Affiliation:
1. Consultant Gastroenterologist
2. Third year General Medicine postgraduate
3. Assistant Professor, General Medicine
Abstract
Hepatic Encephalopathy (HE) is a complex, potentially reversible neuropsychiatric condition that occurs due to acute or chronic liver disease1. In
managing patients with HE in cirrhosis of the liver it is very important to stage the encephalopathy into four clinical stages and then try to identify
and treat the precipitating factors. In the presence of the precipitating factors, the neurological decits are usually completely reversible on their
correction and the prognosis is good if the precipitant can be treated2. Results: A total of 54 patients with cirrhosis of the liver suffering from hepatic
encephalopathy were studied for different precipitating factors over a period of 15 months. Spontaneous bacterial peritonitis (SBP) (48.14%) is the
most common precipitating factor in our study, followed by gastrointestinal bleeding(31.48%), constipation(27.77%), sepsis(24.04%),
hyponatremia(20.37%) and hypokalemia(11.11%). Conclusion: Early detection and diagnosis of the precipitating factors of HE help in the
focused treatment of this highly fatal condition thereby reducing the mortality in such patients
Reference10 articles.
1. Worobetz LJ. Hepatic encephalopathy. In: Thomson AR, Shaffer EA, editors. First principles of gastroenterology. 3rd ed. Toronto: University of Toronto press; 2000. p. 537-39.
2. Alam I, Razaullah, Haider I, Humayun M, Taqweem MA, Nisar M. Spectrum of precipitating factors of hepatic encephalopathy in liver cirrhosis. Pakistan J. Med. Res. 2005;44(2):96-100.
3. Moriwaki H, Shiraki M, Iwasa J, Terakura Y. Hepatic encephalopathy as a complication of liver cirrhosis: An Asian perspective. J Gastroenterol Hepatol 2010;25:858-63
4. Muhammad Sadiq Achakzai Et Al; Factors Leading To Hepatic Encephalopathy Patients With Liver Cirrhosis At A Tertiary Care Hospital In Karachi, Pakistan; Gomal Journal Of Medical Sciences; April-June 2016, vol14 no.2
5. Kevin Charles Raphael Et Al; Hepatic Encephalopathy Prevalence, Precipitating Factors And Challenges Of Management In A Resource Limited Setting: j.gastrointest dig syst 2016; 2016; vol 6, issue 3