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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 ... Management Refractory ... #gastroenterology ... #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Liver Disease (Cirrhosis ... Complications • Ascites ... • Hepatorenal Syndrom ... Complications #diagnosis #management ... #summary #hepatology
Disorders of the Hepatic and Mesenteric Circulation

Platelets in Cirrhosis
Hypercoagulability in Cirrhosis
Bleeding in Cirrhosis
Portal Vein Thrombosis (PVT)
Mesenteric
Portal Vein Thrombosis ... ) Budd Chiari Syndrome ... Circulation #Disorders #Hepatology ... #Gastroenterology ... #diagnosis #Management
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
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
of Cirrhosis ... 8g per liter of ascites ... • Hepatorenal syndrome ... #Cirrhosis #treatment ... #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 Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Hepatic: • Cirrhosis ... • Budd-Chiari syndrome ... • Nephrotic syndrome ... Diagnosis #Algorithm #Hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
HTN: ascites (SAAG ... and hepatorenal syndrome ... Ascites protein ... • Budd Chiari syndrome ... 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 ... - Nephrotic syndrome ... #differential #hepatology
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