PT  - JOURNAL ARTICLE
AU  - Dina Mansour
AU  - Stuart McPherson
TI  - Management of decompensated cirrhosis
AID  - 10.7861/clinmedicine.18-2-s60
DP  - 2018 Apr 01
TA  - Clinical Medicine
PG  - s60--s65
VI  - 18
IP  - Suppl 2
4099  - http://www.rcpjournals.org/content/18/Suppl_2/s60.short
4100  - http://www.rcpjournals.org/content/18/Suppl_2/s60.full
SO  - Clin Med2018 Apr 01; 18
AB  - Decompensated cirrhosis is a common reason for admission to the acute medical unit, and such patients typically have complex medical needs and are at high risk of in-hospital death. It is therefore vital that these patients receive appropriate investigations and management as early as possible in their patient journey. Typical presenting clinical features include jaundice, ascites, hepatic encephalopathy, hepato-renal syndrome or variceal haemorrhage. A careful history, examination and investigations can help identify the precipitating cause (infections, gastrointestinal bleeding, high alcohol intake / alcohol-related hepatitis or drug-induced liver injury), so appropriate treatment can be given. A ‘care bundle’ that has been endorsed by the British Society of Gastroenterology is available to help guide the management of patients with decompensated cirrhosis for the first 24 hours and ensure all aspects are addressed. Specific management of complications, such as infections, gastrointestinal bleeding, hepatic encephalopathy and hepatorenal syndrome, are discussed.