HEPATIC ENCEPHALOPATHY;

PRECIPITATING FACTORS IN PATIENTS WITH CIRRHOSIS

Abstract

Introduction: Hepatic encephalopathy is a common complication of cirrhosis.
Its development heralds a poor prognosis. Hepatic encephalopathy is often precipitated by an identifiable factor. Prompt
diagnosis of precipitating factors is the key to management of this reversible complication of cirrhosis. Objective: To
determine the frequency of precipitating factors for hepatic encephalopathy in patients diagnosed with cirrhosis. Study
Design: Descriptive Study. Place and Duration of study: The study was carried out at Combined Military Hospital
Lahore from 18.6.07 to 18.12.2007. Patients and methods: Eighty Consecutive patients, 18 years and above of both
genders suffering from hepatic encephalopathy were included in the study. Precipitating factors of hepatic
encephalopathy were identified with the help of clinical examination and investigations. Results: Majority of patients
(63.8%) had one precipitating factor; more than one factorwas found in 27.5%. Upper gastrointestinal bleed (56%) and
infections (27%) (spontaneous bacterial peritonitis and urinary tract infections) were the leading precipitating factors.
Use of diuretics/ electrolyte imbalance and constipation were found in 19% and 7% of patients respectively. No
precipitating factor was detected in 9% of patients. Conclusion: In majority of patients with hepatic encephalopathy,
precipitating factor/ factors could be easily identified.