Liver dysfunction is frequently seen in patients with sepsis. The most frequent presentation is cholestatic jaundice. Increases in transaminase, alkaline phosphatase

(one to three times normal) and bilirubin concentrations (usually not >10 mg/dL) are frequently noted. The proposed mechanism for bilirubin elevation involves hemolysis of red blood cells and hepatocellular dysfunction due to endotoxin, cytokines, or immune complex disease. Prolonged or severe hypotension may induce acute hepatic injury or ischemic bowel necrosis.

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