关键词: 戊型肝炎；肝性脑病；肝功能衰竭, 急性；误诊

Abstract: The incidence of acute hepatitis E（AHE） in China is on the rise.In clinical settings，sporadic cases of AHE are very common.However，a patient with AHE may easily receive a missed diagnosis or incorrect diagnosis if his symptoms are atypical，which can lead to delayed treatment.As AHE is mainly characterized by rapid onset and high risk，partial patients without receiving timely treatment may rapidly evolve into severe AHE，even hepatic failure and hepatic encephalopathy，with a high mortality.We analyzed the diagnosis and treatment of a case of severe acute atypical hepatitis E：due to clinicians' insufficient understanding of AHE，he had been diagnosed with acute gastroenteritis，and appendicitis successively and received anti-infection and other treatment，the conditions deteriorated progressively，and eventually developed into hepatic encephalopathy.We suggested that in order to ensure timely diagnosis and treatment，liver function test as well as viral hepatitis test should be performed for patients with digestive tract symptoms.

Key words: Hepatitis E；Hepatic encephalopathy；Liver failure, acute；Diagnostic errors