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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
Management and Complications ... of Cirrhosis and ... Management Refractory ... #diagnosis #management ... gastroenterology #hepatology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... liver disease (cirrhosis ... or chronic hepatitis ... failure - 3-5% Cirrhosis ... Differential #Diagnosis #hepatology
Assessment and management of cirrhosis in people older than 16 years: summary of NICE guidance
#cirrhosis #assessment
Assessment and management ... of cirrhosis in ... NICE guidance #cirrhosis ... #hepatitis #NICE ... #hepatology #primarycare
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Liver Disease (Cirrhosis ... Complications • Ascites ... #ESLD #Liver #Cirrhosis ... Complications #diagnosis #management ... #summary #hepatology
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
Encephalopathy • Pulmonary ... hydrothorax • Cirrhotic ... Hepatorenal syndrome • Ascites ... Complications #hepatology
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
for Albumin for Management ... of Cirrhosis ... 8g per liter of ascites ... #Cirrhosis #treatment ... #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
those with CLD (± cirrhosis ... (DILI) Viral Hepatitis ... Procedures Management ... #Hepatology #gastroenterology ... #management #diagnosis
Ascites Management Principles
Low Salt Diet - 2000 Mg Sodium
Fluid Restriction - Never
Work-horse Diuretic - Aldosterone Antagonist
Combination
Ascites Management ... @ebtapper #Ascites ... #Management #cirrhosis ... #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
of portal HTN: ascites ... Clues to non-cirrhotic ... portal HTN: • Ascites ... /acute hepatitis ... Diagnosis #causes #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... disease - Cirrhosis ... - Alcoholic hepatitis ... - Bile ascites ... #differential #hepatology