View source for Liver disease induced coagulopathy

<languages/>
<translate>

==Background==

[[File:Liver vascular anatomy.png|thumb|Liver vascular anatomy.]]


==Clinical Features==


==Differential Diagnosis==

</translate>
{{Increased bleeding DDX}}
<translate>


==Evaluation==

*PT prolongation
**Decreased synthesis of vitamin K-dependent factors (II, VII, IX, X)
*[[Special:MyLanguage/Thrombocytopenia|Thrombocytopenia]]
**Portal hypertension → congestive hypersplenism → splenic sequestration
*Fibrinolysis increased
**Due to decreased synthesis of alpha2 plasmin inhibitor
**Low fibrinogen level, mild elevation of FDP and D-dimer


==Management==


===Lab abnormalities only (with out significant bleeding)===

*Observation


===Significant bleeding===

*[[Special:MyLanguage/Vitamin K|Vitamin K]] PO or IV
*[[Special:MyLanguage/Desmopressin|Desmopressin]]
**Effective with minimal side effects
**0.3mg/kg IV (preferred) or SC (max 20mg)
**Onset of action ~1hr, duration of action ~4-24hr
*[[Special:MyLanguage/Cryoprecipitate|Cryoprecipitate]]
**May be used to replace fibrinogen in patients with fibrinogen levels <100
**1 bag per 10kg of body weight
*[[Special:MyLanguage/Platelets|Platelets]]
**Aim for >50K for moderate risk procedures; >100K for high risk procedures
*[[Special:MyLanguage/FFP|FFP]]
**Use with caution; requires large volume of FFP to make a significant difference
*[[Special:MyLanguage/PPI|PPI]]/[[Special:MyLanguage/famotidine|famotidine]]/[[Special:MyLanguage/octreotide|octreotide]] ([[Special:MyLanguage/variceal bleeding|variceal bleeding]])

[[Category:GI]]


==Disposition==


==See Also==

*[[Special:MyLanguage/Coagulopathy (Main)|Coagulopathy (Main)]]


==References==

<references/>
[[Category:Heme/Onc]]
</translate>