Some of the early symptoms of liver failure are also common with other ailments [7]. This is why early diagnosis of liver failure is hard. Some of these early symptoms include diarrhea, fatigue, loss of appetite and nausea.

As the disease progresses, other serious symptoms will set in. At this point, urgent medical care is needed. Some of these symptoms are jaundice, easy or excessive bleeding, swollen abdomen, confusion (hepatic encephalopathy), sleepiness and coma.

As mentioned earlier, liver failure diagnosis is often difficult at the early stage due to symptoms being overly vague and close to other health condition. In some instances, the patient may not present any of the common symptoms even when the liver has already been damaged considerably.

The first step in diagnosis is to obtain medical history from the patient [8]. This will establish the presence of possible risk factors. These factors include prescription drug use, sexual activity, alcohol consumption, exposure to blood products, exposure to toxic chemicals, family history of liver disease, use of injection drugs, etc.

Blood tests are then used to check for liver inflammation and test for antibodies that may indicate liver failure.

Liver biopsy is indicated in some cases and imaging tests like magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP), ultrasound, computerized tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) may be required.

Liver failure treatment is dependent on the etiologic factor [9].

Acute liver failure caused by overdose of prescription medications can be treated and the effects can be reversed following early detection. In the same way, liver failure as a result of virus can be treated with supportive care. The supportive care allows the virus to run its course while the liver heals on its own.

Chronic liver failure however, requires actions aimed at salvaging the remains of the liver. Where this is not realistic, a liver transplant will be needed.

The prognosis for this condition is dependent on the etiologic factor in the particular case of liver failure [6].

Both acute and chronic liver failures are unpredictable and there is high mortality and morbidity. Early and accurate diagnosis as well as proper management is vital for increased chances of survival.

For instance patients that have acute liver failure that is caused by acetaminophen have a much better prognosis than those that are dealing with a form of the disorder without a clearly laid out etiology. In patients with stage 3 or 4 encephalopathy, prognosis is also very poor. As soon as a complication like cerebral edema, renal failure or infection arises, the risk of mortality becomes even higher.

In chronic liver failure, the main etiologic factors include persistent and excessive alcohol consumption, cirrhosis, hepatitis C, hepatitis B and malnutrition [2]. Excessive absorption and storage of iron (hemochromatosis) can also lead to chronic liver failure [3].

The etiologic factors for acute liver failure on the other hand differ from the factors above. They include ingestion of poisonous wild mushrooms, reactions to some prescriptions (often herbal), hepatitis A, B and C viruses (mostly seen in children) and overdose of acetaminophen.

In the United States, around 2000 cases of liver failure are reported annually with more than half of these arising from overdose [4]. Around 15% of the cases are a result of unknown etiological factors.

In Europe, the numbers are higher due to the high number of hepatitis B infections but majority of the cases are a result of acetaminophen overdose.

The number of liver failure cases in the developing world is higher than what is obtainable in other locations. A number of environmental factors contribute to this but the high number of hepatitis infections have been fingered as the leading cause of the high incidence.

In patients with liver failure, the development of cerebral edema is the main cause of morbidity and death [5]. The cause of the cerebral edema is still unclear as it is believed that a lot of factors play a role in its development.

It is believed that excessive ammonia in the blood (hyperamonemia) is one of the factors involved in the development of cerebral edema. Over the course of development of the condition, cytokine profiles are often deranged and elevated.

Astrocyte swelling and brain edema arises following the accumulation of glutamine in astrocyte. Increase in intracranial blood volume and cerebral blood flow is another pathophysiological factor in the development.

The major way to prevent liver failure is to reduce the risk of developing cirrhosis or hepatitis. This can be achieved with the aid of following [10]:

• Reduced alcohol intake and total abstinence from it when taking acetaminophen.
• Regular consumption of a proper diet covering all the classes of food.
• Regular use of protection when having sexual intercourse.
• Washing of hands after using public restrooms and before touching any food as well as increased proper hygiene.
•  Vaccination against hepatitis A or B.
• Non-sharing of personal toiletry items like razors and toothbrushes.
• Avoidance of blood and blood products.
• Avoidance of all body piercing materials especially when it can’t be proven that equipment is aseptic. This should also be adhered to when using any intravenous substances. 

Liver failure is a condition typified by the inability of the liver to carry out its natural functions. It sets in when large portions of the liver become irreparably damaged [1]. This may be a life threatening ailment and therefore needs emergency medical care.

In most cases, liver failure occurs slowly, with damage spread over a period of years. This is known as chronic liver failure. On the other hand, the condition can start and peak in 48 hours or less. This is referred to as acute liver failure. Acute liver failure is rare and can be difficult to detect.

Liver failure is loss of the functions of the liver. There are two types of liver failure, acute and chronic liver failure. Acute liver failure is a situation where the patient suddenly develops the condition without any former history of liver problems while chronic liver failure is a situation where liver failure develops slower over a few years.

The complications of the disease are often serious and this includes excessive bleeding, increase in pressure in the brain etc. The condition is a medical emergency that requires hospitalization of the patient if proper treatment is to be achieved.

The outcome of treatment depends on the cause of the condition and type of liver failure. However, liver transplant is required in majority of cases.

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