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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
Transhepatic Intrajugular Portosystemic Shunt (TIPS) 
Indications:
 • Ascites / Hepatic Hydrothorax
 • Variceal Bleeding
Cardiopulmonary, Renal, and
Indications: • Ascites ... / Hepatic Hydrothorax ... • Variceal Bleeding ... Portosystemic #Shunt #Hepatology ... #Gastroenterology
Disseminated Intravascular Coagulation (DIC) Overview

Increased Clotting and Consumption of Clotting Factors

Findings:
 • Bleeding
 • Recent history
dysfunction (25%) • Hepatic ... or venipuncture sites ... 100mg/dL) - Heparin ... #Coagulation #diagnosis ... treatment #management #hematology
Spontaneous Bacterial Peritonitis (SBP) - Diagnosis and Management
Ascites PMN > 250/mm3
? Nosocomial or hospital acquired. Recent
Peritonitis (SBP) - Diagnosis ... and Management Ascites ... Presentation in septic ... acceptable Upper Gl bleeding ... #Management #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Drug Induced Liver ... DILI) - Stepwise Diagnosis ... liver disease, Hepatic ... disorder (e.g. ascites ... #Algorithm #hepatology
Heparin Induced Thrombocytopenia (HIT) - Diagnosis and Management - GrepMed Handbook

Presentation: 
 • Plts ↓50% (nadir
Heparin Induced ... Thrombocytopenia (HIT) - Diagnosis ... (at injection sites ... #Induced #Thrombocytopenia ... #Treatment #Hematology
Hodgkin's Lymphoma vs Non-Hodgkin's Lymphoma - Comparison

Hodgkin's Lymphoma:
 • Epidemiology: young adults 20-30, older 50-70
 •
- Alcohol-induced ... Hepatosplenomegaly, cytopenias(bleeding ... Differential Diagnosis ... NonHodgkins #comparison #oncology ... #hematology
Algorithm regarding the diagnosis and treatment of Hereditary Hemochromatosis HH. 

Step 1: In the patient with
elevated iron indices ... including liver and hematologic ... hemochromatosis; HIC, hepatic ... #management #hepatology ... #gastroenterology