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diagnosis differential injury lfts management aclf acute ascites chemistry chronic cirrhosis druginduced gastroenterology hepatomegaly interpretation liverenzymes rvalue saag transaminitis
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
months without treatment ... Infections Alcohol-Associated ... Hepatitis (AAH) ... Injury (DILI) ... #Hepatology #gastroenterology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... non-essential drug/HDS treatments ... for alternative causes ... HEV, EBV, CMV), Alcohol-related ... #hepatology
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... Non-Malignant • Fatty Liver ... • Right Heart Failure ... Inflammatory • Alcoholic ... #Causes #Hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Differential Diagnosis Algorithm ... Vascular Causes ... function may be abnormal ... ALT Ratios: • Alcoholic ... #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... disease US — Normal ... hepatitis • Drugs ... Others #LFTs #Hepatology ... #Causes
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Check Acute viral hepatitis ... Check Acute viral hepatitis ... Failure (ALF): ... ALT Ratios: • Alcoholic ... #differential #Hepatology
Alcoholic Hepatitis - Management Algorithm Assess Eligibility for Treatment: - Maddrey Discriminant Function ≥ (or possibly MELD
Alcoholic Hepatitis ... exclude other causes ... HCV, DILI, HCC, ... - Multiorgan failure ... #Algorithm #hepatology
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
Causes of Ascites ... Normal Peritoneum ... Cirrhosis - Alcoholic ... hepatitis ... #differential #hepatology
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