Last reviewed: June 2020
Last updated: January  2020

Summary

Definition

History and exam

Key diagnostic factors

  • cirrhosis
  • more severe liver disease
  • alcohol misuse
  • hepatitis B or C infection
  • ascites
  • spider angioma
  • caput medusa
  • jaundice
  • encephalopathy
  • hematemesis
  • melena
  • hematochezia
  • HIV coinfection

Risk factors

  • portal hypertension
  • large varices
  • red wale marks
  • Child-Pugh class
  • ascites

Diagnostic investigations

1st investigations to order

  • hepatic venous pressure gradient (HPVG)
  • complete blood count
  • coagulation profile (INR/prothrombin time)
  • serum LFTs
  • BUN and creatinine
  • blood typing/cross-matching
  • hepatitis B surface antigen (HBsAg)
  • anti-hepatitis C virus IgG (anti-HCV IgG)
  • esophago-gastro-duodenoscopy (EGD)
More 1st investigations to order

Treatment algorithm

Contributors

Clinical Research Fellow

Barts Liver Centre

Barts and the London School of Medicine and Dentistry

London

UK

Disclosures

GED declares that she has no competing interests.

Dr Grace E. Dolman would like to gratefully acknowledge Dr Gennaro D'Amico, Dr Giuseppe Malizia, Dr Vikram Boolchand, and Dr Thomas Boyer, previous contributors to this topic.

Peer reviewersVIEW ALL

Assistant Professor

Department of Gastroenterology

University of California

San Francisco

CA

Disclosures

SS declares that he has no competing interests.

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