Background: Renal dysfunction is a complication in patients with decompensated cirrhosis. Due to the potential morbidity and mortality of these disorders in cirrhotic patients, it is important to ensure accurate clinical measurements of renal function. Standard creatinine-based estimated glomerular filtration rate (eGFR) equations have proven to be inaccurate in cirrhotic patients, as these patients have […]

Background: Spontaneous bacterial peritonitis (SBP) is a commonly encountered complication of end stage liver disease that carries a high morbidity and mortality. Risk factors for SBP are defined by the American Association for the Study of Liver Diseases (AASLD) as a prior history of SBP, active gastrointestinal bleeding, and low ascites total protein (< 1.5 […]

Case Presentation: A 53-year-old woman with a history of metabolic syndrome and necrotizing pancreatitis presented with new onset ascites. Her story began nine months earlier, when she developed abdominal pain. CT at that time revealed pancreatitis and cholelithiasis without biliary dilation. Lab values were notable for: lipase 55000, total bilirubin (TBIL) 5.3, AST 660, ALT […]

Case Presentation: A 76-year-old Chinese woman with history of cryptogenic cirrhosis (MELD-Na 25) presented to our hospital with 1 week of worsening jaundice, abdominal distension, and right upper quadrant pain. Cirrhosis was diagnosed by imaging on admission 2 months previously and presumed to be secondary to Hepatitis C infection due to antibody positivity. CT of […]

Case Presentation: Introduction: Renal cell carcinoma (RCC) is classically associated with the triad of abdominal pain, hematuria, and a palpable mass, but its variability in clinical presentation has earned it the label of “internist’s tumor” (1,2). Liver dysfunction has been observed as a result of metastatic disease and a non-metastatic paraneoplastic syndrome called Stauffer’s syndrome […]

Case Presentation: A 55-year old female with cirrhosis secondary to chronic hepatitis B infection non-adherent with Entecavir therapy presented with altered mental status, diarrhea, abdominal pain, and emesis. Vital signs revealed hypotension, tachycardia, and tachypnea. Exam revealed somnolence and significant abdominal distension without guarding, rebound, or rigidity. Laboratory evaluation was remarkable for a leukocytosis to […]

Case Presentation: 48-year-old female with past medical history of cirrhosis secondary to HBV (on entecavir) and EtOH, decompensated by hepatic encephalopathy and ascites, coronary artery disease s/p stenting to LAD in 2009 presented to the hospital with abdominal pain and distension for a 1-week duration. She stated that the pain radiated to her back and […]