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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
Workup Algorithm ... Ascites Management ... Peritonitis (SBP) Hepatic ... #diagnosis #management ... gastroenterology #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Complications • Ascites ... Esophageal Varices • Hepatic ... • Spontaneous Bacterial ... #management #summary ... #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... of portal HTN: ascites ... INR, bilirubin, albumin ... • Cardiac causes ... #causes #hepatology
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
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
hydrothorax • Cirrhotic ... Hepatorenal syndrome • Ascites ... : Spontaneous bacterial ... Complications #hepatology ... #diagnosis
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
Causes of Splenomegaly - Differential Diagnosis Algorithm
Infectious
 • Bacterial
 • Viral (EBV)
 • Parasitic
 • Fungal
Congestive
Infectious • Bacterial ... Congestive • Cirrhosis ... Hepatic, Portal, ... Serum Sickness Hemolytic ... #Hematology
Ascites - Diagnostic Approach and Differential Diagnosis
The most common causes: cirrhosis, malignancy and heart failure. Approx
Ascites - Diagnostic ... The most common causes ... differential, albumin ... #workup #Differential ... #Diagnosis #hepatology
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis
High albumin gradient (>1.1 g/dl):
 - Cirrhosis	
 - Alcoholic
Serum Ascites Albumin ... - Differential Diagnosis ... >1.1 g/dl): - Cirrhosis ... failure - Hepatic ... #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential Diagnosis ... : • Cirrhosis ... #Algorithm #Hepatology ... #causes