Hepatology

  • Does my patient with acute variceal hemorrhage need a transjugular intrahepatic portosystemic shunt?
    Mahnur Haider, MD, Indira Bhavsar-Burke, MD, Robert S. O’Shea, MD, MSCE and Christina C. Lindenmeyer, MD
    Cleveland Clinic Journal of Medicine July 2024, 91 (7) 409-413; DOI: https://doi.org/10.3949/ccjm.91a.24014

    Placement of a transjugular intrahepatic portosystemic shunt can be used as salvage therapy to control bleeding when endoscopic management fails and as a means of secondary prophylaxis in select patients.

  • What are the management considerations for venous thromboembolic events in patients with cirrhosis?
    Marie M. Plante, MD, BSN, RN, Emily B. Wolf, MD and Razvan M. Chirila, MD
    Cleveland Clinic Journal of Medicine February 2024, 91 (2) 86-88; DOI: https://doi.org/10.3949/ccjm.91a.23045

    The authors review the current evidence on venous thromboembolic event (VTE) risk prediction in patients with cirrhosis, as well as VTE prophylaxis and anticoagulant therapy.

  • Anchors away
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine November 2023, 90 (11) 652-653; DOI: https://doi.org/10.3949/ccjm.90b.11023

    Before you read this, I recommend that you read the interesting article in this issue by Prakash et al, part of our Symptoms to Diagnosis series.

  • What is the role for terlipressin in hepatorenal syndrome?
    Stephanie N. Bass, PharmD, Aanchal Kapoor, MD and Christina C. Lindenmeyer, MD
    Cleveland Clinic Journal of Medicine November 2023, 90 (11) 664-667; DOI: https://doi.org/10.3949/ccjm.90a.23037

    The drug is recommended as a first-line treatment of hepatorenal syndrome-related acute kidney injury, but it is associated with respiratory failure, especially in the setting of albumin administration, and certain comorbidities may increase the risk.

  • Elevated aminotransferases in a 62-year-old woman
    Shahana Prakash, MD, Steven Moore, MD, PhD, Anthony Snow, MD and Kyle E. Brown, MD, FAASLD
    Cleveland Clinic Journal of Medicine November 2023, 90 (11) 669-674; DOI: https://doi.org/10.3949/ccjm.90a.23011

    Her medical history included gastroesophageal reflux disease and Sjögren syndrome. She had recently returned from travel to Malaysia.

  • Cirrhosis: Primary care approaches to screening, immunization, and lifestyle modifications
    Cirrhosis: Primary care approaches to screening, immunization, and lifestyle modifications
    Asim Kichloo, MD, Michael Aljadah, MD, Michael Albosta, MD, Zain El-Amir, MD, Ghazaleh Goldar, MD, Muhammed Zatmar Khan, MD, Dushyant Singh Dahiya, MD and Farah Wani, MD
    Cleveland Clinic Journal of Medicine November 2023, 90 (11) 693-701; DOI: https://doi.org/10.3949/ccjm.90a.21043

    The authors review management of cirrhosis and complications such as esophageal varices and hepatocellular carcinoma, as well as chemical and medication exposures.

  • Portopulmonary hypertension: A focused review for the internist
    Portopulmonary hypertension: A focused review for the internist
    Mamta S. Chhabria, MD, Leela Krishna Teja Boppana, MD, Gaurav Manek, MD and Adriano R. Tonelli, MD, MSc
    Cleveland Clinic Journal of Medicine October 2023, 90 (10) 632-639; DOI: https://doi.org/10.3949/ccjm.90a.23023

    Key aspects of screening, diagnosis, and treatment, and a review of the various pulmonary hemodynamic patterns encountered in patients with liver disease.

  • If a patient has cirrhosis, should I correct coagulation abnormalities before a minor invasive procedure?
    Emily B. Wolf, MD, Marie Plante, MD and Razvan M. Chirila, MD
    Cleveland Clinic Journal of Medicine September 2023, 90 (9) 541-543; DOI: https://doi.org/10.3949/ccjm.90a.23005

    Hemostatic abnormalities in cirrhosis can include thrombocytopenia, prolonged prothrombin time, prolonged activated partial thromboplastin time, elevated international normalized ratio, and decreased fibrinogen.

  • Diagnosis and management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome
    Sarah Khan, MD and Maureen Linganna, MD
    Cleveland Clinic Journal of Medicine April 2023, 90 (4) 209-213; DOI: https://doi.org/10.3949/ccjm.90a.22028

    A review of recommendations from the American Association for the Study of Liver Diseases.

  • Is your patient at risk for NAFLD?
    Patress Ann Persons, MD, FACP, Sophie Bersoux, MD, MPH, FACP and Mary Helen Whited, MD, FACP
    Cleveland Clinic Journal of Medicine December 2022, 89 (12) 719-727; DOI: https://doi.org/10.3949/ccjm.89a.22005

    The authors review identifying individuals at risk, treatment options founded on lifestyle modification, and when to consider referring patients to a hepatologist.

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