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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 ... Workup Algorithm ... Ascites Management ... gastroenterology #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Disease (Cirrhosis ... Complications • Ascites ... #Cirrhosis #Complications ... #diagnosis #management ... #summary #hepatology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic liver ... disease (cirrhosis ... #Differential # ... Diagnosis #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 ... #differential #
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Tests (LFTs) - ... Differential Diagnosis ... • NAFLD • Cirrhosis ... #Differential # ... Diagnosis #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Veno-occlusive disease ... Liver disease ... - Cirrhosis ... Causes #diagnosis #differential ... #hepatology #SAAG
Ascites Management Principles
Low Salt Diet - 2000 Mg Sodium
Fluid Restriction - Never
Work-horse Diuretic - Aldosterone Antagonist
Combination
Ascites Management ... Restriction - Never ... Work-horse Diuretic ... #Management #cirrhosis ... #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
Hypertension - Differential ... of portal HTN: ascites ... portal HTN: • Ascites ... Veno-occlusive disease ... Diagnosis #causes #hepatology
Approach to Hypoproliferative Macrocytic Anemia

 • 812, Folate Deficiency
 • MDS+
 • Hypothyroid
 • Liver Disease
Hypothyroid • Liver ... Disease • Alcohol ... Macrocytic #Anemia #differential ... diagnosis #algorithm #hematology ... #workup
Anemia - Underproduction Diagnostic Algorithm
 - Iron deficiency anemia
 - Anemia of chronic inflammation
 - Anemia
chronic kidney disease ... disorder - TSH, LFTs ... Underproduction #Algorithm #hematology ... #diagnosis #differential ... #workup