Postoperative Mental Disorder?

Decompensated cirrhosis, portal hypertension, hypoalbuminemia, electrolyte imbalance, ascites, hydrothorax…

The list of diagnoses was long and blurry.

It looked like this patient had a hepatitis B infection that had progressed to hepatic cirrhosis, splenomegaly, and portal hypertension. This had then led to refractory ascites.

The earlier diagnosis was similar to a disease progression of hepatitis.

Decompensated cirrhosis would lead to two fatal complications—hematemesis and ascites.

When the ascites developed into refractory ascites, the usual diuretic treatment would not work. The ascites would result in hypoalbuminemia, leading to the leakage of fluids, worsening the ascites, and further lowering the albumin levels.

It became a vicious cycle.

The clinical treatment of ascites and hypoalbuminemia were diuretics and an intravenous infusion of human albumin.