Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • RUQ abdominal pain
  • hepatomegaly
  • ascites
  • jaundice

Other diagnostic factors

  • splenomegaly
  • GI bleeding
  • leg edema
  • truncal venous collaterals
  • hepatic encephalopathy

Risk factors

  • female gender
  • myeloproliferative disorders (MPD)
  • thrombophilic disorders
  • oral contraceptive pill use
  • pregnancy and immediate postpartum period

Diagnostic investigations

1st investigations to order

  • thrombophilia screening
  • color and pulsed Doppler ultrasound
  • LFT
  • BUN and creatinine
  • coagulation profile
  • CBC
  • Janus kinase 2 (JAK2) mutation
  • flow cytometry for CD55- and CD59-deficient blood cells
Full details

Investigations to consider

  • serum-ascites albumin gradient (SAAG)
  • total ascitic protein
  • CT abdomen
  • MRI abdomen
  • hepatic venography
  • contrast-enhanced 3-dimensional magnetic resonance angiography
  • transjugular liver biopsy
  • bone marrow biopsy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Soha Saoud Abdel Moneim

Lecturer of Gastroenterology and Hepatology

Assiut University

Assiut

Egypt

Disclosures

SSAM declares that she has no competing interests.

Vijay H. Shah

Professor of Medicine

Physiology and Cancer Cell Biology

Mayo Clinic

Rochester

MN

Disclosures

VHS is the author of studies referenced in this monograph.

Peer reviewers VIEW ALL

Professor of Medicine and Cell Biology

Columbia University College of Physicians and Surgeons

New York

NY

Disclosures

HJW declares that he has no competing interests.

Senior Lecturer in Hepatology & Honorary Consultant Physician

Liver Research Group

Institute of Biomedical Research

The Medical School

University of Birmingham

Birmingham

UK

Disclosures

PN declares that he has no competing interests.

Specialist Registrar

Liver Unit

Addenbrooke's Hospital

Cambridge

UK

Disclosures

Not disclosed.

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