Hepatic failure - a syndrome, described disturbance of one or many functions of a liver owing to acute or chronic damage of its parenchyma. Distinguish a hepatic failure acute and chronic. At an acute hepatic failure the hepatic encephalopathy develops within 8 weeks from the moment of occurrence of first attributes of disease of a liver. The chronic hepatic failure develops gradually, during several months, however connection of provoking factors (reception of alcohol, an esophageal and gastric bleeding from the varicose-expanded veins of an esophagus, the intercurrent infection, reception of greater doses of diuretic preparations or uniinstantly excision of a plenty of an ascitic liquid, etc.) can quickly provoke development of a hepatic encephalopathy.

Etiology. The acute hepatic failure can arise at serious forms of a virus hepatitis, poisonings industrial (bonds of an arsenic, phosphorus, etc.), vegetative (inedible mushrooms) and other hepatotropic poisons, some medicines (in particular, Paracetamolum). In rare cases the reason of an acute hepatic failure can become an acute fatty dystrophia of a liver at pregnant women (it is observed in last trimester of pregnancy, clinically does not differ from a virus hepatitis), an autoimmune hepatitis. The chronic hepatic failure arises at advance of many chronic diseases of a liver (a cirrhosis, malignant tumours, etc.).

Pathogenesis. The hepatic failure speaks a dystrophia and the widespread necrobiosis of hepatocytes and (at chronic forms) massive development of anastomoses through which the appreciable part of a blood from a portal vein acts in hollow and then - in an arterial bed, passing a liver. It even more reduces its participation in deintoxication of the harmful substances which are soaked up in an intestine, in particular products of albuminous disintegration (ammonia, etc.).