Harrison H B, Middleton H M, Crosby J H, Dasher M N
Gastroenterology. 1981 Apr;80(4):820-5.
Over a 2-yr period, 3 patients with metastatic liver disease presented with a clinical course compatible with fulminant hepatic failure. The course was characterized by abdominal pain, jaundice, rapidly deteriorating mental status, high-serum enzyme values (SGOT, LDH, alkaline phosphatase), prolonged prothrombin times, and death within 1-12 days after hospitalization. At autopsy a similar histologic picture was present in each: extensive infiltration and replacement of liver by tumor and widespread infarction of remaining parenchyma. To place these 3 cases into a proper perspective, they were compared with 3 similar, previously reported cases (1 primary and 2 metastatic); and a retrospective autopsy review of metastatic liver disease occurring over a 4-yr period was performed. Fulminant hepatic failure due to extensive parenchymal infarction appears to represent an uncommon, but distinct entity in the overall spectrum of metastatic liver disease.
在两年的时间里，3例转移性肝病患者出现了与暴发性肝衰竭相符的临床病程。其病程特点为腹痛、黄疸、精神状态迅速恶化、血清酶值（谷草转氨酶、乳酸脱氢酶、碱性磷酸酶）升高、凝血酶原时间延长，且在住院后1至12天内死亡。尸检时，每例患者均呈现出相似的组织学表现：肿瘤广泛浸润并取代肝脏，剩余实质广泛梗死。为了正确看待这3例病例，将它们与3例先前报道的类似病例（1例原发性和2例转移性）进行了比较；并对4年期间发生的转移性肝病进行了回顾性尸检分析。在转移性肝病的整体范围内，由于广泛实质梗死导致的暴发性肝衰竭似乎是一种罕见但独特的病症。
