Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is defined as the presence of ≥5% of hepatic steatosis (HS) in the absence of other liver disorders, such as chronic viral or autoimmune hepatitis, steatosis induced by drugs, significant alcohol consumption, hemochromatosis, or Wilson’s disease. There is limited literature describing national prevalence and epidemiological characteristics of NAFLD in [...]

Background: Hepatic artery pseudoaneurysm (HAP) is a rare entity, potentially life threatening and associated with high mortality. The aim of this study was to evaluate Mayo Clinic enterprise’s clinical experience with HAP occurrence, clinical features and outcome in the last 20 years, and to compare our results with what the literature. Methods: This retrospective analysis [...]

Background: Cholangiocarcinoma is an uncommon cancer with a very bad prognosis despite advances made in treatment. Location intrahepatic versus extrahepatic – determines surgical options. In our study, we examined variations in outcomes between patients admitted to the hospital with intrahepatic versus extrahepatic disease. Methods: Data from the National Inpatient Sample (NIS) which is part of [...]

Background: Rifaximin 550 mg tablets is a nonsystemic antibiotic indicated for reducing the risk of overt hepatic encephalopathy (OHE) recurrence in adults and may be used alone or in combination with the cathartic lactulose. This analysis evaluated the safety profile of rifaximin alone vs rifaximin + lactulose (combination) in patients with cirrhosis. Methods: In a [...]

Background: Rifaximin, a nonsystemic antibiotic, may be used alone or in combination with lactulose for reducing the risk of overt hepatic encephalopathy (OHE) recurrence in adults. This analysis evaluated rifaximin alone and rifaximin + lactulose (combination) on health-related quality of life (QOL) and caregiver burden in patients with a history of OHE. Methods: In a [...]

Background: Hepatic encephalopathy (HE) is a common complication in patients with end stage liver disease. Variability in presentation can be a source of clinical uncertainty for medical providers. Ammonia levels have historically been used to aid in the diagnosis of HE despite low positive and negative predictive values. Our primary objective was to determine the [...]

Background: Hepatic encephalopathy (HE) is a common neurological complication in patients with cirrhosis. In addition to numerous morbidity-related issues, HE is associated with substantial economic burden. Treatment includes lactulose or rifaximin, a nonsystemic antibiotic that is indicated for reducing the risk of overt HE recurrence in adults. Rifaximin has also been shown to reduce the [...]

Case Presentation: Mr. O is a 28 year old Navy cadet with no significant past medical history who presented to the Emergency Department with three days of malaise, nausea, polyuria, and polydipsia in the setting of recent steroids for a new rash. On presentation, Mr. O’s glucose returned at 624 mg/dL, pH was 7.28 and [...]

Case Presentation: 47 year old female with a past medical history of hypertension presented to the emergency room with two days of right upper quadrant pain and a fever to 102F. For several months prior, she complained of bloating, intermittent diarrhea and diffuse abdominal pain that now localized. Her social history was positive for recent [...]

Background: Rifaximin 550 mg tablets is a nonsystemic antibiotic indicated for reducing the risk of overt hepatic encephalopathy (HE) recurrence in adults and may be used in combination with lactulose. Practice guidelines state that rifaximin is effective as add-on therapy to lactulose for preventing overt HE recurrence. This pooled analysis evaluated the efficacy and safety [...]