How Should a Hospitalized Patient with Newly Diagnosed Cirrhosis Be Evaluated and Managed?

Cirrhosis has many etiologies, and new diagnoses require further investigation as to the underlying etiology.
Initial management should focus on evaluation and treatment of complications, including ascites, esophageal varices, and hepatic encephalopathy.
A diagnostic paracentesis, salt restriction, and a nutrition consult are the initial therapies for ascites although most patients will also require diuretics to increase sodium excretion.
Once stabilized, the cirrhotic patient will require specialty care for possible liver biopsy (if etiology remains unclear), treatment (eg, HCV antivirals), and/or referral for liver transplantation.