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Year : 2016  |  Volume : 1  |  Issue : 2  |  Page : 67-69

Acute liver failure due to organophosphorous

1 Dept of Gastroenterology, Apollo Hospital, Bhubaneswar, India
2 Dept of Pharmacology, I.M.S & SUM Hospital, Bhubaneswar, India

Correspondence Address:
Sushant Sethi
Dept of Gastroenterology, Apollo Hospital, Bhubaneswar
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Source of Support: None, Conflict of Interest: None

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A case of acute liver failure who lost five of his family members due to consumption of some food stuff made at home. Autopsy of viscera of the deceased revealed organophosphorous. Only one member who presented as ALF survived. A 33yr old male presented with reeling of head and vomiting after 8-10 hrs of consuming some home made food. He was treated out side for 1 day and shifted to Apollo Hospital Bhubaneswar due to deterioration of condition. On examination he was conscious but disoriented and icteric, hemodynamics and urine output was normal. Investigations revealed serum billirubin 6.3/2.4mg/dl,ALT-10,225u/l,AST-12,865u/l,PT-13.1/66.1sec, INR-8.89, TLC-5,000/cmm, Creatinine:1.1mg, Serum Ammonia 138mmol/l. Other infective markers for viral hepatitis, dengue, malaria and leptospira were negative. Patient went to encephalopathy within an hour. In view of Jaundice, Coagulopathy and encephalopathy diagnosis of ALF was made and Patient was managed with ICU care, head end elevation, mannitol, Inj N-acetyl cystine, Inj vitamine K, IV fluids, IV antibiotics and other supportive treatment. Possibility of need of liver transplantation was discussed but family expressed inability to afford. The patient was not bleeding hence FFP not given. However with conservative management he started improving after 72 hrs and fully recovered within 10days. Investigations: LFT, Infective markers for viral hepatitis, dengue, malaria and leptospira. Diagnosis: Acute Liver Failure

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