The Importance of Stability in Hepatic Encephalopathy

From my standpoint, this guy is critically ill. As a hepatologist, I'd be worrying about what can I do to keep this guy from dying. This guy does not look stable to me. He's tachycardic. He's hypotensive. And that suggests a significant blood loss somewhere in 15 to 40% if this is bleeding. Or this could be septic shock. In the acute setting like this, I don't spend a lot of time worrying about whether they have spider angiomas or not. It's much more important to make sure the patient is stable.