History and investigations
| History |
| Symptoms leading to current presentation |
| History of known liver disease |
| Previous decompensations/complications of liver disease |
| Previous endoscopies – any known varices? |
| Infective symptoms – fever, dysuria, shortness of breath, cough, painful or swollen joints, rashes |
| Bowel habit? Constipation? Meleana/haematemasis |
| Recent foreign travel |
| Abdominal pain or swelling |
| Alcohol consumption (units/day) – currently and in the past |
| Medications and compliance |
| Recreational drug use / over the counter medication |
| Initial baseline investigations |
| Blood tests: full blood count, C-reactive protein, urea and electrolytes, liver enzymes, coagulation, lactate, bone profile, magnesium, blood glucose, venous/arterial blood gas, alpha fetoprotein, alcohol level |
| Chest X-ray |
| Urinalysis, microscopy, culture and sensitivity |
| Blood cultures |
| Ascitic tap in those with ascites – white cell count and differential, culture and fluid albumin |
| Doppler ultrasound abdomen |