Background: Proton pump inhibitors (PPIs) have been associated with adverse events and increased mortality in patients diagnosed with cirrhosis (1). PPIs are commonly prescribed to patients with cirrhosis who present to the hospital with gastrointestinal bleeds (2). However, guidelines do not suggest routine usage of PPI in patients with cirrhosis without gastroesophageal reflux disease (GERD) [...]

Background: Patients with cirrhosis complicated by ascites are often admitted to the hospital and require abdominal paracentesis for diagnostic evaluation and symptom relief. When large volumes are removed there is a risk for acute kidney injury (AKI) which can contribute to morbidity and mortality. There are no clear guidelines for what constitutes a safe volume [...]

Case Presentation: A 67-year-old female with a history of decompensated NASH-cirrhosis with portal hypertensive enteropathy (MELD-Na: 24) and associated iron deficiency anemia (IDA) presents for an incidental hemoglobin of 5.8 g/dL. She had symptoms of fatigue but was otherwise asymptomatic with no melena or hematochezia. Vital signs were within normal limits. The physical exam was [...]

Case Presentation: A 73 year-old man presented with 2 weeks of difficulty completing multi-step tasks, e.g., getting into a car. At baseline, he was independent in instrumental activities of daily living. He had no other symptoms; he denied headache, weakness, numbness, vision changes, confusion, fevers, chills or weight loss. His history included non-alcoholic steatohepatitis with [...]

Case Presentation: 26 yo M with X-linked agammaglobulinemia admitted for RLE extremity non healing wound and abdominal distention found to have hepatosplenomegaly (liver 23 cm), moderate to large ascites, transaminitis (ALP 300, AST/ALT 43/12), hyperbilirubinemia (T bili 6.5->7.5), coagulopathy (INR 1.75 with pancytopenia. On ultrasound porto-systemic collaterals and splanchnic vessels were reported patent. MRI abdomen [...]