الفهرس 
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Abstract
The present study was conducted on fourty eight (48) patients with shock selected from Emergency Department of Mansoura University Hospital and Emergency Room of Emergency Hospital, Mansoura University, they were (33) males and (15) females with age ranging between (17-73 years) and on (15) healthy persons as a control group (volunteers from persons working in the hospital). They were subjected to thorough history taking and thorough clinical examination, investigations; including EeG, chest X -ray, abdominal U. S., liver function tests, serum ’creatinine, TNF assay and PGE2 assay. from the results of the present study. The following conclusions can be made: 1- The clinical picture of shock liver is so characteristic and resolves so rapidly that there should be no confusion with other causes of marked elevation of transaminase levels. 2- Critically ill patients are in need for necessary comprehensive and repeated performed investigations of liver function due to importance of liver involvement in such patients. 3- Hemorrhagic shock produce a significant depression of hepatocyte function which can be reversed by ringer’s lactate.