COMMON PRECIPITATING FACTORS AND PROGNOSIS IN A GROUP OF PATIENTS PRESENTING WITH HEPATIC ENCEPHALOPATHY IN DIAGNOSED CASES OF CIRRHOSIS OF ANY ETIOLOGY

Dr Manish Kumar; Dr Santosh Kumar

Volume : VIII, Issue : V, May - 2019

COMMON PRECIPITATING FACTORS AND PROGNOSIS IN A GROUP OF PATIENTS PRESENTING WITH HEPATIC ENCEPHALOPATHY IN DIAGNOSED CASES OF CIRRHOSIS OF ANY ETIOLOGY

Dr Manish Kumar, Dr Santosh Kumar

Abstract :

Background: Liver diseases affect millions of people worldwide each day. However, in the developing countries where cost of health care has always been an issue, long lasting diseases such as liver cirrhosis and its complications are a major health problem and pose a big challenge to the health economy .The syndrome of hepatic encephalopathy (HE) 1 describes all neuropsychiatric symptoms occurring in patients with acute or chronic liver diseases (CLD) in the absence of other neurological disorders. In the present study an attempt was made to study the common precipitating factors and the prognosis in patients presenting with HE. METHODOLOGY: This study was conducted in RIMS Ranchi during the period from December 2017 to November 2018.The study included 50 diagnosed cases of cirrhosis presenting or complicating into HE For data collection, a questionnaire was developed. A detailed clinical history of the patient was taken regarding the present and past illnesses. For each patient full CBC, LFT, RFT, random blood sugar, serum electrolytes, serum ammonia and coagulation profile were carried out. An abdominal ultrasound was done to look for liver and spleen size, parenchyma echogenicity, portal vein diameter, and ascites. In case of ascites, an ascites tap was also done to look for SBP RESULTS: In this study most common clinical presentation was ascitis (70%) and Altered sensorium (68%). Most common precipitating factor was GI bleeding. Serum ammonia was raised in 40(80%) of patients. Mortality rate was 48% CONCLUSION: Gastrointestinal bleeding, electrolyte disturbances, infection, constipation are the most common factors of hepatic encephalopathy in this study. Caution must be exercised in putting cirrhotic patients on diuretics. Early and effective infection control measures and better hygienic conditions are needed to be maintained. More and more endoscopic facilities should be made available nationwide for prompt control of gastrointestinal bleeding.