16 results
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
of portal HTN: ascites ... portal HTN: • Ascites ... INR, bilirubin, albumin ... • Cardiac causes ... sarcoidosis) • Liver
Approach to the Hospitalized Patient with Cirrhosis
1) Recognize and Manage Decompensation
 • Ascites
 • Variceal Bleeding
Decompensation • Ascites ... • Variceal Bleeding ... • Hepatic Encephalopathy ... Portosystemic Shunt • Liver ... diagnosis #treatment #management
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Disease (Cirrhosis ... Complications • Ascites ... Esophageal Varices • Hepatic ... #Cirrhosis #Complications ... #diagnosis #management
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Indications for Albumin ... for Management ... of Cirrhosis • ... of ascites removed ... #Cirrhosis #treatment
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis
High albumin gradient (>1.1 g/dl):
 - Cirrhosis	
 - Alcoholic
Serum Ascites Albumin ... >1.1 g/dl): - Cirrhosis ... - Massive liver ... - Fulminant hepatic ... failure - Hepatic
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... Liver disease ... - Cirrhosis ... - Acute fatty liver ... #Causes #diagnosis
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... Hypertension - Hepatic ... : • Cirrhosis ... disease • Acute liver ... Hypertension - Post-Hepatic
Upper GI Bleed - Management Algorithm

Upper GI bleed Suspected: Melena, hematemesis, coffee-ground emesis, BRBPR
Initial Stabilization
Concern for
Upper GI Bleed - Management ... Consult GI ± EGD Causes ... GI Bleed: • Peptic ... Ulcer Disease • Variceal ... GAVE (idiopathic, liver
Spontaneous Bacterial Peritonitis (SBP) - Diagnosis and Management
Ascites PMN > 250/mm3
? Nosocomial or hospital acquired. Recent
Ascites PMN > ... Presentation in septic ... response Give IV albumin ... protein (< 1.5g/L) ascites ... dysfunction or liver
Spontaneous Bacterial Peritonitis
DIAGNOSTICS
Paracentesis: 
 • Calculate absolute PMN count (total WBC x PMN %)
 • Correct
as 10 days 2) Albumin ... : lg/kg of 25% albumin ... Any etiology (variceal ... dL and advanced liver ... SBP #diagnosis #management