Case of the Month #26 - liver failure

Published 10/02/2022

What are the symptoms and signs of paracetamol toxicity?

It is helpful to know the time of ingestion (and whether the overdose was staggered), the dose of paracetamol ingested and any other medications taken.

First stage (30 min to 24 hours): may be asymptomatic or may have nausea and vomiting.

Second stage (18 to 72 hours): right upper quadrant abdominal pain, hypotension.

Third stage (72 to 96 hours): liver failure, renal failure, coagulopathy, metabolic acidosis, encephalopathy, death is most common at this stage.

Fourth stage (4 days to 3 weeks): recovery high likely.