LIVER CIRRHOSIS

CLINICAL PRESENTATION

Abstract

I NTRODUCTION: Cirrhosis is defined as necrosis of the liver followed by fibrosis and regeneration. Alcohol
and viral hepatitis are two important causes of cirrhosis. Its clinical features are produced by hepatocellular
dysfunction, portal hypertension and portosystemic shunting but frequency of some of the clinical features may be related to the underlying etiology. OBJECTIVE: This study was conducted to find the frequency of various clinical features in patients of cirrhosis admitted to Nishtar Hospital Multan and to compare it with that reported in the western literature. MATERIAL & METHODS: Fifty patients of cirrhosis admitted to the Medical Wards of Nishtar Hospital Multan between Dec 1997 to Oct 1998 were included in the study. Detail history, clinical examination and relevant investigations were recorded in the proforma. RESULTS: Distension of abdomen (52%) melena (48%), hematemesis (36%), anorexia (36%) and fever (36%) were the common symptoms. Other symptoms were, decreased sleep(32%), pain abdomen (28%), altered conscious level (28%) and swelling of feet (26%). Jaundice (70%) and anemia (68%) were the most common signs. Other signs found were edema feet (54%), poor nutritional status (38%), loss of hair (38%), pyrexia (36%), spider naevi (30%), leuconychia (26%), gynecomastia (22%), pigmentation (22%), purpura (20%), palmer erythema (14%), testicular atrophy (14%) and clubbing (12%). CONCLUSIONS: Frequency of some of the clinical features of cirrhosis like jaundice, pyrexia, spider angiomas, gynecomastia, palmer erythema and dupuytren’s contracture is different in our population as compared to that reported in western literature. It could
be due to difference in etiology of cirrhosis (alcohol in the west and viral hepatitis in our population).