[Hepatic encephalopathy – the acute management].

Hepatic encephalopathy causes significant impairment and morbidity. Hepatic encephalopathy is just one of many causes for altered mental status in patients with cirrhosis of the liver. The initial management at admission to hospital includes a search for differential diagnoses and precipitating factors. A structured description of the type, cause, time course and clinical severity is essential for achieving medically safe communication and care of the HE patient. Lactulose and correction of any precipitating factors is the basis for initial therapy. A post-discharge management which includes frequent monitoring, preventive measures as well as education of patient and caregivers may ameliorate the often very high readmission rate.