ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-based Learning (Day Two) | March 2025-Cirrhosis and Complications of Liver Disease

Video Transcription

Video Summary

The talk focuses on cirrhosis and portal hypertension, emphasizing their clinical significance, especially for healthcare providers like Advanced Practice Providers (APPs). The liver's multifaceted role in metabolism, storage, detoxification, immune function, and protein synthesis is explained, highlighting that these functions are compromised with cirrhosis—a condition defined by fibrotic tissue replacement leading to advanced scarring and portal hypertension.<br /><br />Cirrhosis affects over 2 million adults in the U.S., primarily due to alcohol-related liver disease, hepatitis C, and metabolic-associated steatotic liver disease (MASLD). The incidence of cirrhosis is rising, particularly among younger populations due to alcohol use. Key symptoms include muscle cramps, insomnia, pruritus, and sexual dysfunction. Clinical features seen in imaging include nodular liver surface and signs of portal hypertension like ascites and splenomegaly.<br /><br />Common complications such as ascites, hepatic encephalopathy, and variceal bleeding are discussed alongside diagnostic tactics, including liver biopsy and non-invasive fibrosis assessment. Management includes dietary modifications, medication adjustments, and interventions like transjugular intrahepatic portosystemic shunt (TIPS). The presentation also addresses the evaluation for liver transplantation based on scoring systems like Child-Pugh and MELD, which assess the severity and priority for transplant consideration.

Asset Subtitle

Sumeet K. Tewani, MD, FASGE

Keywords

cirrhosis

portal hypertension

Advanced Practice Providers

liver disease

hepatic encephalopathy

transjugular intrahepatic portosystemic shunt

liver transplantation

Child-Pugh and MELD scoring