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Ascites - Workup and Management

#Ascites #Workup #Diagnosis #Management #SAAG #Evaluation #SBP #Hepatology
Ascites - Workup ... and Management ... #Ascites #Workup ... #Diagnosis #Management ... Evaluation #SBP #Hepatology
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 ... Ascites Workup ... Management Refractory ... Complications #diagnosis #management ... gastroenterology #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Normal Peritoneum ... Veno-occlusive disease ... Liver disease ... dL) - Ovarian disease ... #differential #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
End Stage Liver Disease ... Complications • Ascites ... Complications #diagnosis #management ... #summary #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... • Infiltrative disease ... Hemoperitoneum • Chylous ascites ... amzn.to/2LmUODZ #Ascites ... Diagnosis #Algorithm #Hepatology
Ascites Management Principles
Low Salt Diet - 2000 Mg Sodium
Fluid Restriction - Never
Work-horse Diuretic - Aldosterone Antagonist
Combination
Ascites Management ... Restriction - Never Work-horse ... @ebtapper #Ascites ... #Management #cirrhosis ... #hepatology
Ascites - Diagnostic Approach and Differential Diagnosis
The most common causes: cirrhosis, malignancy and heart failure. Approx
Ascites - Diagnostic ... of patients w/ ascites ... of underlying disease ... #workup #Differential ... #Diagnosis #hepatology
Causes of Bleeding / Bruising - Differential Diagnosis Algorithm
Thrombocytopenia - Quantitative Defect
 • Decreased Production
 •
Destruction • Abnormal ... ASA) • Renal Disease ... Von Willebrand's Disease ... - Acquired • Anticoagulation ... Algorithm #Causes #Hematology
Deciphering the SAAG - Serum to Ascites Albumin Gradient
Ascites is either made in the liver sinusoid
SAAG - Serum to Ascites ... Albumin Gradient Ascites ... the blood The diseased ... sinusoid with (ie Portal ... liverprof #Diagnosis #Hepatology
CHA2DS2VASc vs HAS-BLED scores for stroke risk and bleed risk on anticoagulation

C	Congestive Heart Failure	1

H	Hypertension	1

A2	Age >75	2

D	Diabetes Mellitus	1

S2	Stroke,
bleed risk on anticoagulation ... 2 V Vascular disease ... hypertension 1 A Abnormal ... CHADS2VASc #HASBLED #Comparison ... AFib #Diagnosis #Hematology