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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 ... Peritonitis (SBP) Hepatic ... Hydrothorax AKI in Cirrhosis ... TinaPhamHang #Cirrhosis ... gastroenterology #hepatology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... liver disease (cirrhosis ... Disease, Fulminant Hepatic ... #Differential # ... Diagnosis #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
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Function Tests (LFTs ... ) - Differential ... • NAFLD • Cirrhosis ... liver) • Non-hepatic ... Diagnosis #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Liver Disease (Cirrhosis ... Complications • Ascites ... Esophageal Varices • Hepatic ... #ESLD #Liver #Cirrhosis ... management #summary #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... protein ≤ 2.5 g/dL: Cirrhosis ... albumin #gradient #hepatology ... #differential #
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
Hypertension - Differential ... of portal HTN: ascites ... portal HTN: • Ascites ... #Hypertension #Differential ... Diagnosis #causes #hepatology
Cirrhosis Timeline and Mortality Rate
Compensated Cirrhosis
Stage 1 - No varices (Annual Mortality Rate 1%)
Stage 2 -
Cirrhosis Timeline ... Rate Compensated Cirrhosis ... Stage 3 - Ascites ... Gl bleeding or Hepatic ... Timeline #diagnosis #hepatology
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
Hypertension • Hepatic ... hypertension, Hepatic ... hydrothorax • Cirrhotic ... Hepatorenal syndrome • Ascites ... Complications #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
- Differential ... Hypertension - Hepatic ... : • Cirrhosis ... #Differential # ... Diagnosis #Algorithm #Hepatology