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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 ... diagnosis #management #gastroenterology ... #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... syndrome, Massive liver ... albumin #gradient #hepatology ... differential #diagnosis #algorithm
Ascites - Differential Diagnosis and Workup Algorithm

•
Perform paracentesis:
 • Cell count and diff 
 • Total
Diagnosis and Workup ... Algorithm • ... Differential #Diagnosis #Algorithm ... #gastroenterology ... #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Liver Failure ( ... months without treatment ... disease, liver ... #gastroenterology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Drug Induced Liver ... non-essential drug/HDS treatments ... Alcohol-related liver ... disorder (e.g. ascites ... #DrugInduced #Liver
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... current MELD - Chronic ... liver disease work ... - Prior liver ... #Gastroenterology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic ... liver disease ( ... cirrhosis or chronic ... Chylous <1% #Ascites
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Idiosyncratic Drug-induced Liver ... presentation • Chronic ... or symptoms of liver ... Drug #induced #Liver ... #algorithm #gastroenterology
Approach to Hypoproliferative Macrocytic Anemia

 • 812, Folate Deficiency
 • MDS+
 • Hypothyroid
 • Liver Disease
Hypothyroid • Liver ... differential #diagnosis #algorithm ... #hematology #workup
Fever of Unknown Origin (FUO) - Further Workup

 • CNS symptoms? Get an LP and imaging
FUO) - Further Workup ... Returning Traveler’ algorithm ... duplex or CTA • Liver ... Liver biopsy • ... values supporting hematologic