Fulminant hepatic failure

Fulminant hepatic failure (FHF), although uncommon, is one of the most challenging gastrointestinal emergencies encountered in practice. Few conditions in clinical medicine are more dramatic or more devastating than FHF. It evolves after a catastrophic insult to the liver and is defined by the appearance of severe hepatic dysfunction heralded by the rapid onset of altered mentation in a previously healthy individual. Until recently, FHF carried a very high mortality rate (widely reported to be in excess of 80%) [1]; however, with an improved understanding and recognition of the syndrome, more aggressive medical therapy, intensive monitoring, and the advent of orthotopic liver transplantation (OLT) as a treatment option, survival rates have improved considerably [2]. Nevertheless, FHF constitutes a medical emergency with a tendency to evolve rapidly and the prompt response of experienced clinicians is imperative for a successful outcome to be achieved.