Liver is an important organ; it is mainly responsible for body detoxification and removal of waste products, also it has an important secondary role in food digestion and absorption. Unhealthy liver develops due to several factors such as; unhealthy diet, viral infection, heavy smoking… etc.

Hepatic failure usually manifested with certain clinical signs; they include:

1. Water retention: it's the most common sign of hepatic failure, it develops due to portal hypertension and hypo-albuminemia, this retention usually causes abdominal ascites and lower limb edema. It's recommended to follow a low-sodium diet; also diuretics may be helpful, paracentesis (ascities draining by fine needle) could be a therapeutic option in resistant and severe cases.
2. Jaundice: it's usually manifested with pale yellow discoloration of skin as well as dark smoky urine. It develops due to increased level of bilirubin (the waste product of RBCs break down).
3. Bleeding tendency: hepatic failure may be manifested with hematemesis (vomiting blood) or melena (bleeding per rectum). A healthy liver produces certain types of protein responsible for blood coagulation, so hepatic patients are more susceptible for bleeding tendency. In these cases endoscopy is an important for clinical assessment, blood elements transfusion should be in mind.
4. Confusion: hepatic encephalopathy develops due to toxins accumulation in the brain tissue; it's usually manifested with confusion which may end with hepatic coma.