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diagnosis differential hepatology management causes algorithm microscopy casts cirrhosis clinical nephrology gastroenterology urine abdominal albumin complications hepatorenal hrs liver saag
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
Cirrhosis, Late Budd-Chiari ... syndrome, Massive ... pericarditis, Early Budd-Chiari ... syndrome, IVC obstruction ... leak, Nephrotic syndrome
Examples of varying granular and granular/waxy mixed casts: A: coarse granular/broad-waxy (and surrounding white blood cells);
Examples of varying granular ... and granular/waxy ... /muddy brown granular ... , C and D: muddy ... brown granular/
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG) SAAG ≥ 1.1: • Cirrhosis • Portal
Ascites Differential ... Table - Serum Ascites ... thrombosis • Late budd-chiari ... obstruction • Early budd-chiari ... • Nephrotic syndrome
Muddy Brown Granular Casts three ways - Brightfield, Darkfield, Phase Contrast. Dr. Vipin Varghese @vipvargh #Muddy #Brown #Granular
Muddy Brown Granular ... Varghese @vipvargh #Muddy ... #Brown #Granular
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
Granular & “Muddy ... Finely granular ... slightly coarser granular ... coarse (c) and muddy ... brown (mb) granular
Causes of Ascites - Differential Diagnosis Algorithm Portal Hypertension - Prehepatic: • Portal vein thrombosis • Splenic
Causes of Ascites ... pericarditis • Budd-Chiari ... syndrome • Inferior ... • Nephrotic syndrome ... amzn.to/2LmUODZ #Ascites
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
concentrated urine Granular ... cellular casts "Muddy-brown ... " heme-granular ... Fatty - Nephrotic syndrome
Systemic Lupus Erythematosus: Gastrointestinal Manifestations - Thrombosis of vessels in the pancreas, Vasculitis -> Acute Pancreatitis
Liver Enzymes - Budd ... Chiari Syndrome ... Enteropathy -> Ascites
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
Causes of Ascites ... insufficiency - Budd-Chiari ... syndrome ... - Nephrotic syndrome ... - Bile ascites
Suggested diagnostic approach to a patient with exudative ascites. Low ascitic fluid protein should direct practitioners
with exudative ascites ... Low ascitic fluid ... out nephrotic syndrome ... for exudative ascites ... obstruction, nephrotic syndrome
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