See the patient
The case unfolds in short clinical stages, with only the information available at that point in the story.
Clinical Cases
Make the decision. Then open the evidence.
Short, interactive cases in liver critical care. Work through the clinical problem as it evolves, commit to an approach, and then compare your reasoning with the evidence and its limitations.
Interactive clinical cases
Work through a case
Each case undergoes named clinical and editorial review before publication, with the evidence and its limitations made explicit.
CASE 018–10 minutes
Would you admit this patient to ICU?
A patient with cirrhosis is deteriorating on the ward. Work through escalation, organ failure and what the next few days might change.
CirrhosisACLFICU admissionTransplantation
CASE 028–10 minutes
Variceal bleeding: when should TIPS happen?
A patient with cirrhosis presents with acute variceal haemorrhage. Work through resuscitation, pre-emptive TIPS and what to do if bleeding is not controlled.
Variceal bleedingTIPSHaemorrhagePortal hypertension
CASE 038–10 minutes
Severe acute hepatitis: when do you call the transplant centre?
A previously well patient develops severe acute hepatitis, coagulopathy and then encephalopathy. Decide when this becomes acute liver failure and when transplant-centre involvement should begin.
Acute liver failureAcute hepatitisTransplant referralEncephalopathy
CASE 048–10 minutes
The deteriorating patient after liver transplantation
A recent liver transplant recipient becomes acidotic and haemodynamically unstable. Work through early graft dysfunction, vascular catastrophe and when retransplantation needs to enter the conversation.
Liver transplantationGraft dysfunctionHepatic artery thrombosisRetransplantation
CASE 059–11 minutes
ACLF with worsening multiorgan failure: when does continued support stop helping?
A patient with ACLF continues to deteriorate despite full organ support. Work through sequential prognosis, transplant options and how to approach treatment limits without turning a score into a decision.
ACLFOrgan supportPrognosticationGoals of care
How it works
Reason first. Reveal second.
The design deliberately holds the discussion back until you choose an approach, then puts the response distribution, evidence and uncertainty beside your decision.
Commit to an approach
Choose what you would do before seeing the discussion. The aim is reasoning, not an exam score.
Open the evidence
Each decision reveals the rationale, uncertainty, how other readers answered, and the guideline or primary literature behind it.
Editorial standard
Fictional cases. Real evidence. Visible uncertainty.
Cases use fictionalised scenarios and no patient-identifiable information. Clinical claims are linked to guidelines or primary literature, with limitations made explicit.
They are educational resources, not protocols. Local guidance, specialist advice and individual patient factors remain decisive in clinical care.