Background: Paracentesis is a common procedure for patients with decompensated cirrhosis. In patients with cirrhosis and superimposed renal impairment, clinicians may hesitate to perform a large volume paracentesis, given concerns of intraabdominal fluid shifts resulting in further renal dysfunction. In this study, we aimed to answer whether greater ascites fluid removal was associated with 48-hour [...]

Case Presentation: A 54-year-old man with a history of alcoholic cirrhosis presented to the emergency department for evaluation of a new facial rash and was found to be hypercalcemic to 15.6 mg/dL. A subsequent ionized calcium and cystatin C were also found to be elevated at 1.90 mMol/L and 2.55 mg/L (eGFR 23), respectively. His [...]

Case Presentation: A 46-year-old male with alcohol use disorder and cirrhosis presented to the emergency department for 1 day of persistent ascitic fluid leakage from his umbilicus. Exam was significant for ascites and a reducible, ulcerated umbilical hernia. The ulcer was cleaned, sealed with skin glue, and the patient was discharged. He presented again 7 [...]

Case Presentation: A 48-year-old male with past medical history significant for hypertension, alcohol use disorder in remission, known grade I esophageal varices, and cirrhosis who presented with confusion and oral mucosa bleeding. He was tachycardic to 100 but had adequate blood pressure of 106/68. Initial labs remarkable for hemoglobin 9.4 g/dL and platelet count 1 [...]

Case Presentation: A 64-year-old female with decompensated alcoholic liver cirrhosis was admitted to the hospital for lower abdominal pain. The initial paracentesis polymorphonuclear (PMN) leukocyte count was 149 cells/mm3, but the patient was found to have E. coli urinary tract infection. During the course of her treatment, the patient developed pancreatitis and her hepatic encephalopathy [...]