Last reviewed: 19 Dec 2020
Last updated: 07 Feb 2019
Summary
Definition
History and exam
Other diagnostic factors
- moderate lowering of BP
- peripheral edema
- hepatosplenomegaly
- spider angioma
- oliguria
- bruising
- petechiae
- palmar erythema
- scratch marks
- gynecomastia
- encephalopathy
- pruritus
- confusion
- drowsiness
Risk factors
- advanced cirrhosis
- ascites
- alcoholic hepatitis
- acute liver failure
- hyponatremia
- high plasma renin activity (PRA)
- spontaneous bacterial peritonitis
- large volume paracentesis
- gastrointestinal (GI) bleeding
Diagnostic investigations
1st investigations to order
- creatinine
- BUN
- electrolytes
- CBC
- LFTs
- coagulation study
- diagnostic paracentesis and culture of ascitic fluid
- blood culture
- urinalysis and culture
- CXR
Treatment algorithm
Contributors
Authors

Associate Professor of Surgery
Michigan State University
Lansing
MI
Disclosures
JK declares that he has no competing interests.
Peer reviewers
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.
Professor of Medicine
University of Connecticut Health Center
Farmington
CT
Disclosures
GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.
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