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diagnosis hepatology differential ascites causes algorithm management gradient injury laboratory lfts hepatitis interpretation pathophysiology peritonitis serum spontaneous transaminitis treatment acute
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
serum ascites albumin ... Cirrhosis, Late Budd-Chiari ... syndrome, Massive liver ... pericarditis, Early Budd-Chiari ... #ascites #albumin
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
Gradient (SAAG) ... ascites - Massive liver ... vein thrombosis (Budd-Chiari ... - Acute fatty liver ... ischemia/infarction #SAAG
Portal Hypertension - Differential Diagnosis Portal Pressure = the pressure difference between the pressure in the portal
HTN: ascites (SAAG ... INR, bilirubin, albumin ... pericarditis • Budd ... sarcoidosis) • Liver ... metastasis • Fatty liver
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG) SAAG ≥ 1.1: • Cirrhosis • Portal
Serum Ascites Albumin ... Gradient (SAAG) ... thrombosis • Late budd-chiari ... obstruction • Early budd-chiari ... #Table #Serum #Albumin
Deciphering the SAAG - Serum to Ascites Albumin Gradient Ascites is either made in the liver sinusoid
Deciphering the SAAG ... either made in the liver ... or not by the liver ... fibrosis) High SAAG ... oncotic pressure Low SAAG
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
hypertension (SAAG ... insufficiency - Budd-Chiari ... Liver disease ... - Acute fatty liver ... - Myxedema (SAAG
Ascites - Differential Diagnosis and Workup Algorithm • Perform paracentesis: • Cell count and diff • Total
protein • Fluid albumin ... and serum albumin ... • Calculate SAAG
Ascites - Diagnosis and Management Summary Paracentesis studies: cell count + differential, albumin, protein, culture • Serum-ascites-albumin-gradient
differential, albumin ... Serum-ascites-albumin-gradient ... (SAAG): > 1.1 g ... LVP > 5L: 25% albumin ... Summary #Hepatology #SAAG
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Indications for Albumin ... paracentesis (>5 liter ... ) - 8g per liter ... terlipressin #Albumin
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism AST and ALT: • AST: liver
Liver Chemistry ... ALT: • AST: liver ... In liver, 80% of ... circulates with albumin ... Released from albumin
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