The Curbsiders Internal Medicine Podcast # 398:Live! From SHM: Inpatient Cirrhosis Management
52 snips
Jun 5, 2023 AI Snips
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Episode notes
Ascites Evaluation
- Systematically evaluate new-onset ascites in cirrhosis patients, including imaging and paracentesis.
- Don't assume infection based on clinical presentation alone, as spontaneous bacterial peritonitis (SBP) requires paracentesis.
PVT Management
- Confirm portal vein thrombosis (PVT) with cross-sectional imaging after ultrasound.
- Consider anticoagulation for PVT based on clinical significance and patient-centered decision-making, consulting hepatology.
INR and Transfusions
- INR doesn't fully reflect clotting function; ROTEM provides a more accurate assessment.
- Avoid routine FFP/platelet transfusions before diagnostic paracentesis, per guidelines.