Elective surgery should be postponed until the acute hepatitis phase has resolved as indicated by normalization of liver tests. Studies indicate increased mortality (perioperative) up to 10? and morbidity up to 12? with laparotomy during acute viral hepatitis . Although the risk with alcoholic hepatitis may not be great, acute alcohol toxicity greatly complicates anesthetic management.
Moreover, alcohol withdrawal during surgery may be associated with a mortality rate as high as 50. Only truly emergent surgeries should be considered in such instances. Patients with hepatitis are at high risk for deterioration of hepatic function and the development of complications from hepatic failures, such as encephalopathy, coagulopathy or hepatorenal syndrome. Laboratory investigations should include blood urea nitrogen, Serum electrolytes, creatinine, glucose, transaminases, ability, alkaline…
