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diagnosis hepatology differential management ultrasound algorithm clinical albumin gradient hematology metastases metastatic syndrome treatment abdominal abscess biliary classification gallbladder gastroenterology
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
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
albumin gradient (SAAG ... ) SAAG ≥ 1.1: ... ≤ 2.5 g/dL: Cirrhosis ... syndrome, Massive liver ... Tuberculosis #SAAG
Portal Hypertension - Differential Diagnosis Portal Pressure = the pressure difference between the pressure in the portal
of portal HTN: ascites ... (SAAG>I.I), esophageal ... portal HTN: • Ascites ... : • Cardiac causes ... sarcoidosis) • Liver
Deciphering the SAAG - Serum to Ascites Albumin Gradient Ascites is either made in the liver sinusoid
Deciphering the SAAG ... either made in the liver ... or not by the liver ... fibrosis) High SAAG ... oncotic pressure Low SAAG
Approach to the Hospitalized Patient with Cirrhosis 1) Recognize and Manage Decompensation • Ascites • Variceal Bleeding
Hospitalized Patient with Cirrhosis ... Decompensation • Ascites ... • Variceal Bleeding ... • Hepatic Encephalopathy ... Portosystemic Shunt • Liver
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
Gradient (SAAG) ... >1.1 g/dl): - Cirrhosis ... - Massive liver ... - Fulminant hepatic ... failure - Hepatic
End Stage Liver Disease (Cirrhosis) - Complications • Ascites • Esophageal Varices • Hepatic
End Stage Liver ... Disease (Cirrhosis ... Complications • Ascites ... Esophageal Varices • Hepatic ... #Cirrhosis #Complications
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
Ascites - Differential Diagnosis Chronic liver disease (cirrhosis or chronic hepatitis) - 80% Underlying malignancy - 10% Congestive heart
Ascites - Differential ... Diagnosis Chronic liver ... disease (cirrhosis ... failure - 3-5% Cirrhosis ... Disease, Fulminant Hepatic
Meigs Syndrome - Diagnosis and Management Summary Triad: 1) Pleural effusion + 2) Ascites + 3) Benign Ovarian
effusion + 2) Ascites ... & mistaken for cirrhosis ... c/b Hepatic Hydrothorax ... transudative • SAAG
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