Open AccessThe patient presenting with decompensated cirrhosis
Author(s) -
Berry Pa,
Susan Thomson
Publication year - 2013
Publication title -
acute medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.14
H-Index - 12
eISSN - 1747-4892
pISSN - 1747-4884
DOI - 10.52964/amja.0325
Subject(s) - medicine , cirrhosis , intensive care medicine , alcoholic liver disease , sepsis , liver transplantation , spontaneous bacterial peritonitis , acute kidney injury , liver disease , disease , transplantation
The rates of liver disease in the UK are rising and hence more patients than ever are presenting to acute medical units with potentially life threatening sequelae. Early recognition and treatment of sepsis, kidney injury, bleeding and alcoholic hepatitis can significantly improve outcomes, but requires a comprehensive approach to assessment. This patient cohort often suffers from a perceived uniform poor prognosis, especially in alcohol related disease, but evidence for this is changing and reassessment of prognosis after 48 hours of organ support may be more accurate than that made ‘at the front door’. This article summarises the most important complications of decompensated cirrhosis, their early management, and presents a targeted system of care: ‘RING Liver’ – Renal failure, Infection, Nutrition, Gastrointestinal bleeding and transit, Liver dysfunction/transplantation. Factors favouring transfer to tertiary units are also explored.