31 results
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... syndrome, Massive liver ... metastases - Ascitic ... gradient #hepatology #differential
Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis
Spontaneous Bacterial Peritonitis
 • Cirrhosis (high SAAG)
(high SAAG) + ascites ... Runyon's Criteria: Ascitic ... glucose < 50, LDH ULN ... Peritoneal #diagnosis #differential ... #ascites
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury
Hepatocellular Liver Injury
 • AST/ALT elevation
Liver Enzymes (LFTs ... and Cholestatic Liver ... value = (ALT + ULN ... phosphatase + ULN ... Transaminitis #diagnosis #differential
Deciphering the SAAG - Serum to Ascites Albumin Gradient
Ascites is either made in the liver sinusoid
SAAG - Serum to Ascites ... Albumin Gradient Ascites ... either made in the liver ... or not by the liver ... Interpretation #Differential
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic liver ... Chylous <1% #Ascites ... #Differential #
Acute Fatty Liver of Pregnancy (AFLP)
Pathophysiology:
 • Defect in fetal free fatty acid metabolism products →
Acute Fatty Liver ... hepatocytes → Liver ... develops (DIC, ascites ... AST/ALT (5-10x ULN ... infiltration) Differential
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential ... disease • Acute liver ... amzn.to/2LmUODZ #Ascites ... #Differential #
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... Liver disease ... - Acute fatty liver ... - Bile ascites ... Causes #diagnosis #differential
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... - Differential ... Severe ALT > 15x ULN ... Mild ALT < 5x ULN ... #LiverEnzymes #Differential
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
Hypertension - Differential ... of portal HTN: ascites ... portal HTN: • Ascites ... sarcoidosis) • Liver ... metastasis • Fatty liver