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Copyright ©2011 Baishideng Publishing Group Co.
World J Hepatol. May 27, 2011; 3(5): 125-129
Published online May 27, 2011. doi: 10.4254/wjh.v3.i5.125
Table 1 General approach to treatment of a patient with alcoholic hepatitis
ComplicationInitial evaluationTreatmentTreatment for refractory cases
Alcohol withdrawalHistory of alcohol abuse Ethanol levelFluid hydration Benzodiazepines Glucose supplementation Vitamin replacementICU placement IV benzodiazepines Propofol Phenobarbital Endotracheal intubation
AscitesLFTs, ascetic fluid analysis, CT abdomenDiuretics IV albumin ParacentesisTIPS Liver transplantation
Altered mental statusCBC/BMP LFTs NCCT head Pancultures Lumbar punctureIV antibiotics Lactulose Treat precipitantRifa × imin
Variceal bleedingCBC LFTsBlood transfusion octreotide Prophylactic antibiotics EVLTIPS Shunt surgery for compensated cirrhosis
InfectionCBC/BMP PanculturesAntibiotics for gram negative coverageBroad spectrum antibiotics covering both gram positive and negative organisms
MalnutritionWeight comparison Serum albuminOral supplementationPEG placement Nutritionist consultation