Hypoxic liver injury (hypoxic hepatitis) can be diagnosed when certain clinical and laboratory findings are present.


Criteria for the diagnosis of hypoxic liver injury:

(1) episode of cardiac or circulatory shock, hepatic hypoperfusion, toxic exposure or other event

(2) marked elevation in serum aminotransferase (AST and ALT) and LDH concentrations

(3) rapid reversal in the serum enzyme concentrations if the cause is reversed and the patient survives

(4) centrilobular necrosis on liver biopsy

(5) exclusion of other causes (drug-induced hepatitis, toxic hepatitis, viral hepatitis, pancreatic disease, biliary diseases, hepatic trauma)



• The aminotransferase levels may be > 3,000 IU/L.

• Some authors require an increase in aminotransferase levels > 20 times normal. Other authors allow lesser elevations.

• A liver biopsy may be hazardous to perform.


Clinical findings:

(1) right upper quadrant pain

(2) weakness

(3) dyspnea


To read more or access our algorithms and calculators, please log in or register.