Portal hypertension differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Differential Diagnosis

• Portal hypertension must be differentiated from other diseases that cause ascites, splenomegaly, hematemesis or melena, bacterial peritonitis, hydrothorax, hypoxemia, and pulmonary hypertension.
• Portal hypertension must be differentiated from various diseases as in the following table.

Differentiating symptom	Diseases	Laboratory Findings				Physical Examination				History and Symptoms				Other Findings
		Lab Test 1	Lab Test 2	Lab Test 3	Lab Test 4	Physical Finding 1	Physical Finding 2	Physical Finding 3	Physical Finding 4	Finding 1	Finding 2	Finding 3	Finding 4
	Portal Hypertension			+
Ascites	Malignant ascites			+
	Nephrogenic ascites	↑			-
	Tuberculosis		↓
Splenomegaly	Thalassemia
	Sickle cell disease
	Hereditary spherocytosis
Hematemesis/ Melena	Peptic ulcer disease
	Mallory-Weiss tear
	Colorectal cancer
Bacterial peritonitis	Secondary bacterial peritonitis
Hydrothorax	Malignancy
	Sarcoidosis
	Nephrotic syndrome
Hypoxemia	Heart failure
	Central nervous system depression
	Muscular weakness
Pulmonary hypertension	Idiopathic pulmonary arterial hypertension
	Valvular heart disease
	Connective tissue diseases