CIRRHOSIS 1⃣0⃣1⃣ by @JosephCAhnMD
@AmCollegeGastro #ACG2021 #LiverTwitter #Liver #GITwitter
Early recognition of cirrhosis is important
We should CONFIRM the diagnosis, not assume it
Portal hypertension (i.e., HVPG) drives outcomes in cirrhosis
Life expectancy in compensated cirrhosis: 12 yrs
Decompensated: 3-4 years
Preventive care
⚠️Make sure they are vaccinated against COVID-19
Screening for esophageal varices
Pathophysiology of portal hypertension
Treatment of esophageal varices
Carvedilol might be the best
Outpatient management pearls
Ascites
✅Low sodium diet
✅furosemide and spironolactone
AKI in cirrhosis is usually pre-renal. Don't just assume it's HRS!
Hepatorenal syndrome: new and improved (see amazing article by @DougSimonetto in @bmj_latest!)
❓What to do with AKI in cirrhosis
Treatment of HRS
Keep you 👁 out for terlipressin!
Hyponatremia in cirrhosis
Hepatic encephalopathy
⚠️Keep broad differential
⚠️Measurement/following ammonia is NOT recommended
Spontaneous bacterial peritonitis (SBP)
💎s of the inpatient management of cirrhosis
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