liver injury



Overview

What is Liver Injury?

Definition

Liver injury is an abnormality in the structure or function of liver cells caused by various factors.

It can be caused by external violence, as well as alcoholic, fatty, pharmacologic, and autoimmune factors that result in damage to liver cells.

Classification

Classification according to the speed of disease progression

Acute liver injury: rapid onset and rapid progression of liver injury.

Chronic liver injury: sustained damage to liver cells over a long period of time (usually more than 6 months).

Classification according to the cause

Traumatic liver injury: Liver injury caused by an external blow. According to whether there is an open wound, it can be divided into open liver injury and closed liver injury.

Non-traumatic liver injury: liver injury caused by non-traumatic factors, such as drug liver injury, alcoholic liver injury, etc.

Morbidity

Traumatic liver injury accounts for 15% to 20% of abdominal injuries.

Acute drug liver injury in China accounts for about 20% of the proportion of acute liver injury hospitalization.

Women taking certain drugs (e.g., minocycline, methyldopa) are more prone to drug-related liver injury.

Women’s livers are more sensitive to the toxic effects of alcohol, and a history of smaller doses and shorter periods of alcohol consumption may result in more severe alcoholic liver injury compared to men.

Questions you may be concerned about

How is liver injury treated?

Liver injury is mainly treated with surgery, allopathic and symptomatic treatment.

Traumatic liver injury should be treated with early surgery.

Alcoholic liver injury should quit drinking as early as possible.

Fatty liver injury should adjust the dietary habits, mainly low-fat diet.

Pharmacological liver injury should adjust drugs or reduce drug dosage under doctor’s guidance, and use liver protective drugs appropriately.

Viral liver injury mainly adopts antiviral drugs such as cytarabine and acyclovir.

Bacterial liver injury is mainly treated with antibiotics such as cephalosporin.

Can drug-induced liver injury heal on its own?

Whether or not a drug-induced liver injury can heal on its own depends on the severity of the liver injury, whether or not the drug was stopped in time, and the duration and dosage of the drug used.

If the liver injury is caused by the use of less toxic drugs within a short period of time, it can often be cured after early diagnosis and timely discontinuation of the drugs.

If the drug liver injury for a longer period of time, drug toxicity, liver damage, such as long-term use of drugs caused by liver fibrosis, cirrhosis, or even lead to liver failure and other cases can not be self-healing.

How long does it normally take to recover from liver injury?

The specific recovery time of liver injury is related to the cause of damage.

Alcoholic liver injury can be recovered in about 2 weeks after abstaining from alcohol and taking medication to protect the liver.

Liver injury caused by viral hepatitis requires liver-protecting treatment combined with antiviral treatment. Acute hepatitis A can be recovered in 1 to 2 months; chronic hepatitis requires antiviral treatment and can be recovered in a few months.

Drug-induced liver injury with mild symptoms will recover in a few days after stopping the drug; severe cases may also have liver dysfunction after stopping the drug, and the recovery time will be longer.

Causes

Causes

Trauma

Impact (e.g., car accident, fall) or penetrating injuries (e.g., knife or gunshot wounds) that will directly cause damage to the liver.

Infection

Infections such as viral, bacterial, fungal, and parasitic infections can lead to liver damage.

Hepatotoxic substances

Alcohol: The metabolism of alcohol takes place mainly in the liver, and alcohol abuse will lead to chronic liver damage.

Some drugs and poisons: Drugs or poisons that enter the body are generally metabolized or detoxified by the liver. If there is an overdose of drugs or poisons or a decrease in the liver’s detoxification ability, liver cells will continue to be damaged and die, leading to the development of liver damage.

Autoimmunity

Autoimmune diseases may cause damage to liver cells, leading to the development of liver injury. Common examples include autoimmune hepatitis, IgG4-related hepatitis, and systemic lupus erythematosus.

Others

Cardiovascular diseases such as chronic right heart failure and chronic constrictive pericarditis may cause long-term stagnation and hypoxia in the liver, leading to hepatocellular damage and necrosis, causing liver injury.

Genetic and metabolic diseases, such as hepatomegaly, hemochromatosis, etc., can lead to metabolic disorders of liver cells and cause liver injury.

Pathogenesis

Trauma

The liver is the largest parenchymal organ and the largest gland in the human body. The liver has a rich blood supply and a brittle texture. External blows may cause varying degrees of hepatic injury; relatively minor hepatic injuries may result in an accumulation of blood within the liver (hematoma), and severe hepatic injuries may result in a large tear within the liver.

Infection

Some pathogens themselves can secrete toxins that cause damage to liver cells. Some pathogens (e.g., hepatitis B virus) do not damage liver cells themselves, but viral infection of liver cells changes the surface morphology of liver cell membranes and stimulates the immune system to attack the liver cells, leading to liver injury.

Hepatotoxic substances

Hepatotoxic substances themselves and their metabolites can cause direct damage to the liver, and further cause immune-inflammatory reactions, resulting in severe damage to the liver.

Autoimmunity

Autoimmune diseases may lead to disorders of immune regulation and the production of autoantibodies, some of which can cause persistent damage to liver cells, leading to degeneration and necrosis.

Predisposing factors

Age

Children and the elderly are more prone to liver injury.

Pregnancy

In order to adapt to the needs of pregnancy, the structure and function of the liver change, increasing the burden on the liver. Meanwhile, changes in hormone levels and metabolism during pregnancy can also induce liver disease, making the liver more susceptible to injury.

Underlying Diseases

Patients with underlying chronic liver disease have impaired liver function and are more prone to liver injury, such as viral hepatitis.

Symptoms

Traumatic liver injury

Abdominal pain

Abdominal pain is persistent, with ipsilateral shoulder involvement pain, usually not serious.

If there is bile overflow into the abdominal cavity, abdominal pain and signs of peritoneal irritation are more obvious.

Blood loss

Blood loss is related to the degree of liver rupture and the amount of bleeding, the greater the blood loss, the more serious the patient’s symptoms.

Usually, patients show pale face, decreased blood pressure, and oliguria, and hemorrhagic shock symptoms such as decreased body temperature, unconsciousness, and respiratory distress may occur with large amount of bleeding in a short period of time.

Blood may sometimes enter the duodenum through the bile duct, and the patient may have black stools or vomit blood.

Non-traumatic liver injury

In the early stage of liver injury, patients may have no obvious symptoms, mostly showing nonspecific symptoms such as loss of appetite, weakness, dyspepsia, weight loss, etc. With the aggravation of liver injury, patients gradually show symptoms of impaired liver function.

Jaundice

It manifests as yellowish coloration of sclera and skin.

Urine is dark yellow and resembles strong tea.

Bleeding tendency

There may be bleeding from the mouth and nose.

Purple spots or hemorrhages appear on the skin.

Women often have increased menstruation.

Endocrine disorders

Hypogonadism and breast development in men.

Women may experience amenorrhea and infertility.

Other symptoms

Spider nevus: Spider nevus may appear on the skin surface, i.e., pinpoint red spots appear on the skin, with multiple red lines radiating out from the center of the spots extending in all directions, resembling spiders; the center of the spots is slightly elevated, and when the center of the spots is pressed by the tip of a pen, the red lines around the spots will fade away, and the color will return when the pen is released. Mostly seen on the face, neck and forehead.

Liver palms: reddening of the skin in the palms of the hands at the major and minor fissures, with fading of color after pressure.

Itchy skin: Itchy skin usually occurs and patients often scratch the skin involuntarily.

Right upper abdominal pain: pain may be felt in the right upper abdominal liver area.

Complications

Hemorrhagic shock: severe traumatic liver injury can lead to massive bleeding, which can easily trigger hemorrhagic shock, with symptoms such as drop in body temperature, indifference, drop in blood pressure, coma, etc., and even lead to death.

Acute peritonitis: traumatic liver injury may lead to direct inflow or extravasation of bile into the peritoneal cavity, causing acute peritonitis, which may be manifested as mild abdominal pain, or severe abdominal pain, accompanied by abdominal mass, fever, or even coma.

Cirrhosis: long-term liver injury may lead to cirrhosis, in addition to the symptoms of liver injury, there may be ascites, vomiting blood, black stool, blood in stool, change of consciousness and other symptoms.

Liver failure: liver failure will be caused when liver injury is serious, which may result in extreme fatigue, rapid aggravation of jaundice in a short period of time, lowering of blood pressure, oliguria or anuria, and hepatic encephalopathy manifestations such as vomiting, lethargy, mental confusion, and behavioral disorders in some patients.

Portal hypertension: manifestations such as splenomegaly, ascites and esophageal varices.

Consultation

Department of Medicine

Gastroenterology

When abnormalities related to liver function are found in routine physical examination, or symptoms such as unexplained right upper abdominal pain, jaundice, fatigue, loss of appetite, etc., it is recommended to consult a doctor promptly.

Emergency Medicine

If you feel abdominal pain after trauma, or if you develop symptoms such as severe abdominal pain and drop in blood pressure, it is recommended that you consult a doctor immediately.

Preparation for medical treatment

Preparation for medical consultation: registration, preparation of documents, and common problems

Tips for seeking medical treatment

Before seeking medical treatment, try to record the symptoms you have experienced, their duration, etc. for the doctor’s reference.

Preparation List

Symptom list

Pay particular attention to the time of onset of symptoms, special manifestations, etc.

What is the discomfort?

Any change in the color of urine?

Have you had bleeding gums or nosebleeds recently?

Any trauma to the abdomen?

Any fever, lethargy, or fatigue?

List of medical history

Have you had any liver or gallbladder diseases such as hepatitis, cirrhosis, or fatty liver in the past?

Have you had any related examinations or treatments?

Any history of drug allergy, etc.?

Have you taken any medications or been exposed to any chemicals recently?

Do you drink alcohol? How much do you drink every day? How long have you been drinking?

Checklist

Test results for the last six months, which can be brought to the doctor’s office

Blood test, urine test, stool test

Liver Function

Virology test

Alpha Fetoprotein

Coagulation Function

Abdominal Ultrasound, Abdominal CT, Abdominal MRI

Abdominal puncture, pathology report

Medication List

Medication used in the last 3 months, if available in boxes or packages, bring with you to the doctor’s office

Antimicrobials: cefuroxime, amoxicillin, vancomycin

Glucocorticoids: dexamethasone, prednisone acetate

Immunosuppressants and antitumor agents: azathioprine, cyclosporine, infliximab, cisplatin

Antihypertensive drugs: methyldopa

Chinese medicine: He Shou Wu, Tu San Qi

Diagnosis

Diagnosis is based on

Medical history

There may be a history of liver disease (e.g. hepatitis), blood circulation disease (e.g. constrictive pericarditis), autoimmune disease (e.g. systemic lupus erythematosus).

There may be a history of abdominal trauma, e.g., impact, knife wounds.

There may be a history of chronic alcohol consumption.

There may be a history of exposure to hepatotoxic drugs or other chemicals.

Clinical manifestations

Traumatic liver injury

Abdominal pain, pallor, decreased blood pressure, decreased urine output.

Abdominal pressure, rebound pain is obvious, abdominal muscle tension, may appear right upper abdomen mass.

Non-traumatic liver injury

There may be non-specific gastrointestinal symptoms (e.g. decreased appetite, dyspepsia), jaundice, liver palms, spider nevus, bleeding tendency, and manifestations of endocrine disorders.

Some of them may have enlarged liver and spleen or liver with hard texture, uneven surface with nodular sensation, tenderness, and positive abdominal mobile turbid sound.

In some cases, the subcutaneous veins of the chest and abdominal wall may be exposed or varicose, and even the veins around the umbilicus may protrude to form a jellyfish head; venous murmurs may be heard on auscultation of the varicose veins.

In the case of hepatic encephalopathy, there is bad breath and fluttering tremor (when the forearm and hand are stretched out horizontally, the fingers are spread out, and the wrist joints are kept fixed in a certain position, the fingers will tremble rapidly without rhythm).

Laboratory Tests

Routine blood tests

To find out the changes of red blood cells, white blood cells and platelets.

Can assess bleeding or anemia, determine the presence of infection, and assess coagulation function.

Fasting is not required.

Urine Routine Tests

Liver injury can cause an increase in urobilinogen.

Clean mid-stream urine should be retained for the test, i.e., a portion of the urine should be drained first, then a urine cup should be used to catch the urine, and then the remaining urine should be drained.

Fecal Occult Blood Test

To determine the presence of gastrointestinal bleeding.

Liver Function Test

Allows an overall assessment of liver function.

Test Indicators

Alanine aminotransferase (ALT), aspartate aminotransferase (AST): are the most commonly used indicators to determine the degree of liver cell damage. The more severe the degree of hepatocellular damage, the greater the increase in ALT and AST.

Bilirubin: including serum total bilirubin (TBil), combined bilirubin (DBil) and indirect bilirubin (IBil). Total bilirubin accurately reflects the degree of jaundice and is elevated in the presence of hepatobiliary abnormalities; conjugated bilirubin and indirect bilirubin can be used to identify the type of jaundice. Hepatocellular damage can lead to elevated serum bilirubin. In liver failure, serum bilirubin is elevated and ALT and AST are decreased.

Albumin and globulin: The liver synthesizes albumin, and if albumin levels fall, liver synthesis is impaired. As the disease worsens, the albumin to globulin ratio may gradually decrease.

γ-Glutamyl transpeptidase (γ-GTP): γ-GTP can be seen to be mildly or moderately elevated in acute hepatitis, chronic active hepatitis, and decompensated stage of cirrhosis; if cholestasis occurs, γ-GTP can be significantly elevated.

Alkaline phosphatase (ALP): mainly excreted through the hepatobiliary system, excessive production or impeded excretion can be elevated, which can be used to observe the development of the disease and treatment.

Total bile acids: can be elevated in cases of hepatocellular damage or obstruction of the intrahepatic or extrahepatic biliary system.

Cholinesterase: It can reflect the reserve function of the liver.

Precautions: Liver function tests require fasting, and the night before the test, after dinner, you need to temporarily prohibit eating and drinking until the blood is drawn.

Virology

Detection of hepatitis virus-related antibodies/antigens and genetic material (viral DNA or RNA) to determine the presence of hepatitis virus infection and help to clarify the cause of liver injury.

Tumor Marker Test

Alpha-fetoprotein (AFP) is suggestive for the diagnosis of hepatocellular carcinoma and can assist in determining the cause of liver injury.

Coagulation function test

Patients with liver injury may have coagulation dysfunction, and coagulation function test is needed to formulate diagnosis and treatment plan.

It usually includes activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), prothrombin time (TT), international normalized ratio (INR), and prothrombin activity (PTA).

Imaging

Ultrasonography

It is the most commonly used imaging method.

Abdominal ultrasound can determine the size and shape of the liver and spleen, the condition of important blood vessels in the liver, and whether there are any space-occupying lesions.

Precautions: Fasting is required before the abdominal ultrasound examination, and the night before the examination, you need to temporarily prohibit eating and drinking after dinner, and adjust the position during the examination according to the doctor’s instructions.

CT examination

CT examination can observe the shape, size and structure of the liver, and find out whether there is cirrhosis or space-occupying lesions.

If space-occupying lesions are found, it can also roughly determine whether they are benign or malignant.

Precautions

Fasting for at least 4 hours before the abdominal scanning and enhanced CT examination.

Remove any metal objects, such as headdresses, hairpins, keys, etc., from your body before the examination.

Magnetic Resonance Imaging (MRI)

MRI is not radioactive and shows structural changes in the liver with equal clarity.

With the help of contrast, dynamic enhancement scanning, etc., it can be more effective in distinguishing whether the occupying lesion is benign or malignant.

Precautions

Remove all metal objects from your body, including cell phones, keys, coins, watches, etc. before the examination.

During the examination, you will hear loud noises from the machine, please keep calm, breathe steadily and do not move your body in any way to avoid affecting the image quality.

Patients with pacemaker or defibrillator in their body, contrast allergy, or pregnant, please inform your doctor promptly.

Diagnostic Abdominal Puncture

Traumatic liver injury may lead to intra-abdominal hemorrhage. Diagnostic laparotomy is the gold standard for diagnosing intra-abdominal hemorrhage, with an accuracy rate of 90% to 98%, but laparotomy cannot determine the source of the hemorrhage or the damaged organ.

Generally, the extraction of non-coagulated blood can be considered to have internal organ damage.

Precautions: Urine should be emptied before the examination. After puncture, pay attention to the sterilization and care of the puncture site; if there is blood seepage or pain at the puncture site, the doctor must be contacted promptly.

Transient Elastography

Instantaneous elastography is a non-invasive test, based on ultrasound, with the advantages of convenience, speed and the ability to repeat the test several times.

The results are reliable and can accurately differentiate between mild liver fibrosis, progressive liver fibrosis or early cirrhosis, which is helpful in determining the cause and severity of liver injury.

Classification

Drug induced liver injury

Grade 0 (no liver injury): tolerable to drugs, no hepatotoxic reaction.

Grade 1 (mild hepatic injury): reversible elevation of serum ALT and/or ALP, TBil <2.5 times the upper limit of normal (42.75 μmol /L), and INR <1.5. Most patients can adapt, with or without symptoms such as malaise, weakness, nausea, anorexia, right upper abdominal pain, jaundice, itching, skin rash, or weight loss.

Grade 2 (moderate liver injury): elevated serum ALT and/or ALP, TBil ≥2.5 times the upper limit of normal, or INR ≥1.5 without elevated TBil. these symptoms may be exacerbated.

Grade 3 (severe liver injury): elevated serum ALT and/or ALP, TBil ≥ 5 times the upper limit of normal value (85.5 μmol/L), with or without INR ≥ 1.5. The patient’s symptoms may further worsen, requiring hospitalization or prolonged hospitalization.

Grade 4 (Acute Liver Failure): Elevated serum ALT and/or ALP levels, TBil ≥ 10 times the upper limit of normal (171 μmol/L) or ≥ 17.1 μmol/L per day, INR ≥ 2.0, or PTA < 40%, with concomitant ascites or hepatic encephalopathy, or other organ failure related to the drug-related liver injury.

Grade 5 (fatal): Death from drug-induced liver injury or need for liver transplantation for survival.

Differential Diagnosis

Liver injury is a pathological state of the liver caused by various factors, which can be diagnosed on the basis of imaging and biochemical parameters, and usually no differential diagnosis is needed, and the focus in the diagnosis of nontraumatic liver injury is on the cause of the liver injury.

Treatment

Traumatic liver injury: according to the patient’s general condition and the severity of the combined injury, a reasonable treatment plan should be determined. For simple liver injury, actively correcting hemorrhagic shock while actively preparing for surgery.

Non-traumatic liver injury: based on the protection of liver function, treatment for different causes.

Traumatic liver injury

Non-surgical treatment

Indications

Patients who are hemodynamically stable and have no other comorbid injuries requiring surgery.

In adult patients, hemodynamic stability is defined as a systolic blood pressure of 90 mmHg or more, without the need for large doses of fluids, blood transfusions and pressure-boosting medications to maintain it, and without signs of hemorrhagic shock such as signs of capillary constriction of the skin (cold skin, clammy skin), altered consciousness, and shortness of breath.

In pediatric patients, hemodynamic stability is defined as a systolic blood pressure greater than (70 + 2 x child’s age) mmHg or greater that responds to rehydration therapy.

Contraindications

Free gas in the retroperitoneum; free fluid in the abdominal cavity in the absence of parenchymal organ injury; limited thickening of the intestinal wall; bullet trajectory in patients with gunshot wounds close to surrounding cavity organs with hematomas; and patients with high-energy penetrating injuries detected on CT scan.

Treatment.

Bed rest, fasting, restriction of activity.

Fluid and blood transfusion to replenish circulating blood volume and correct electrolyte disorders.

Anti-infection treatment: use broad-spectrum antibiotics, such as amoxicillin.

Monitor coagulation function and determine whether supplemental coagulation factors, fibrinogen, etc. are needed according to the actual situation.

Monitor liver function and use hepatoprotective therapy if there is liver injury.

In some patients, selective hepatic arteriography can be used to find the bleeding foci and then embolization treatment, which is more effective.

Closely monitor the vital signs during treatment, and dynamically observe the changes of liver injury and intra-abdominal blood accumulation. If there is still a progressive decline in hemoglobin and circulatory instability after active rehydration, surgical treatment should be carried out immediately.

Surgical treatment

Indications

Patients with hemodynamic instability, other organ injuries requiring surgical treatment, and patients with contraindications to nonsurgical treatment.

Common Surgical Procedures

Different surgical styles are chosen according to the injury, such as debridement and suturing, hepatic artery ligation, hepatectomy, gauze tamponade, etc.

After surgery, a porous silicone double cannula is left in the trauma or perihepatic area, and negative pressure suction is performed to drain out the oozing blood and bile.

Postoperative care

For patients who use drainage tubes to drain after surgery, care should be taken that the drainage tubes are not pressurized, folded, etc. If the drainage bottle becomes blocked, please contact the doctor in time.

Keep the surgical incision dry. If the incision becomes painful or oozes blood, please contact the doctor promptly.

Non-traumatic liver injury

Some mild drug-induced liver injuries can be self-healed after stopping medication and do not require special treatment.

General supportive treatment

Bed rest, reduce physical exertion to reduce the burden on the liver.

Immediately stop using the suspected drugs, stop drinking alcohol.

Hepatoprotective treatment

Apply anti-inflammatory and hepatoprotective drugs (e.g. compound glycyrrhizin, diammonium glycyrrhizinate, etc.), hepatocyte membrane protectors (e.g. polyene phosphatidylcholine, etc.), detoxifying and hepatoprotective drugs (e.g. thiopronin, reduced glutathione, etc.), and cholagogues (e.g. arbutinic deoxycholic acid, fennel trisulfide, etc.).

Treatment of Causes

Different causes of liver injury are treated differently.

For those caused by hepatitis virus infection, interferon or nucleoside (acid) drugs (e.g. entecavir, tenofovir, etc.) can be used for antiviral treatment.

Those caused by some hepatotoxic drugs may be treated with specific therapeutic drugs, such as N-acetylcysteine for those caused by acetaminophen, and penicillin G and silymarin for those caused by muscarinic poisoning.

Glucocorticoid therapy (e.g., methylprednisolone) may be used for those not caused by viral infections, autoimmune diseases, acute alcoholism, as well as for those with drug-induced liver injury that does not improve after discontinuing hepatotoxic drugs, or for those whose disease progresses rapidly without serious complications such as infection or hemorrhage.

Non-biological artificial liver therapy

Through an extracorporeal device, various harmful substances are removed, essential substances are supplemented, and part of the functions of the liver are temporarily replaced, so as to create conditions for regeneration of liver cells and recovery of liver function or wait for the opportunity of liver transplantation.

Indications: patients with liver injury whose condition has progressed to liver failure or waiting for liver transplantation, PTA between 20%~40% is appropriate.

Relative contraindications: patients with severe active bleeding or disseminated intravascular coagulation; those who are highly allergic to blood products or medicines used in the course of treatment, such as plasma, heparin, and caviar; those with circulatory failure; those with cardio-cerebral infarction in a non-stable stage; and those who are in the late stage of pregnancy.

Complications: There may be bleeding, hypotension, secondary infection, allergic reaction, imbalance syndrome, hypercitratemia, etc.

Liver transplantation

Indications: other treatments are ineffective and the condition is still deteriorating.

Contraindication

Failure of 4 or more organs (liver, kidney, lung, circulation, brain).

Cerebral edema complicating brain herniation.

Circulatory failure: 2 or more vasoactive substances are required for maintenance and there is no significant response to an increase in the dose of vasoactive substances.

Pulmonary hypertension: mean pulmonary artery pressure greater than 50 mmHg.

Severe respiratory failure: requires maximal ventilatory support [inspired oxygen concentration (FiO2) ≥ 0.8, high positive end-expiratory pressure ventilation (PEEP)] or extracorporeal membrane pulmonary oxygenation (ECMO) support.

Persistent severe infection: sepsis due to bacteria or fungi, infectious shock, severe bacterial or fungal peritonitis, tissue-invasive fungal infection, active tuberculosis.

Persistent severe pancreatitis or necrotizing pancreatitis.

Severe state of weakness due to malnutrition and muscle wasting requires careful evaluation for liver transplantation.

Long-term immunosuppression, prevention of infection, cessation of smoking and alcohol consumption, and regular follow-up are required after liver transplantation.

Prognosis

Cure

Traumatic liver injury: after active treatment, most of them can achieve better curative effect; if untreated or improperly treated, it may lead to hemorrhagic shock or even death.

Non-traumatic liver injury: different etiology and severity, different prognosis results.

Liver injury caused by non-tumor diseases with early detection and early treatment usually has a good prognosis.

Some acute liver injuries progress quickly, start rapidly, and have a poorer prognosis if not treated in time.

Harmfulness

Liver injury requires bed rest and some patients may need to be admitted to hospital for treatment, which brings great inconvenience to patients’ life and work.

If liver injury is serious, it will lead to liver failure, hemorrhagic shock and other serious complications, which may even be life-threatening if not treated in time.

Daily

Daily Management

Dietary management

It is better to consume low-fat, high-protein, vitamin-rich and easy-to-digest food.

Avoid oily, spicy and irritating foods.

Eat more fresh fruits and vegetables.

Avoid drinking alcohol.

Avoid taking medications that are damaging to the liver.

Life management

Keep a good state of mind and avoid excessive excitement or tension.

Take rest and get enough sleep.

Follow-up

Liver injury requires early treatment and regular follow-up.

Follow the doctor’s instructions for regular follow-ups, and bring along your personal medical records and examination reports.

If the symptoms do not decrease or even worsen, you need to consult the doctor promptly.

If there is any other discomfort, you should inform the doctor of the symptoms in detail for timely diagnosis.

Physical examination, ultrasonography, abdominal X-ray, etc. may be done during follow-up.

Prevention

Actively treat liver diseases.

Take medication as prescribed by the doctor, and consult the doctor in time if any abnormality occurs while taking medication; for medications that may have hepatotoxicity, liver function should be rechecked regularly as prescribed by the doctor during the period of taking the medication.

Pay attention to production and life safety, avoid trauma.

Avoid staying up all night and develop a good work routine.

Eat a light diet and less greasy food.

Have regular medical checkups and consult the doctor if there is any abnormality.