver failure.

Abstract

Hepatic failure emerging in a patient after injury is generally manifested as cholestatic jaundice. It differs in several important respects from hepatic failure, as it is understood to present in alcoholic or posthepatitic patients. Sepsis is the etiology of the hepatic failure in the overwhelming majority of patients who die following posttraumatic organ failure. Therefore, aggressive attempts to localize and eradicate infected foci are the foundation of treatment. Exploratory laparotomy will be a necessary diagnostic and therapeutic maneuver in many of these patients and will yield a 50 per cent rate of improvement and survival of patients.