Clinico-etiological profile and outcome in hepatic encephalopathy

 

 

Abstract              Background: Hepatic encephalopathy may arise spontaneously but more commonly will develop as a result of some precipitating factors in the course of acute or chronic liver disease. Early identification of precipitating factor is extremely important in the diagnosis and treatment of this fatal condition. Aim: To investigate the clinical features, etiology of hepatic encephalopathy and outcome of hepatic encephalopathy. Material and Methods: In this hospital based descriptive and prospective study, 100 patients manifesting with symptoms and signs of hepatic encephalopathy were taken up for study. A detailed history and clinical examination with required relevant investigations was carried out in every patient. Hepatic encephalopathy was diagnosed on clinical basis and graded according to West Haven criteria and Child –Pugh score assessed for each patient. Results: Abdominal distension, altered sensorium and upper gastrointestinal bleeding were the commonest presenting symptoms. Pedal edema, icterus, asterixis, pallor and ascites were the commonest presenting signs. Majority of the patients in this study were cirrhotics (81%) followed by acute liver failure (19%). The commonest cause of cirrhosis in this study was alcoholism, followed by viral hepatitis. 63% of the patients in our study were improved and got discharged and 37% were expired. Conclusion: In most of the cases there are different factors which play a key role in precipitating hepatic encephalopathy. The early detection and diagnosis of these precipitating factors helps in starting treatment of this fatal condition hence reducing the mortality.

Key Words: Hepatic encephalopathy, abdominal distension, liver cirrhosis, Child-Pugh classification, West Haven grading, outcome