Snapshot A 50-year-old man presents to his primary care physician with yellowing skin and increased abdominal girth. He believes that he has gained weight and is worried about obesity. He also reports being concerned about increased breast size. He denies having a history of alcohol abuse, but when he is questioned further, he admits to drinking a bottle of vodka daily to cope with stressors in his life. On exam, he has spider angiomas on his abdomen, jaundice, and gynecomastia. Introduction Overview login to view 2 more bullets Epidemiology login to view 12 more bullets Pathogenesis login to view 21 more bullets Prognosis login to view 5 more bullets Presentation Symptoms login to view 7 more bullets Physical exam login to view 21 more bullets Imaging Computed tomography (CT) of abdomen login to view 7 more bullets Liver ultrasound login to view 7 more bullets Transient elastography login to view 5 more bullets Studies Serum labs login to view 18 more bullets Invasive studies login to view 4 more bullets Differential Acute viral hepatitis login to view 3 more bullets Treatment Management approach login to view 1 more bullet Lifestyle login to view 4 more bullets Medical login to view 16 more bullets Surgical login to view 10 more bullets Complications Hepatocellular carcinoma login to view 2 more bullets Esophageal or gastric varices login to view 2 more bullets Spontaneous bacterial peritonitis