Chronic Liver Disease Case Sheet

Ascites and portal hypertension: a complete abdominal long case for final MBBS

• Free PDF
• Case sheets
• 30 pages
• 8.9 MB
• 1st (2026) edition

The commonest abdominal long case in the final MBBS General Medicine examination, fully worked from history to viva. One composite case of decompensated alcohol-related cirrhosis with large-volume ascites, portal hypertension and hepatic encephalopathy, written exactly as it should be recorded in the case record and presented at the bedside, with the reasoning behind every question asked and every sign elicited. Case-taking in 12 steps; history of presenting illness, the five decompensation events, alcohol, viral, drug and metabolic aetiology screen; general examination and the stigmata of chronic liver disease; abdominal inspection, liver and spleen palpation, the tests for ascites and the signs of portal hypertension; summary, final diagnosis, Child–Pugh and MELD, differential diagnosis and causes of portal hypertension; investigations including LFT, viral markers, ascitic fluid analysis and SAAG, ultrasound, endoscopy and elastography; management of ascites, variceal bleeding, SBP, hepatic encephalopathy and hepatorenal syndrome, prevention and transplant, following AASLD, EASL and Baveno VII. Ends with a model presentation to practise aloud and 42 viva questions with short answers. Tap-to-open photos of clinical signs, ultrasound and CT images, bedside technique videos and AETCM YouTube lectures, with a visual atlas of QR codes for the printed copy. For final-year MBBS students, interns and teachers of clinical medicine.

Author: Dr. Gireesh Kumar K. P. · For: MBBS / UG students