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Case Details
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Case Details
Hepatic encephalopathy
Author: Dr. Hasan Altarrah
Published Date: 10/05/2026
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Additional Information:
CC:
Confusion
Description
Reviews
Description
Diagnosis
Hepatic encephalopathy
It is a clinical diagnosis
Symptoms range from personality change to coma
Supportive Findings
Asterixis (flapping hand tremor)
Causes
Spontaneously
Infection
Sedating medications
Volume depletion
Gastrointestinal bleeding
What Will You Do?
Check vitals and remember ABC
ICU consult
Treat and eliminate causes such as infection, sedating medications, volume depletion and GI bleeding
Lactulose enema TDS
Lactulose PO TDS
Rule out sepsis and do septic workup
Rifaximin 550 mg PO BD
Ammonia is not used for diagnosis or follow up
Target Stool Per Day
3 to 5 stools per day
Classification of Hepatic Encephalopathy
Minimal
Grade 1
Grade 2
Grade 3
Grade 4
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