TABLE 4

Screening recommendations for patients with liver cirrhosis

ComplicationScreening recommendations
Esophageal varicesInitial screening may be performed by platelet count and transient elastography
All patients with high-risk varices should be offered esophagogastroduodenoscopy
For those with medium to large varices, endoscopic variceal band ligation is appropriate for prevention of bleeding9
Hepatocellular carcinomaAll patients with cirrhosis should undergo routine ultrasonography every 6 months to screen for hepatocellular carcinoma9,16
Hepatic encephalopathyClinical diagnosis based on exclusion of other causes of brain dysfunction18
Ammonia levels should not be used to diagnose or stage patients with hepatic encephalopathy17,18