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Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG)

SAAG ≥ 1.1:
 • Cirrhosis
 • Portal
Ascites Differential ... SAAG ≥ 1.1: • Cirrhosis ... • Portal vein ... • Nephrotic syndrome ... Gradient #SAAG #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
protein ≤ 2.5 g/dL: Cirrhosis ... Late Budd-Chiari syndrome ... leak, Nephrotic syndrome ... albumin #gradient #hepatology ... #differential #
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... liver disease (cirrhosis ... Fitz-Hugh-Curtis syndrome ... #Differential # ... Diagnosis #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential ... - Hepatic: • Cirrhosis ... #Differential # ... Diagnosis #Algorithm #Hepatology
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
Hepatopulmonary syndrome ... hydrothorax • Cirrhotic ... Renal: Hepatorenal syndrome ... • Ascites: Spontaneous ... Complications #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential ... HTN: ascites (SAAG ... and hepatorenal syndrome ... Ascites protein ... Diagnosis #causes #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Normal Peritoneum ... - Budd-Chiari syndrome ... disease - Cirrhosis ... Causes #diagnosis #differential ... #hepatology #SAAG
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
Hepatorenal Syndrome ... + ascites • No ... No haematuria, Normal ... #Hepatorenal #Syndrome ... HRSAKI #HRSNAKI #hepatology
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis
High albumin gradient (>1.1 g/dl):
 - Cirrhosis	
 - Alcoholic
Gradient (SAAG) - Differential ... >1.1 g/dl): - Cirrhosis ... ) - Portal vein ... without cirrhosis ... #Diagnosis #hepatology
Causes of Portal Hypertension According to Site of Vascular Obstruction
1) Prehepatic pre-sinusoidal: Portal vein thrombosis due
or secondary to cirrhosis ... 3) Sinusoidal: Cirrhosis ... post-sinusoidal: Budd-Chiari syndrome ... portalhypertension #phtn #differential ... diagnosis #causes #hepatology