Abnormal liver function associated with coagulopathy AND hepatic encephalopathy in a previously normal liver with onset within a 6 month period

Paracetamol Overdose, Antibiotics (Augmentin, Rifampicin), Mushroom Ingestion (Amanita Phalloides), Wilsons Disease, Autoimmune Hepatitis, Thrombosis Of Hepatic Vein (Budd-Chiari), Hepatitis B, Malignancy

Drowsiness, confusion (hepatic encephalopathy), abdominal pain, abdominal distension (ascites) vomiting, easy bruising

Bloods: LFTs show raised bilirubin, ALP, ALT and decreased Albumin. Clotting 

screen, Paracetamol level, Hepatitis serology, autoimmune profile

Imaging: Ultrasound Abdomen shows no blood flow into hepatic vein in Budd-

Chiari

Dependent on cause

Paracetamol: N-acetylcysteine 

Drugs: Supportive and stop causative agent

Mushroom Ingestion: May require liver transplant 

Wilsons Disease: May require liver transplant 

Budd Chiari: May require liver transplant

Autoimmune: High dose steroid

Hepatitis B: Supportive treatment

Usually poor without liver transplantation 

Paracetamol, autoimmune hepatitis, antibiotic related most likely  improve without 

transplant