Cirrhosis differential diagnosis: Difference between revisions
No edit summary |
No edit summary |
||
Line 374: | Line 374: | ||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Differentiating Tests | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Differentiating Tests | ||
|- | |- | ||
|'''Constrictive pericarditis''' | | style="background:#DCDCDC; + " | '''Constrictive pericarditis''' | ||
| | | | ||
* Increased [[jugular venous pressure]] | * Increased [[jugular venous pressure]] | ||
Line 388: | Line 388: | ||
* [[Doppler ultrasound]] shows ventricular filling abnormalities | * [[Doppler ultrasound]] shows ventricular filling abnormalities | ||
|- | |- | ||
|'''Budd-Chiari Syndrome''' | | style="background:#DCDCDC; + " | '''Budd-Chiari Syndrome''' | ||
| | | | ||
* Abdominal pain | * Abdominal pain | ||
Line 397: | Line 397: | ||
* 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 | ||
|- | |- | ||
|'''Splenic vein thrombosis''' | | style="background:#DCDCDC; + " | '''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 | ||
Line 410: | Line 410: | ||
* Normal hepatic venous pressure gradient is present | * Normal hepatic venous pressure gradient is present | ||
|- | |- | ||
|'''Portal vein thrombosis''' | | style="background:#DCDCDC; + " | '''Portal vein thrombosis''' | ||
| | | | ||
* Symptoms depend on the underlying cause: | * Symptoms depend on the underlying cause: | ||
Line 435: | Line 435: | ||
* MR or direct angiography show a normal hepatic venous pressure gradient. | * MR or direct angiography show a normal hepatic venous pressure gradient. | ||
|- | |- | ||
|'''Schistosomiasis''' | | style="background:#DCDCDC; + " | '''Schistosomiasis''' | ||
| | | | ||
* Patients may have a history of travel to endemic areas | * Patients may have a history of travel to endemic areas | ||
Line 455: | Line 455: | ||
* MR or direct angiography shows a normal hepatic venous pressure gradient | * MR or direct angiography shows a normal hepatic venous pressure gradient | ||
|- | |- | ||
|'''Sarcoidosis''' | | style="background:#DCDCDC; + " | '''Sarcoidosis''' | ||
| | | | ||
* Dry cough with [[dyspnea]] | * Dry cough with [[dyspnea]] | ||
Line 471: | Line 471: | ||
** Liver biopsy shows non-necrotizing, [[non-caseating granulomas]] | ** Liver biopsy shows non-necrotizing, [[non-caseating granulomas]] | ||
|- | |- | ||
|'''Inferior vena cava obstruction''' | | style="background:#DCDCDC; + " | '''Inferior vena cava obstruction''' | ||
| | | | ||
* Signs and symptoms of [[renal cell carcinoma]]: | * Signs and symptoms of [[renal cell carcinoma]]: | ||
Line 482: | Line 482: | ||
* Ultrasound of the abdomen shows evidence of inferior vena cava obstruction | * Ultrasound of the abdomen shows evidence of inferior vena cava obstruction | ||
|- | |- | ||
|'''Nodular regenerative hyperplasia''' | | style="background:#DCDCDC; + " | '''Nodular regenerative hyperplasia''' | ||
|None | |None | ||
| | | | ||
* [[Liver biopsy]] shows small regenerative nodules with little or no fibrosis on reticulin staining | * [[Liver biopsy]] shows small regenerative nodules with little or no fibrosis on reticulin staining | ||
|- | |- | ||
|'''Idiopathic portal hypertension (hepatoportal sclerosis)''' | | style="background:#DCDCDC; + " | '''Idiopathic portal hypertension (hepatoportal sclerosis)''' | ||
|None | |None | ||
| | | | ||
* [[Liver biopsy]] shows no evidence of cirrhosis | * [[Liver biopsy]] shows no evidence of cirrhosis | ||
|- | |- | ||
|'''Vitamin A intoxication, arsenic, and vinyl chloride toxicity''' | | style="background:#DCDCDC; + " | '''Vitamin A intoxication, arsenic, and vinyl chloride toxicity''' | ||
|None | |None | ||
| | | |
Revision as of 15:36, 19 December 2017
Cirrhosis Microchapters |
Diagnosis |
---|
Treatment |
Case studies |
Cirrhosis differential diagnosis On the Web |
American Roentgen Ray Society Images of Cirrhosis differential diagnosis |
Risk calculators and risk factors for Cirrhosis differential diagnosis |
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]
|
Differential diagnosis of cirrhosis based on altered hepatic function:
Condition | Differentiating signs and symptoms | Differentiating Tests |
---|---|---|
Constrictive pericarditis |
|
|
Budd-Chiari Syndrome |
|
|
Splenic vein thrombosis | Signs and symptoms of:
|
|
Portal vein thrombosis |
|
|
Schistosomiasis |
|
|
Sarcoidosis |
|
|
Inferior vena cava obstruction |
|
|
Nodular regenerative hyperplasia | None |
|
Idiopathic portal hypertension (hepatoportal sclerosis) | None |
|
Vitamin A intoxication, arsenic, and vinyl chloride toxicity | None |
|
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)