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Original Article

J Liaquat Uni Med Health Sci. 2008; 7(2): 61-66


Cirrhosis of liver: Etiological factors, complications and prognosis

Suhail Ahmed Almani, A. Sattar Memon, Amir Iqbal Memon, M. Iqbal Shah, M. Qasim Rahpoto, Rahim Solangi.

Abstract
OBJECTIVE: To determine the etiological factors, complication(s) and prognosis of patients suffering
from liver cirrhosis in our setup.
DESIGN: Cross-sectional study.
SETTING: Medical and surgical departments of Liaquat University Hospital Hyderabad/
Jamshoro, Sindh – Pakistan, from April 2005 to April 2007.
METHODS: Patients having an evidence of cirrhosis of liver on ultrasound examination of abdomen
were enrolled. All those patients who were not confirmed to be cirrhotic, excluded from
this study. All cases were studied to determine the etiological factors, complications and prognosis
of disease. All data were recorded on a proforma. Patients with acute variceal hemorrhage
were referred to surgical department for endoscopic sclerotherapy or variceal band ligation.
RESULTS: Total 100 patients were studied, 67(67%) males and 33(33%) females. Their mean age
was 53.09 with SD= 8.85814 years. Majority of patients, 52(52%) had HCV infection, 16(16%) had
HBV infection, 16(16%) had HBV and HCV co-infection, 08(08%) had alcohol abuse, 01(01%) had
primary biliary cirrhosis, 02(02%) had Wilson’s disease and no etiological factors were recorded
in 05(05%) patients. Ascites was present in 59(59%) cases, portal hypertension in 42(42%), esophageal
varices in 29(29%), spontaneous bacterial peritonitis in 29(29%), acute variceal hemorrhage
in 27(27%), hepatic encephalopathy in different grades in 24((24%), hepatorenal syndrome
in 09(09%) and hepatocellular carcinoma in 07(07%) patients. All patients with acute variceal
episode(s) were adequately and timely treated in surgical department. When cirrhotic patients
were grouped into child-Pugh’s classification, 37(37%) were in class ‘A’ category, 37(37%) in
class ‘B’ category, and 26(26%) in class ‘C’ category.
CONCLUSION: HCV infection is the major risk factor for cirrhosis in our setup. Ascites was the
commonest complication. Patients with child-Pugh’s class ‘A’ cirrhosis had significantly longer
survival than patients with child-Pugh’s class ‘B’ and ‘C’. A multidisciplinary approach for prevention
and control of ever increasing HCV infection must be adopted and to make the public
awareness through the mass media about its drastic complications, and possible modes of its
transmission.

Key words: Liver. Cirrhosis. Viral hepatitis. HCV infection. Ascites.



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