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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
Complications of Cirrhosis ... Ascites Workup Algorithm ... Hydrothorax AKI in Cirrhosis ... TinaPhamHang #Cirrhosis ... gastroenterology #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 #diagnosis #algorithm
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... Differential Diagnosis Algorithm ... - Hepatic: • Cirrhosis ... Differential #Diagnosis #Algorithm ... #Hepatology #causes
Causes of Anemia with Normal Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Decreased WBCs
 - Decreased/NormaI
Causes of Anemia ... Differential Diagnosis Algorithm ... #Normocytic #Anemia ... Differential #Diagnosis #Algorithm ... #Causes #Hematology
Hemolysis - Diagnostic Algorithm and Causes

Increased red cell production: 
 • Increased Reticulocytosis/polychromasia 
 • Erythroid
Hemolysis - Diagnostic Algorithm ... and Causes Increased ... #Algorithm #Differential ... #Causes #Workup ... #Hematology #Diagnosis
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
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
HTN: ascites (SAAG ... and hepatorenal syndrome ... Clues to non-cirrhotic ... Ascites protein ... #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
Causes of Anemia with elevated Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Normal Blood Smear
 •
Causes of Anemia ... Differential Diagnosis Algorithm ... Myelodysplastic Syndromes ... Differential #Diagnosis #Algorithm ... #Causes #Hematology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... Normal Peritoneum ... - Budd-Chiari syndrome ... disease - Cirrhosis ... #differential #hepatology