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Table 77.6

Precipitants of Decompensated Chronic Liver Disease

  • Intercurrent infection, especially spontaneous bacterial peritonitis (Appendix 24.1)
  • Acute gastrointestinal bleeding (variceal and non-variceal) (Chapter 73)
  • Drugs: diuretics, hypnotics, sedatives and opioid analgesics
  • Alcoholic hepatitis
  • Viral hepatitis
  • Major surgery and anaesthesia
  • Liver ischaemia secondary to hypotension
  • Acute portal vein thrombosis
  • Hypokalaemia and hypoglycaemia
  • Constipation
  • Development of hepatocellular carcinoma
  • No cause apparent (in up to 40% of patients)