The Management of Hospitalized Patients with Cirrhosis: The Mount Sinai Experience and a Guide for Hospitalists
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ponni V. Perumalswami Thomas D. Schiano
- چاپ و سال / کشور: 2011
Description
Background Cirrhosis and chronic liver disease carry appreciable morbidity and mortality. Cirrhotic patients frequently require hospitalization and their care is both extremely complex and labor-intensive. Aim We seek to provide a review for gastroenterologists, hepatologists, internists, and hospitalists on the approach to care in patients hospitalized for complications related to end-stage liver disease. Methods The Mount Sinai Medical Center’s inpatient liver service has developed an integrated team approach for cirrhotic patients and throughout the years has educated fellows-in-training and medical house staff on both the treatment principles and ‘‘pearls’’ in managing the hospitalized cirrhotic patient. We reviewed the literature and provide recommendations on the management of complications of end-stage liver disease. Additionally, we provide a review of the protocols used at our institution in the care for cirrhotic patients. Results Major complications of advanced liver disease include infection, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal hemorrhage, hepatorenal syndrome, and hepatocellular carcinoma. Management of these complications involves selecting the appropriate diagnostic studies and prompt administration of therapy. Conclusions There are many complications of cirrhosis. Management of these complications can be complex and are targeted at stabilizing the patient’s clinical condition. Liver transplantation remains the only definitive treatment.
Dig Dis Sci (2011) 56:1266–1281 DOI 10.1007/s10620-011-1619-9 Received: 15 October 2010 / Accepted: 5 February 2011 / Published online: 18 March 2011
