Other tests

Liver biopsy is not indicated in ALF because sampling error may misrepresent the degree of necrosis and because of the potential for bleeding caused by the profound coagulopathy. However, imaging of the liver and its vasculature using either ultrasound or CT scanning techniques is useful for assessing liver size, excluding biliary obstruction or hepatic vein thrombosis, and assessing the liver vasculature if transplantation is contemplated. Other tests are used to assess cerebral function and structure in deeply encephalopathic patients. Advances in CT scanning technology make this test a more useful detector of cerebral edema than previous studies have suggested. Continuous monitoring of intracranial pressure is commonly used to detect episodes of cerebral edema despite the significant risk of intracranial bleeding (Ho.o.f0ยง0!e.. eLai 1995). Non-invasive methods of assessing cerebral function, such as sensory evoked potentials, may prove useful in the future.

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