Aisha Sheikh, Syed Irfan Ahmed, M Naseemullah.
Aetiology of Hepatic Encephalopathy and Importance of Upper Gastrointestinal Bleeding and Infections as Precipitating Factors.
J Rawal Med Coll Jan ;5(1):10-2.

One hundred patients with hepatic encephalopathy were studied. 58 were suffering from Hepatitis C virus (HCV) infection, 17 were infected with Hepatitis B virus (HBV) while 8 had both HCV and HBV infection. A single precipitating factor was found responsible in 74 patients whereas multiple causes were found in the remaining 26. Upper Gastrointestinal haemorrhage was responsible for precipitating hepatic encephalopathy in 38 patients followed by infections in 26. Spontaneous bacterial peritonitis occurred in 20 while constipation was the triggering agent in 18. A bigger percentage of females presented in a higher grade of encephalopathy compared to males. The overall in-hospital mortality was 29%. It is concluded that Hepatitis C has become the major aetiological factor of Hepatic encephalopathy in our country with Upper G.I. bleeding and infections playing a major role in triggering this condition.

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