Snapshot A 65-year-old man is brought to the emergency room for abdominal pain. He has a history of alcohol abuse. He reports that he has felt fatigued, itchy, and “out of it” for the past several weeks. His wife also noticed that his skin looks more orange. On exam, his abdomen is distended with a positive fluid wave. Dermatologic exam reveals jaundice, palmar erythema and spider angiomata. A hepatic ultrasound shows nodularity and fibrosis of the liver. Introduction Overview login to view 1 more bullet Epidemiology Incidence login to view 1 more bullet Risk factors login to view 9 more bullets ETIOLOGY Pathogenesis login to view 7 more bullets Presentation Symptoms login to view 7 more bullets Physical exam login to view 10 more bullets Imaging Liver ultrasound login to view 7 more bullets Transient elastography login to view 5 more bullets Studies Serum labs login to view 19 more bullets Invasive studies login to view 4 more bullets Differential Acute viral hepatitis login to view 3 more bullets Treatment Management approach login to view 1 more bullet Lifestyle login to view 4 more bullets Medical login to view 10 more bullets Surgical login to view 7 more bullets Complications Hepatocellular carcinoma login to view 2 more bullets Spontaneous bacterial peritonitis Esophageal or gastric varices login to view 5 more bullets Hepatic hydrothroax login to view 4 more bullets Prognosis Model for End-Stage Liver Disease (MELD) score login to view 4 more bullets