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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
Cirrhosis and Ascites ... Ascites Workup ... Algorithm Ascites ... Peritonitis (SBP) Hepatic ... gastroenterology #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Differential Diagnosis Algorithm ... Hypertension - Hepatic ... Hypertension - Post-Hepatic ... Differential #Diagnosis #Algorithm ... #Hepatology #causes
Complications of Portal Hypertension
 • Hepatic Encephalopathy
 • Pulmonary: Hepatopulmonary syndrome, Portopulmonary hypertension, Hepatic hydrothorax
 •
Complications of Portal ... Hypertension • Hepatic ... hypertension, Hepatic ... Hepatorenal syndrome • Ascites ... Complications #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Normal Peritoneum ... Portal hypertension ... Hepatic congestionl ... Portal vein occlusion ... #differential #hepatology
Ascites Differential Diagnosis Table - Serum Ascites Albumin Gradient (SAAG)

SAAG ≥ 1.1:
 • Cirrhosis
 • Portal
Diagnosis Table ... - Serum Ascites ... Cirrhosis • Portal ... Differential #Diagnosis #Table ... Gradient #SAAG #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... metastases - Ascitic ... albumin #gradient #hepatology ... differential #diagnosis #algorithm
Deciphering the SAAG - Serum to Ascites Albumin Gradient
Ascites is either made in the liver sinusoid
liver sinusoid (hepatic ... the liver The hepatic ... is hepatic lymph ... sinusoid with (ie Portal ... liverprof #Diagnosis #Hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
HTN: ascites (SAAG ... HTN: • Ascites ... g/dl (suggest hepatic ... • Preserved hepatic ... Diagnosis #causes #hepatology
Ascites - Differential Diagnosis and Workup Algorithm

•
Perform paracentesis:
 • Cell count and diff 
 • Total
Ascites - Differential ... Diagnosis and Workup Algorithm ... SAAG and check ascites ... Differential #Diagnosis #Algorithm ... gastroenterology #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Complications • Ascites ... Esophageal Varices • Hepatic ... management #summary #hepatology