11 results
 End Stage Liver Disease (Cirrhosis) - Complications 
 • Ascites
 • Esophageal Varices
 • Hepatic
Disease (Cirrhosis ... Complications • Ascites ... Esophageal Varices • Hepatic ... • Spontaneous Bacterial ... #diagnosis #management
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
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Indications for Albumin ... for Management ... of Cirrhosis • ... of ascites removed ... • Spontaneous Bacteria
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
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... Liver disease ... - Cirrhosis ... Infections - Bacterial ... #Causes #diagnosis
Spontaneous Bacterial Peritonitis (SBP) - Diagnosis and Management
Ascites PMN > 250/mm3
? Nosocomial or hospital acquired. Recent
Spontaneous Bacterial ... Ascites PMN > ... Presentation in septic ... response Give IV albumin ... 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
Hepatic Encephalopathy - Diagnosis and Management Summary
Definition:
 • Alteration in brain function manifested by neuropsychiatric symptoms
Hepatic Encephalopathy ... Diagnosis and Management ... by liver insufficiency ... Prevalence: At cirrhosis ... acid by colonic bacteria
Hepatic Hydrothorax
 • Presents as right sided in 85% of cases
 • Fluid studies:
sided in 85% of cases ... Serum-to-pleural fluid albumin ... • Spontaneous bacterial ... may develop • Management ... TIPS, Liver transplant
Hepatorenal Syndrome (HRS)

Definition:
• Functional, potentially reversible kidney impairment.
• Occurs in advanced liver disease: cirrhosis, severe alcoholic
disease: cirrhosis ... • Caused by splanchnic ... Exclude other AKI causes ... diuretic-resistant ascites ... - IV albumin