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diagnosis differential liver hepatitis dili hyperbilirubinemia management abdominal alcoholic congenital conjugated direct distention drug druginduced hepatocellular idiosyncratic induced inherited liverenzymes
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
dose dependent injury ... Chronic - ongoing ↑ LFTs ... Diagnosis #Management #gastroenterology ... #algorithm #gastroenterology ... #hepatology
Approach to Conjugated Hyperbilirubinemia - Differential Diagnosis Algorithm 1. Definition: T.bili elevation + >20% conjugated 2. Obtain RUQ
Differential Diagnosis Algorithm ... non-ICU vs ICU causes ... Hyperbilirubinemia #direct #bilirubin ... #gastroenterology ... #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Differential Diagnosis Algorithm ... Drugs/Toxins • Ischemia ... • Others #LFTs ... #Hepatology #LiverEnzymes ... #Causes
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... for alternative causes ... disease, Hepatic ischaemia ... disorder (e.g. ascites ... #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
Hepatocellular Liver Injury ... • Vascular: Ischemic ... Differential #Diagnosis #hepatology ... #algorithm #Transaminitis ... #LFTs #hepatitis
Inherited Non-hemolytic Disorders of Hyperbilirubinemia == Disorders of Conjugation == Gilbert Syndrome: • 5-10% of the population
hemolysis or liver injury ... associated with bilirubin ... and stress may cause ... #hepatology #diagnosis ... #gastroenterology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Differential Diagnosis Algorithm ... Vascular Causes ... • Bilirubin - ... differential #diagnosis #algorithm ... #hepatology
Abdominal Distention - Differential Diagnostic Algorithm Ascites Bowel Dilatation Other Causes Mechanical Obstruction • Adhesions 60% • Volvulus 3% •
Differential Diagnostic Algorithm ... Ascites Bowel ... Dilatation Other Causes ... Infectious • Ischemic ... Sclerosis, Spinal Injury
Alcoholic Hepatitis - Management Algorithm Assess Eligibility for Treatment: - Maddrey Discriminant Function ≥ (or possibly MELD
Hepatitis - Management Algorithm ... exclude other causes ... blood, urine and ascites ... - Acute kidney injury ... #hepatology
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