Ketamine as a possible cause of cirrhosis in a patient with chronic pain.

Ketamine has been typically administered in short-term, few doses in the clinical setting of acute pain. Its hallucinogenic side effects have made it popular as a recreational drug. Reports of urological, biliary and liver abnormalities have been reported, mainly in cases of abuse. It is now increasingly used for chronic pain conditions, and here we report liver abnormalities and ultimately cirrhosis in an adult on regular ketamine for chronic facial pain. Abnormal liver function tests were detected incidentally, and with no other cause for liver disease found, liver biopsy was performed. This showed fibrosis with incomplete cirrhosis.