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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
Complications of Cirrhosis ... Ascites Workup Algorithm ... , HRS-AKI Tina ... TinaPhamHang #Cirrhosis ... gastroenterology #hepatology
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG)

SAAG ≥ 1.1:
 • Cirrhosis
 • Portal
Ascites Differential ... Diagnosis Table ... SAAG ≥ 1.1: • Cirrhosis ... #Differential # ... Gradient #SAAG #hepatology
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
+ ascites • No ... - No other cause ... + ascites • HRS-CKD ... - No other cause ... HRSAKI #HRSNAKI #hepatology
Ascites - Diagnostic Approach and Differential Diagnosis
The most common causes: cirrhosis, malignancy and heart failure. Approx
The most common causes ... more than one cause ... (e.g. cirrhosis ... #workup #Differential ... #Diagnosis #hepatology
Ascites Management Principles
Low Salt Diet - 2000 Mg Sodium
Fluid Restriction - Never
Work-horse Diuretic - Aldosterone Antagonist
Combination
Ascites Management ... Principles Low ... Restriction - Never Work-horse ... #Management #cirrhosis ... #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential ... - Hepatic: • Cirrhosis ... Diagnosis #Algorithm #Hepatology ... #causes
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
Hypertension - Differential ... of portal HTN: ascites ... portal HTN: • Ascites ... #Diagnosis #causes ... #hepatology
Causes of Hypocomplementemia - CHAMPS Mnemonic
C - Cryoglobulinemia (85%), C3 glomerulopathy, cirrhosis
H - Heavy Chain deposition
Causes of Hypocomplementemia ... glomerulopathy, cirrhosis ... Hypocomplementemia #Low ... Mnemonic #diagnosis #differential ... #hematology
Causes of Arterial and Venous Thrombosis - Differential Diagnosis Framework

STRUCTURAL:
 - PFO: paradoxical emboli
 - Popliteal
Causes of Arterial ... artery aneurysm: Causes ... thrombosis and other sites ... - MAHA: TTP, HUS ... Diagnosis #clots #hematology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... disease - Cirrhosis ... #Causes #diagnosis ... #differential # ... hepatology #SAAG