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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
Cirrhosis and Ascites ... Ascites Workup ... Algorithm Ascites ... Peritonitis (SBP) Hepatic ... diagnosis #management #gastroenterology
Deciphering the SAAG - Serum to Ascites Albumin Gradient
Ascites is either made in the liver sinusoid
either made in the liver ... sinusoid (hepatic ... or not by the liver ... The hepatic sinusoid ... is hepatic lymph
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury
Hepatocellular Liver Injury
 • AST/ALT elevation
Liver Enzymes (LFTs ... and Cholestatic Liver ... Hepatocellular Liver ... more specific for hepatic ... #Enzymes #LFTs
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... Tests (LFTs) - ... (Drug-induced liver ... ) • Non-hepatic ... Function #Tests #LFTs
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Hepatic congestionl ... Liver disease ... - Fulminant hepatic ... - Massive hepatic ... - Acute fatty liver
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
End Stage Liver ... Complications • Ascites ... Esophageal Varices • Hepatic ... Syndrom (HRS) • Liver ... SBP) #ESLD #Liver
Clinical Examination for Liver and Biliary Diseases
1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
Examination for Liver ... Flapping tremor (hepatic ... Aspiration of ascitic ... Splenornegaly, Ascites ... Palpable gallbladder, Hepatic
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
The Gastroenterology ... CBC - Coags, LFTs ... Focus on prior GI/Liver ... GregoryTBrennan #Liver ... Calling #Referral #Gastroenterology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
of portal HTN: ascites ... portal HTN: • Ascites ... g/dl (suggest hepatic ... sarcoidosis) • Liver ... metastasis • Fatty liver
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Focus on prior Liver ... - Vitals - LFTs ... US - Prior liver ... Referral #Hepatology #Gastroenterology