Sadiq Hussain Malik, Muhammad Imran Suliman, Shahid Irfan, Faiqa Imran.
Chronic liver disease.
Professional Med J Jan ;11(4):446-9.

To find out common precipitating factors leading to hepatic encephalopathy in selected known cases of cirrhosis of liver .Design: It is a descriptive study comprising patients selected through non-probability convenient sampling. Setting: Department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Period: From January 2000 to December 2002. Subject: Fifty (50) known cases of cirrhosis of liver with encephalopathy. Main Outcome Measures: One or more precipitating factors leading to hepatic encephalopathy, grades of encephalopathy, etiology of cirrhosis of liver. Results: Thirty two (64%) patients were male and 18 (36%) females. The commonest age group involved was between 40-49 years (26%). Most of the patients (46%) were in grade-IV encephalopathy. HBV (46%) was the commonest cause of cirrhosis. The most common precipitating factor of encephalopathy was gastrointestinal bleeding in 20(40%) patients. Other precipitating factors detected were, infections in 15(30%) patients, combination of gastrointestinal bleeding and infections in 7(14%), constipation in 3(6%), gastrointestinal bleeding and constipation in 2(4%), infections and constipation in 2(4%) and abdominal paracentesis in 1(2%)patients. Conclusion: Gastrointestinal bleeding is the most common precipitating factor of encephalopathy followed by infections.

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