AbstractMeasurements of liver area on antero-posterior99Tcmsulphur colloid scans in fulminant hepatic failure (FHF) showed reduction in liver size in six of the 33 patients and enlargement in three. By contrast, liver area was normal or increased in all 20 patients with severe acute hepatitis without encephalopathy. The serum bilirubin and aspartate aminotransferase were not significantly different between the two groups but there was greater prolongation of the prothrombin time in the FHF patients. All six patients with reduction of liver area on the initial scan died but neither the finding of a normal or enlarged liver area on admission nor serial liver scans were helpful in assessing the prognosis of an individual patient. Peak activity over the liver was sometimes higher than normal, possibly due to shrinkage of the liver with approximation of the Kupffer cells.