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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
of Cirrhosis and ... Ascites Workup Algorithm ... Refractory Ascites Hyponatremia ... Complications #diagnosis ... #hepatology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... : Hypovolemia, Heart ... failure, Cirrhosis ... #algorithm #causes
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... • Congestive heart ... failure • Cirrhosis ... #Algorithm #Causes
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... • Congestive heart ... failure • Cirrhosis ... #Algorithm #Causes
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Nonalcoholic fatty liver ... disease Congestive heart ... 14 percent) #Diagnosis ... #Differential #Hepatology ... #Cirrhosis #Causes
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Algorithm Malignant ... Congestive • Right Heart ... Primary Biliary Cirrhosis ... #Algorithm #Causes ... #Hepatology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Hypervolemic - Heart ... failure, liver ... #Algorithm #causes
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... to non-cirrhotic ... including R heart ... #Differential #Diagnosis ... #causes #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... Algorithm Portal ... - Hepatic: • Cirrhosis ... Post-Hepatic: • Heart ... #Algorithm #Hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
protein ≤ 2.5 g/dL: Cirrhosis ... syndrome, Massive liver ... protein ≥ 2.5 g/dL: Heart ... albumin #gradient #hepatology ... #algorithm