A Study on Clinico Etiological Profile study of Chronic Liver Disease among Female Patients and Its Complications

INTRODUCTION: Cirrhosis is defined as a diffuse process with fibrosis and nodular formation in hepatic architecture anatomically. Cause for the chronic liver disease among female patients are different in proportions when compared to the male populations as female gender is more prone to go for cirrhosis in certain causes like Wilsons disease, Auto immune hepatitis, Primary biliary cirrhosis, Intra hepatic cholestasis of pregnancy, Less alcohol intake etc. AIMS AND OBJECTIVE: 1. To study the profile of clinical presentation and etiological diagnosis of female chronic liver disease. 2. To profile the Complications of cirrhosis at the time of admission and the same at 6 months. MATERIALS AND METHODS: During May 2018 to April 2019, All 71 cases-female chronic liver disease patients who are all diagnosed by clinical examination, ultrasonogram abdomen, portalvein doppler and other nessery investigations -aged above 12 falling under the inclusion and exclusion criteria were selected. Their clinical presentation were profiled at the time of admission .Etiological diagnosis for each patient are profiled while they are on admission. Complications that are documented at the time of admission and the complications at the end of 6 months are profiled. RESULTS: Total sample size taken as 80 .But 9 lost to attrition and the actual sample size is 71.Among 71 patients, 49 patients (69%) were presented with abdominal distension, 57 patients (80.3%) jaundice,24 patients (33.8%) upper gastro intestinal bleed, only 7 (9.9%) lower gastro intestinal tract bleeding, 26 patients (36.6%) presented with bilateral pedal edema, 20 patients (28.2%) bruises, 18 patients abdominal pain, 9 patients (12.7%) fever, 37 patients (52.1%) anorexia 3 cases diagnosed incidentally. Etiological diagnosis by- hbv around 8 patients (11.3%), hcv -12 patients (16.9%) alcohol -6 patients (8.5%), auto immune hepatitis 5 patients (7%), primary biliary cirrhosis -1patients (1.4%), budd Chiari syndrome- 2 patients (2.8), non alocoholic fatty liver disease -4 patients (5.6%), wilsons disease- 5 patients (5.6%), hepatotoxic drugs/toxins- about 53 patients (4.2%), hemochromatosis causing -2 patients (2.8%), 25 patients (35.2%) cause for chronic liver disease is not identified. From endoscopic findings - 30 patients (42.3%) shows esophageal varices, 9 patients (12.7%) shows gastric varices , 14 patients (19.7%) shows hypertensive gastropathy, 6 patients (8.5%) shows gastric erosions, 24 patients (33.8%) shows normal anatomy Complications are all increased :complication at the time of recruitment and at 6 months areportal vein thrombosis – 7 cases (9.9%) and 9 cases (12.7%) respective, coagulopathy -29 cases (40.8%) And 46 cases (64.8%) respectively, spontaneous bacterial peritonitis- 12cases (16.9%) and 9cases (12.7%) respectively, sepsis - 7 cases (9.9%) and 6 cases (8.5%) respectively, HRS-12cases (16.9%) and 15 (21.1%) respectively, decompensation -57 cases (80.3%) and 64cases (90.1%) respectively, coagulopathy-54 cases (76.1%) and 64 cases (90.1%) respectively, There is a significant rise in child pugh score, total bilirubin-7.56- mean (s.d-4.74) and 9.11-mean (s.d-5.68)values respectively, serum albumin 2.77- mean (s.d-0.43)and 2.92-mean (s.d-0.37) values respectively, small increment in mean pt inr 1.49-mean (s.d-0.52) and 1.55-mean (s.d-0.43) values respectively, rise in child pugh score 10.25-mean (s.d-2.8) and 10.97-mean (s.d-2.14)values respectively. COCLUSIONS: Chronic liver disease is on the rise in recent decades with significant mortality, with major study population in between 30 to 60 years .Most common presentation is jaundice and most common etiology is HCV among female patients. Surprisingly alcohol among female causing cirrhosis is also noted. In Esophageal endoscopy most common finding noted is esophageal varices. All complications like portal hypertension features, hepatic encephalopathy, hepatorenal syndrome, child pugh scores, and coagulopathy are increased in 6 months follow up significantly when compared with at the time of recruitment. cryptogenic cause of cirrhosis remains a major portion of this study which needs more invasive procedures like liver biopsy after the common etiological factors have been ruled out priorly