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A medical triad is a group of three signs or symptoms, the result of injury to three organs, which characterise a specific medical condition. The appearance of all three signs conjoined together in another patient, points to that the patient has the same medical condition, or diagnosis.
The misnomer "portal triad" traditionally has included only the first three structures, and was named before lymphatic vessels were discovered in the structure. [7] [8] It can refer both to the largest branch of each of these vessels running inside the hepatoduodenal ligament, and to the smaller branches of these vessels inside the liver.
Often, the liver is enlarged in those who have the syndrome. [2] Prevention is typically by avoiding the use of aspirin in children. [1] When aspirin was withdrawn for use in children in the US and UK in the 1980s, a decrease of more than 90% in rates of Reye syndrome was observed. [2] Early diagnosis of the syndrome improves outcomes. [1]
The King's College criteria were described in a seminal publication in 1989 by J.G. O'Grady and colleagues from King's College School of Medicine. [2] 588 patients with acute liver failure who presented to King's College Hospital from 1973 to 1985 were assessed retrospectively to determine if there were particular clinical features or tests that correlated poorly with prognosis.
Pediatric end-stage liver disease (PELD) is a disease severity scoring system for children under 12 years of age. [1] It is calculated from the patient's albumin , bilirubin , and international normalized ratio (INR) together with the patient's age and degree of growth failure .
Liver failure is the inability of the liver to perform its normal synthetic and metabolic functions as part of normal physiology. Two forms are recognised, acute and chronic (cirrhosis). [ 1 ] Recently, a third form of liver failure known as acute-on-chronic liver failure ( ACLF ) is increasingly being recognized.
The hepatopulmonary syndrome results from the formation of microscopic intrapulmonary arteriovenous dilatations in patients with both chronic, and far less commonly acute liver failure. The mechanism is unknown but is thought to be due to increased liver production or decreased liver clearance of vasodilators, possibly involving nitric oxide. [1]
Acute liver failure also results from poisoning by the death cap mushroom (Amanita phalloides) as well as other amatoxin-producing fungus species. Certain strains of Bacillus cereus—a common species of bacterium implicated as a frequent cause of food poisoning—can cause fulminant liver failure through the production of cereulide, [14] a ...
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