Gastro and HepatoBilliary Critical Care​

Hepatorenal Syndrome (HRS) Definition Hepatorenal syndrome (HRS) is a functional, potentially reversible acute kidney injury (AKI) occurring in patients with advanced cirrhosis and portal hypertension(Ascites), in the absence of intrinsic renal disease or structural kidney damage. Epidemiology  Occurs in advanced decompensated cirrhosis (often Child-Pugh C) Triggers: Refractory ascites Spontaneous bacterial peritonitis (SBP) Large-volume paracentesis without […]

Portopulmonary Hypertension (PoPH) Definition Portopulmonary Hypertension (PoPH) is a form of pulmonary arterial hypertension (PAH, Group 1 PH) that develops in patients with: Portal hypertension (with or without cirrhosis) Increased pulmonary vascular resistance due to pulmonary arteriopathy Normal left-sided filling pressures Diagnosis requires: 1. Portal Hypertension Evidence of: Cirrhosis Non-cirrhotic portal hypertension Portosystemic shunts AND

 Acute Cholangitis  1. Definition Acute cholangitis is a life-threatening ascending infection of the biliary tree occurring due to biliary obstruction + bacterial infection. Classic triad = Charcot’s triad Fever Jaundice Right upper quadrant pain Severe disease = Reynolds pentad Charcot triad Hypotension Altered mental status Charcot triad present in ~50–70% only → absence does NOT

Peritonitis  Definition Peritonitis is inflammation of the peritoneum caused by infection, chemical irritation, ischemia, foreign material, or sterile inflammatory processes. Anatomy Relevant to Peritonitis The peritoneum is a serous membrane consisting of: Layer Description Parietal peritoneum Lines abdominal wall Visceral peritoneum Covers abdominal organs The peritoneal cavity normally contains:<50–100 mL sterile fluid Classification of Peritonitis