Recent heavy drinking then a serious liver injury

Suppose I’m a male in my mid-30s, and up until this point in my life, I’ve never been much of a drinker. I’ve never averaged more than one unit of alcohol a month.

But then I’m heartbroken and decide the best way to deal with this to drink myself insensible most nights for two months solid. It worked for Dad after Mom died, so why not?

I end up getting injured pretty badly at the tail end of this period, maybe I’m shot, maybe it’s trauma from a car accident or falling from a great height, and my liver is damaged pretty badly. Has my recent participation in recreational alcoholism made it more likely that I’m not going to be able to recover from the liver injury without a transplant? Does the drinking increase the risk of complications?

Of course this is for a story. You didn’t really need to ask, did you? If the answer is “no” we’ll just have the injury be that much more liver-destroying to begin with

One thing to remember is that people vary a lot in their susceptibility to liver damage from drinking (there are ethnic/racial variables, differences based on other drugs the person might be taking (like Tylenol) etc.). One person who drinks heavily for two months might have nothing more than reversible fatty change in their liver, another could have full-blown alcoholic hepatitis and starting to get fibrotic changes that are the precursor to cirrhosis. I’ve personally seen (at autopsy) mildly damaged but functional livers in lifelong drinkers, and one case of fatal alcoholic liver disease with cirrhosis in a guy in his 30s who’d been drinking heavily for less than a year.

Bearing more closely on your question, there seems to be conflicting data on whether the earliest liver change secondary to drinking (fatty liver) makes you more susceptible to traumatic injury. One researcher who posted preliminary data online had findings suggesting a possible protective effect of fatty liver in crashes involving motorcyclists (not specifically limited to liver injuries). I don’t see in PubMed where he ever published his paper, plus he noted opposite findings by another researcher.

Cursory PubMed and Google searches did not turn up anything definitive for me, but maybe you’ll have better luck.

I haven’t seen a blunt trauma liver injury lead directly to liver failure and transplant. Typically the injury is structural (ie a liver laceration) and it is repaired in the operating room. Jackmannii, do you know any data on liver injury leading to failure?

Also, if you want to combine drinking with injury to lead to liver failure just have the character stub his toe. As few as three drinks combined with some Tylenol is enough to cause fulminant liver failure in some cases as Jackmannii alludes to.

I’m now trying to convince my cowriter that we should have most of his liver ripped out, Prometheus-style. Perhaps by giant eagles. She hasn’t gotten back to me yet.

If you want the drinking and the injury to combine to cause massive problems, have him go into alcohol withdrawal while stuck in the hospital with his liver laceration.