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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
Workup Algorithm ... Ascites Management ... #diagnosis #management ... #gastroenterology ... #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
End Stage Liver ... Complications • Ascites ... Syndrom (HRS) • Liver ... SBP) #ESLD #Liver ... #diagnosis #management
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
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic Liver ... disease, liver ... support, or liver ... #Hepatology #gastroenterology ... #management #diagnosis
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 ... #hepatology
Hepatocellular Carcinoma (HCC) in Cirrhosis - Management Algorithm

Very early (0) - Single <2 cm, Preserved liver
- Management Algorithm ... cm, Preserved liver ... cm, Preserved liver ... #Management #Algorithm ... #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
- Differential Diagnosis ... Algorithm Portal ... - Hepatic: • Cirrhosis ... disease • Acute liver ... #Algorithm #Hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI)

DILI Types:
 • Intrinsic - predictable, dose dependent
Diagnosis and Management ... or symptoms of liver ... Drug #induced #Liver ... #Management #gastroenterology ... #algorithm #gastroenterology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Liver disease ... - Cirrhosis ... - Acute fatty liver ... #Causes #diagnosis ... #differential #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... of portal HTN: ascites ... sarcoidosis) • Liver ... metastasis • Fatty liver ... #causes #hepatology