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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 ... Peritonitis (SBP) Hepatic ... Complications #diagnosis ... #management #gastroenterology ... #hepatology
Disorders of the Hepatic and Mesenteric Circulation

Platelets in Cirrhosis
Hypercoagulability in Cirrhosis
Bleeding in Cirrhosis
Portal Vein Thrombosis (PVT)
Mesenteric
Disorders of the Hepatic ... in Cirrhosis Bleeding ... Circulation #Disorders #Hepatology ... #Gastroenterology ... #diagnosis #Management
Cirrhosis Timeline and Mortality Rate
Compensated Cirrhosis
Stage 1 - No varices (Annual Mortality Rate 1%)
Stage 2 -
Cirrhosis Stage 3 - Ascites ... Stage 4 - Gl bleeding ... or Hepatic Encephalopathy ... Mortality #Timeline #diagnosis ... #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Differential Diagnosis ... Hypertension - Hepatic ... #Algorithm #Hepatology ... #causes
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... Hepatic congestionl ... - Massive hepatic ... #Causes #diagnosis ... #differential #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential Diagnosis ... of portal HTN: ascites ... portal HTN: • Ascites ... #Differential #Diagnosis ... #causes #hepatology
Transhepatic Intrajugular Portosystemic Shunt (TIPS) 
Indications:
 • Ascites / Hepatic Hydrothorax
 • Variceal Bleeding
Cardiopulmonary, Renal, and
Indications: • Ascites ... / Hepatic Hydrothorax ... • Variceal Bleeding ... Portosystemic #Shunt #Hepatology ... #Gastroenterology
Causes of Bone/Joint Pain in Sickle Cell Disease
Vaso-occlusive pain:
 • Mechanism: ischemic pain
 • Can present
Causes of Bone/Joint ... • Most common sites ... Osteomyelitis / Septic ... #differential #diagnosis ... #causes #hematology
Causes of Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup
History:
 - Prior platelet count, family
- Differential Diagnosis ... - History of bleeding ... epistaxis, gingival bleeding ... candidate) - Bone ... #hematology
Ascites - Diagnostic Approach and Differential Diagnosis
The most common causes: cirrhosis, malignancy and heart failure. Approx
Ascites - Diagnostic ... The most common causes ... have more than one ... cause (e.g. cirrhosis ... #hepatology