Testing & Diagnosis for Acute Liver Failure in Children

How is liver failure diagnosed?

When diagnosing liver disease, your child’s physician looks at your child’s symptoms and conducts a physical examination. In addition, the physician may request a combination of the following tests:

Blood tests

  • Albumin level: A sample of blood is obtained from your child's vein. Below-normal levels of albumin — a protein made by the liver and found in the bloodstream — are associated with many chronic liver disorders.
  • Bilirubin level: A sample of blood is taken from your child's vein. Bilirubin is produced by the liver and is excreted in the bile. Elevated levels of bilirubin may indicate an obstruction of bile flow or a defect in the processing of bile by the liver.
  • Liver enzymes: A sample of blood is taken from your child's vein, and the amounts of enzymes that the liver normally makes are measured. Elevated levels of liver enzymes can alert physicians to liver damage or injury, since the enzymes leak from the liver into the bloodstream under these circumstances.
  • Prothrombin time (PT) test: This test measures the time it takes for blood to clot. Blood clotting requires vitamin K and a protein made by the liver. Liver cell damage and bile flow obstruction can both interfere with proper blood clotting.

Abdominal ultrasound (also called sonography)

Ultrasounds are used to view your child’s liver as it functions to and assess blood flow through various vessels

Liver biopsy

A procedure that takes a small tissue sample for examination.

Computerized tomography scan (CT or CAT scan)

A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called “slices”), both horizontally and vertically, of your child’s liver.

  • A CT scan shows a detailed image of your child’s liver. CT scans are more detailed than general x-rays.

  • Your child will lie on a bed that moves into a doughnut shaped machine that takes many pictures of different areas of the body.

  • Because the machine is noisy, and because your child may need to lie still for a while with his arms over his head, a sedative might be given to help your child rest during the procedure.