Cirrhosis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Differentiating Cirrhosis from other Diseases
Differentiating Cirrhosis from other Diseases Based on Ascitic Fluid
Ascites may be caused by portal hypertension due to cirrhosis of liver or due to other causes like malignancies etc.,
Ascitic fluid analysis should be done to broadly categorize the cause of ascites.
Ascites is broadly classified as two types based on the serum-ascites albumin gradient (SAAG):
- Transudate - SAAG > 1.1 g/dL (indicates the ascites is due to portal hypertension).
- Exudate - SAAG < 1.1 g/dL (indicates the ascites is due to non-portal hypertension etiology).
| Condition | Differentiating Signs and Symptoms | Differentiating Tests |
| Constrictive pericarditis | Increased jugular venous pressure, atrial fibrillation, and tachycardia. Quiet heart sounds with a third heart sound (ventricular knock) present. | *EKG will show tachycardia, atrial fibrillation, low-voltage QRS complexes and T wave abnormalities. Doppler ultrasound will show ventricular filling abnormalities. |
| Budd-Chiari Syndrome | Abdominal pain, diarrhea, and worsening ascites. | Doppler ultrasound and CT of the abdomen will show absence of the hepatic vein filling. Abdominal CT will show a rapid clearing of the caudate lobe of the liver. |
| Splenic vein thrombosis | Similar signs and symptoms of pancreatitis with upper abdominal pain radiating to the back, vomiting, poor bowel sounds, fever and shock. Cullen's sign and Grey-Turner's sign may be present. | An ultrasound of the abdomen and CT will show evidence of a splenic vein thrombosis. Normal hepatic venous pressure gradient is present. |
| Portal vein thrombosis | The presentation of drug molecules by major histocompatability complexes to T cells, causing the release of cytokines and other inflammatory mediators. Also associated with the activation of eosinophils, monocytes, and neutrophils. | rashes, organ tissue damage, contact sensitivity. |
| Schistosomiasis | The presentation of drug molecules by major histocompatability complexes to T cells, causing the release of cytokines and other inflammatory mediators. Also associated with the activation of eosinophils, monocytes, and neutrophils. | rashes, organ tissue damage, contact sensitivity. |
| Sarcoidosis | The presentation of drug molecules by major histocompatability complexes to T cells, causing the release of cytokines and other inflammatory mediators. Also associated with the activation of eosinophils, monocytes, and neutrophils. | rashes, organ tissue damage, contact sensitivity. |
| Inferior vena cava obstruction | The presentation of drug molecules by major histocompatability complexes to T cells, causing the release of cytokines and other inflammatory mediators. Also associated with the activation of eosinophils, monocytes, and neutrophils. | rashes, organ tissue damage, contact sensitivity. |