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Management and Complications of Cirrhosis and Ascites

Ascites Workup Algorithm
Ascites Management
Refractory Ascites
Hyponatremia
Spontaneous Bacterial Peritonitis (SBP)
Hepatic Hydrothorax
AKI in
of Cirrhosis and ... Spontaneous Bacterial ... Peritonitis (SBP) Hepatic ... #diagnosis #management ... gastroenterology #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... HTN: ascites (SAAG ... Ascites protein ... INR, bilirubin, albumin ... #causes #hepatology
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
hydrothorax • Cirrhotic ... Hepatorenal syndrome • Ascites ... : Spontaneous bacterial ... Complications #hepatology ... #diagnosis
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Complications • Ascites ... Esophageal Varices • Hepatic ... • Spontaneous Bacterial ... #management #summary ... #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... disease - Cirrhosis ... Infections - Bacterial ... #Causes #diagnosis ... #differential #hepatology
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG)

SAAG ≥ 1.1:
 • Cirrhosis
 • Portal
Diagnosis Table ... Albumin Gradient ... SAAG ≥ 1.1: • Cirrhosis ... • Portal vein ... Gradient #SAAG #hepatology
Deciphering the SAAG - Serum to Ascites Albumin Gradient
Ascites is either made in the liver sinusoid
liver sinusoid (hepatic ... the liver The hepatic ... sinusoid with (ie Portal ... Matherly @liverprof #Diagnosis ... #Hepatology #SAAG
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential Diagnosis ... : • Cirrhosis ... #Algorithm #Hepatology ... #causes
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Infectious • Bacterial ... Congestive • Cirrhosis ... Hepatic, Portal, ... Serum Sickness Hemolytic ... #Hematology
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
for Management ... of Cirrhosis • ... 8g per liter of ascites ... • Spontaneous Bacteria ... #hepatology