Portal-Systemic Encephalopathy Follow-up

  • Author: Gagan K Sood, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Mar 25, 2010
 

Further Inpatient Care

  • Alcohol rehabilitation is a requirement for consideration of acceptance for listing for orthotopic liver transplantation. Regardless of whether the patient is a candidate for orthotopic liver transplantation, the development of portosystemic encephalopathy is a potential revelation that permits progress toward achieving and maintaining abstinence. This is a critical step for increasing the probability of survival and often is best approached initially by taking advantage of the inpatient status.
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Complications

  • Respiratory and ventilatory insufficiency and failure to protect the airway with consequent aspiration are anticipated complications that should be avoided with endotracheal intubation.
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Prognosis

  • In general, the prognosis for patients with advanced liver disease is poor unless they are able to undergo liver transplantation. The contribution that portosystemic encephalopathy makes to the decline of these individuals is limited, and, rather than acting as a causal factor, it is essentially a marker of decompensated liver disease. As with other complications of chronic liver disease, survival likely correlates better with Child-Pugh score than the outcome of the complication itself.
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Contributor Information and Disclosures
Author

Gagan K Sood, MD  Associate Professor, Department of Medicine and Surgery, Baylor College of Medicine

Gagan K Sood, MD is a member of the following medical societies: American Association for the Study of Liver Diseases and American Gastroenterological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Ann Ouyang, MBBS  Professor, Department of Internal Medicine, Pennsylvania State University College of Medicine; Attending Physician, Division of Gastroenterology and Hepatology, Milton S Hershey Medical Center

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Noel Williams, MD  Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada

Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor, Blake A Jones, MD, to the development and writing of this article.

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