Decompensated cirrhosis
Needs existing diagnosis of cirrhosis
| Headline | |
|---|---|
| Etiology | |
| Epidemiology | |
| Clinical presentation | New ascites, encephalopathy, GI bleed, hepatorenal syndrome - encephalopathy: asterixis, hypoactive Delirium, ↑ resp drive Less risk of cerebral oedema compared to HE associated with acute liver failure |
| Pathogenesis | |
| Diagnostic investigations | Other causes of encephalopathy e.g. stroke, alcohol withdrawal/intoxication... |
| Management | Complications: |
| Prevention |
Hepatorenal syndrome
| Headline | |
|---|---|
| Etiology | ↑↑ renal vasoconstriction due to altered renal autoregulation. Type 1: progressive; Type 2: slower |
| Epidemiology | |
| Clinical presentation | Ddx: |
| Pathogenesis | |
| Diagnostic investigations | |
| Management | ➥ Type 1 – terlipressin + albumin; 2nd line = octreotide + midodrine + albumin ➥ Type 2 – portosystemic shunt. Relieves portal hypertension. ➥ Prevention in alc hepatitis: prednisolone 40mg OD 4/52 ➥ Liver transplantation is definitive |