Hepatic Cirrhosis

McCormick, P. Aiden; Jalan, Rajiv

doi:10.1002/9781119237662.ch8

Cited by 4 publications

(3 citation statements)

References 73 publications

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“…Clinically, patients may have jaundice, ascites, hepatic encephalopathy, bleeding varices (decompensated), or they may be asymptomatic (compensated). [2]…”

Section: Introductionmentioning

confidence: 99%

“…Clinically, patients may have jaundice, ascites, hepatic encephalopathy, bleeding varices (decompensated), or they may be asymptomatic (compensated). [2] Ascites is free fluid within the peritoneal cavity. It develops as a result of peritoneum-related conditions (infection and cancer), as well as conditions caused by external illnesses (liver disease, heart failure, and hypoproteinemia).…”

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confidence: 99%

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A Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver with Ascites at a Tertiary Care Hospital in North India: Prevalence, Clinical, and Microbiological Profile

Mohan,

Kumar,

Singh

2023

Apollo Medicine

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Background and Objectives: In patients with chronic liver disease and ascites, spontaneous bacterial peritonitis (SBP) is a common complication. This can progress gradually and subtly or go undiagnosed until signs start to show. Early diagnosis is essential for effective treatment and the prevention of subsequent episodes because the mortality rate following a single episode varies from 20% to 40%. The goal was to study the incidence, clinical profile, and microbiological characteristics of SBP and its variants in people with liver cirrhosis and ascites. Materials and Methods: This observational study was done on 104 cirrhotic patients with ascites admitted at a tertiary care hospital. Basic demographics, symptoms, and clinical signs of patients were recorded. Diagnostic paracentesis was done aseptically and immediately sent for ascitic fluid cytology, biochemistry, and culture. Bacterial examination and antibiotic sensitivity tests were carried out by standard microbiological techniques. Results: Out of a total of 104 cirrhotic patients, 28 (26.9%) were diagnosed with SBP. Alcohol was the most common etiological factor, followed by hepatitis C infection. Among the SBP patients, the most common presentation was culture-negative neutrocytic ascites (71.4%), followed by classical SBP (17.8%), then mono bacterial non neutrocytic bacterascites MNB (10.7%). Among the symptoms, the most common was abdominal distension, followed by icterus, pedal edema, and abdominal pain. Majority of the patients belonged to Child–Pugh’s Grade C. Of 28 cases of SBP, 8 were culture positive. Gram-negative isolates were predominant (75%) and Escherichia coli were the most common isolate. Interpretation and Conclusion: The prevalence of SBP in cirrhotic patients was 26.9%, and Gram-negative isolates were predominant. Ascitic fluid culture and susceptibility testing can lead to accurate diagnosis of SBP and can guide for treatment as resistance to antibiotics is common.

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“…Clinically, patients may have jaundice, ascites, hepatic encephalopathy, bleeding varices (decompensated), or they may be asymptomatic (compensated). [2]…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

A Study of Spontaneous Bacterial Peritonitis in Cirrhosis of Liver with Ascites at a Tertiary Care Hospital in North India: Prevalence, Clinical, and Microbiological Profile

Mohan,

Kumar,

Singh

2023

Apollo Medicine

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“…L iver cirrhosis results from hepatic cell death, nodule formation and irreversible liver scarring. 1 With liver cirrhosis, there is a reduction in the synthesis of procoagulant and coagulant factors. The parallel decrease in both factors rebalances the coagulation system; however, this new balance is fragile and may be tilted towards bleeding or thrombosis when exposed to minimal stimuli.…”

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confidence: 99%

Bleeding risk of oral anticoagulants in liver cirrhosis

Gong,

Aquite,

Hayes

et al. 2022

NZMJ

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aim:The safety of dabigatran is poorly studied in patients with liver cirrhosis and has rarely been compared to warfarin in terms of bleeding risks. method:We undertook a retrospective cohort study across three tertiary centres in Auckland, New Zealand, between 2008 to 2020. Adults 18 years and over and those with a clinically confirmed diagnosis of cirrhosis were included. Data collected included demographic data and clinical characteristics, baseline medication and comorbidities. The primary outcome measure was the incidence of any bleeding event that resulted in hospital admission. results: Overall, 100 patients were included in this study. A total of 52 patients took warfarin, and 48 took dabigatran. Baseline characteristics for both groups were generally similar. The incidence rate of bleeds for patients taking warfarin was 14.4 per 100 person-years (95% CI, 8.8-23.5) compared to 9.1 per 100 person-years (95% CI, 4.5-18.1) for patients taking dabigatran. The incidence rate ratio comparing dabigatran to warfarin was 0.63 (95% CI, 0.23-1.60), p=0.25. conclusion: Our study found that patients on dabigatran may have a lower bleeding risk than patients taking warfarin, but this was not statistically significant.

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