Cirrhosis differential diagnosis: Difference between revisions
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!Differentiating Tests | !Differentiating Tests | ||
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|Constrictive pericarditis | |'''Constrictive pericarditis''' | ||
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* Increased [[jugular venous pressure]] | * Increased [[jugular venous pressure]] | ||
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* [[Doppler ultrasound]] shows ventricular filling abnormalities | * [[Doppler ultrasound]] shows ventricular filling abnormalities | ||
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|Budd-Chiari Syndrome | |'''Budd-Chiari Syndrome''' | ||
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* Abdominal pain | * Abdominal pain | ||
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* Abdominal CT will show a rapid clearing of the caudate lobe of the liver | * Abdominal CT will show a rapid clearing of the caudate lobe of the liver | ||
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|Splenic vein thrombosis | |'''Splenic vein thrombosis''' | ||
|Signs and symptoms of: | |Signs and symptoms of: | ||
* Upper abdominal pain radiating to the back | * Upper abdominal pain radiating to the back | ||
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* Normal hepatic venous pressure gradient is present | * Normal hepatic venous pressure gradient is present | ||
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|Portal vein thrombosis | |'''Portal vein thrombosis''' | ||
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* Symptoms depend on the underlying cause: | * Symptoms depend on the underlying cause: | ||
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* History generally reveals exposure | * History generally reveals exposure | ||
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===Differentiating Cirrhosis from other Diseases Based on Ascitic Fluid=== | ===Differentiating Cirrhosis from other Diseases Based on Ascitic Fluid=== | ||
[[Ascites]] may be caused by [[portal hypertension]] due to cirrhosis of [[liver]] or due to other causes such as [[Cancer|malignancy]]. [[Ascites|Ascitic]] fluid analysis should be done to broadly categorize the cause of [[ascites]]. | [[Ascites]] may be caused by [[portal hypertension]] due to cirrhosis of [[liver]] or due to other causes such as [[Cancer|malignancy]]. [[Ascites|Ascitic]] fluid analysis should be done to broadly categorize the cause of [[ascites]]. |
Revision as of 15:28, 19 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]}Sudarshana Datta, MD [3]
Overview
Cirrhosis may present in a similar way to some other diseases. History, physical examination, and diagnostic testing may help to differentiate cirrhosis from other diseases such as malignancy, constrictive pericarditis, Budd-Chiari syndrome, portal vein thrombosis and splenic vein thrombosis.
Differentiating Cirrhosis from other Diseases
Differential diagnosis of cirrhosis on the basis of jaundice is as follows: [1]
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Differential diagnosis of cirrhosis based on altered hepatic function:
Condition | Differentiating signs and symptoms | Differentiating Tests |
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Constrictive pericarditis |
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Budd-Chiari Syndrome |
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Splenic vein thrombosis | Signs and symptoms of:
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Portal vein thrombosis |
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Schistosomiasis |
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Sarcoidosis |
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Inferior vena cava obstruction |
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Nodular regenerative hyperplasia | None |
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Idiopathic portal hypertension (hepatoportal sclerosis) | None |
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Vitamin A intoxication, arsenic, and vinyl chloride toxicity | None |
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Differentiating Cirrhosis from other Diseases Based on Ascitic Fluid
Ascites may be caused by portal hypertension due to cirrhosis of liver or due to other causes such as malignancy. Ascitic fluid analysis should be done to broadly categorize the cause of ascites.
Ascites is broadly classified as two types based on the serum-ascites albumin gradient (SAAG):
- Transudate - SAAG > 1.1 g/dL (indicative of ascites due to portal hypertension)
- Exudate - SAAG < 1.1 g/dL (indicative of ascites due to other etiologies)