Enflurane-induced hepatitis with prominent cholestasis1
P. Gregory Foutch, D.O., F.A.C.P.
D. Roy Ferguson, M.D.
Ralph J. Tuthill, M.D.
Previously reported cases of enflurane-induced hepatitis share similar clinical, biochemical, and histological features. Systemic symptoms follow a brief latent period after exposure to the anesthetic. Aminotransferase abnormalities predominate and coincide with the histological finding of centrilobular necrosis. The authors describe a case of enflurane-induced hepatitis with typical clinical manifestations associated with mixed hepatocellular and cholestatic liver-function-test abnormalities. Biochemical cholestasis eventually predominated and spuriously simulated an extrahepatic bile duct obstruction. Results of a percutaneous liver biopsy showed a mixed hepatocanalicular drug reaction.