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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
Ascites Workup ... Algorithm Ascites ... Complications #diagnosis ... #management #gastroenterology ... #hepatology
Ascites - Differential Diagnosis and Workup Algorithm

•
Perform paracentesis:
 • Cell count and diff 
 • Total
Diagnosis and Workup ... Algorithm • ... #Differential #Diagnosis ... #Algorithm #gastroenterology ... #hepatology
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... albumin #gradient #hepatology ... #differential #diagnosis ... #algorithm
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
- Differential Diagnosis ... Algorithm Portal ... • Infiltrative disease ... #Differential #Diagnosis ... #Algorithm #Hepatology
Diagnostic Schema for Hyperferritinemia

Pearl: Diseases associated with extreme elevations: 
1. HLH 
2. Still's disease 
3. Systemic
Diagnostic Schema ... Still's disease ... Hyperferritinemia #Algorithm ... #Differential #Diagnosis ... #Hematology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic ... liver disease ( ... Chylous <1% #Ascites ... #hepatology
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Veno-occlusive disease ... Liver disease ... dL) - Ovarian disease ... #Causes #diagnosis ... #differential #hepatology
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
End Stage Liver Disease ... Complications • Ascites ... Complications #diagnosis ... management #summary #hepatology
Ascites - Diagnostic Approach and Differential Diagnosis
The most common causes: cirrhosis, malignancy and heart failure. Approx
Ascites - Diagnostic ... and Differential Diagnosis ... of underlying disease ... #Differential #Diagnosis ... #hepatology
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 ... Matherly @liverprof #Diagnosis ... #Hepatology #SAAG