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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 ... Workup Algorithm ... Ascites Management ... #diagnosis #management ... gastroenterology #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... protein ≤ 2.5 g/dL: Cirrhosis ... syndrome, Massive liver ... albumin #gradient #hepatology ... #algorithm
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic ... liver disease ( ... hepatitis) - 80% ... #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Disease (Cirrhosis ... Complications • Ascites ... #Cirrhosis #Complications ... #diagnosis #management ... #summary #hepatology
Step by Step Algorithmic Approach to Pediatric Fever

Age < 21 days old (or 28 days for
Step by Step Algorithmic ... Fever Age < 21 ... #Peds #Diagnosis ... #Management #StepByStep ... #Fever
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
- Cirrhosis ... - Alcoholic hepatitis ... Mediterranean fever ... #Causes #diagnosis ... #differential #hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
- Differential Diagnosis ... Algorithm Malignant ... Non-Malignant • Fatty Liver ... Primary Biliary Cirrhosis ... #Hepatology
Ascites Management Principles
Low Salt Diet - 2000 Mg Sodium
Fluid Restriction - Never
Work-horse Diuretic - Aldosterone Antagonist
Combination
Ascites Management ... Restriction - Never ... @ebtapper #Ascites ... #Management #cirrhosis ... #hepatology
Approach to the Hospitalized Patient with Cirrhosis
1) Recognize and Manage Decompensation
 • Ascites
 • Variceal Bleeding
Decompensation • Ascites ... Scenarios • Alcoholic Hepatitis ... Portosystemic Shunt • Liver ... #diagnosis #treatment ... #management
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
those with CLD (± cirrhosis ... (DILI) Viral Hepatitis ... #Failure #Cirrhosis ... #Hepatology #gastroenterology ... #management #diagnosis