Adherent clots on peptic ulcers are associated with a high rebleeding rate. Adherent clot management options include medical therapy alone with proton pump inhibitors (PPIs) or clot removal with or without endoscopic therapy along with PPIs.E..Read More

Autoimmune hepatitis (AIH) typically affl icts young women of childbearing potential, with frequent presentations including subfertility and amenorrhea. They may become pregnant, whether planned or unplanned.Prominent issues concerning AIH in..Read More

The utility of new biomarkers in therapeutic decisions, particularly in the diagnosis and assessment of chronic hepatitis B, is a subject of extensive study.Several markers, including hepatitis B virus (HBV) RNA, HBcrAg and HBsAg isoforms, ar..Read More

Biomarkers to identify early alcohol use disorder (AUD), alcoholic liver disease (ALD) and alcoholic hepatitis play a crucial role in predicting mortality, complications, organ failure and the recovery of hepatic function.The identifi cation ..Read More

Ammonia is central to the pathophysiology of hepatic encephalopathy (HE). Elevated serum ammonia levels are associated with death and transplantation.Normal ammonia levels are less common in West-Haven Grade 3 HE and are rare in Grade IV. The..Read More

Challenges unique to pregnancy include imaging modalities, fetal monitoring, mode of delivery, challenges in cesarean section and caregiver crisis. The approach to acute liver injury/acute liver failure (ALF) in pregnancy involves assess..Read More

The global prevalence of nonalcoholic fatty liver disease (NAFLD) is 30% and is increasing. This requires urgent and comprehensive strategies to raise awareness and address all aspects of NAFLD on local, regional and global levels.According t..Read More

Management options for refractory bleeding include balloon tamponade or Danis Ella stent (bridging therapies), interventional radiology-guided TIPS (IR-TIPS)/balloon-occluded retrograde transvenous obliteration and surgery.Essential considerat..Read More

Use NSBBs early to prevent 1° decompensation and not just variceal bleed. Consider NSBBs in clinically signifi cant portal hypertension/varices (or any other manifestation of PHTN).NSBBs + EVL are fi rst-line therapy for 2° prophylaxis. TIPS..Read More

Alcohol use disorder (AUD) is chronic relapsing unhealthy use of alcohol. The constellation of features include withdrawal, compulsive search for alcohol, tolerance, craving, negative emotional state and failure to meet major obligations. AUD..Read More

The currently approved therapies for hepatitis B include interferon (IFNα-2b, PEG-IFNα), lamivudine, adefovir, telbivudine, entecavir, TDF and TAF.The HBV is an oncogenic virus. The hepatocarcinogenesis could be underway even without signif..Read More

Hepatitis B virus (HBV) is the most common cause of HCC as per the Global Burden of Disease data (2019). The most important risk factors for HCC, as mentioned in the INASL Puri recommendations include cirrhosis liver, HBV infection, chronic h..Read More

When the initial evaluation is nondiagnostic, then additional history is essential. AST and ALT levels help guide the evaluation.Acetaminophen should be strongly suspected with high ALT and AST, recent medicines (antibiotics), supplements, vac..Read More

Hepatic recompensation has been defi ned as removal of the primary etiologic factor, resolution of all decompensating events and sustained improvement in hepatic function (bilirubin, INR, albumin). No ascites (off diuretics), no HE (off Precom..Read More

Mother-to-child transmission (MTCT) of the virus in women with chronic HBV may occur in various phases.Prenatal (intrauterine) potential mechanisms include maternalfetal transcytosis, trophoblastic cell infection, maternal placental dysfuncti..Read More