English

Abstract

BACKGROUND Cirrhosis is a progressive clinical condition associated with considerable mortality and morbidity. It leads to a wide spectrum of characteristic clinical manifestations, mainly attributable to hepatic insufficiency and portal hypertension.1 In cirrhosis, primary diagnostic test for evaluation of upper-gastro-intestinal bleeding (UGIB) is endoscopy.2 The present study attempts to find out different clinical patterns of the chronic liver disease (CLD) with portal hypertension along with the endoscopic profile of the patients. METHODS It was a cross sectional study conducted in Down Town Hospital, Guwahati, Assam. RESULTS A cross sectional study was conducted at Downtown Hospital, Guwahati, Assam on patients diagnosed with chronic liver disease from 01 January 2017 to 31 January 2018. Male predominance was observed in this study with 84 % males and 16 % females. Male to female ratio was 5.25 : 1. Maximum patients (58 %) were observed in the age group of 40 to 60 years followed by 30 % in the age group of 60 to 80 years. The average age was 53.6 years. Most common aetiological factor was alcohol (66 %) followed by non-alcoholic steatohepatitis (NASH) (16 %). Other aetiologies were hepatitis-B, hepatitis-C and cryptogenic. 88 % cases were recorded in model for end stage liver disease (MELD) score range of 10 to 29. Ascites was noted in 88 % cases, of which 20 % had grade-1 and grade-2, 48 % had grade-3. Splenomegaly was noted in 70 % cases. Child-Pugh class-C consisted of 26 % cases (13) with grade-III varices followed by 18 % cases (9) with grade-II varices while Child-Pugh Class-B had 24 % cases (12) and 8 % cases (4) with grade-III and grade-II varices respectively. Child-Pugh class-A had all the cases with grade-I varices. CONCLUSIONS Alcoholism was the leading cause for cirrhosis followed by hepatitis-B, hepatitis-C, NASH and cryptogenic. Class-C had maximum number of cases with grade-III varices followed by class-B. MELD score ranged between 10 - 29 in majority. Severe anaemia was noted in 10 % cases. Thrombocytopenia a non-invasive indicator of oesophageal varices was noted in 70 % with different grades of oesophageal varices. KEYWORDS Endoscopy, Portal Hypertension, Chronic Liver Disease