38 research outputs found
Retrospective studies with inconsistent data: Results, conclusions and recommendations should be taken with a grain of salt
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Hepatitis C Acquisition in Saudi Arabia: Are the Majority of Cases Without Risk Factors?
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Presentation, diagnosis and outcome of predominantly hepatic Wilson′s disease in adult Saudi patients: A single centre experience
No full textBackground/Aim: To evaluate the clinical manifestations, diagnostic features, disease course and response to treatment among Saudi adults with predominantly hepatic Wilson′s disease. A retrospective cohort study of 40 adult patients diagnosed with predominantly hepatic Wilson′s disease between 1994 and 2008 at King Abdulaziz Medical City, Riyadh was carried out. Patients and Methods: The diagnosis was based on varying combinations of clinical and laboratory evidence of liver disease, presence of Kayser Fleisher rings, low serum ceruloplasmin levels, elevated 24 hour urinary copper excretion and histopathological findings on liver biopsy. Results: The most frequent clinical presentation was decompensated chronic liver disease in 19 (47.5%), followed by chronic hepatitis in 15 (37.5%) and fulminant hepatic failure (FHF) in 5 (12.5%) patients. Eight (20%) patients with end-stage liver disease had liver transplantation, while 24 (60%) patients followed up on medical treatment for a variable period of 1-12 years showed clinical and laboratory improvement. One patient was lost early in follow up. Eight (20%) patients died during the study period, 5 with FHF, and 2 with advanced hepatic and neurological disease and one seven years after liver transplantation. Mortality rate was 100% in FHF without liver transplantation. Conclusion: A predominantly hepatic Wilson′s disease has varied clinical presentations with decompensated chronic liver disease being the most common among adult patients. Majority of the patients show stabilization of the disease on medical treatment. FHF in Wilson′s disease has a grave prognosis without liver transplantation, the later remains a definitive treatment option for decompensated cirrhotics and patients with FHF
Hepatopulmonary Syndrome Associated with Schistosomal Liver Disease
No full textA 55-year-old man with schistosomal liver disease presented with shortness of breath, orthodeoxia, platypnea, cyanosis, marked digital clubbing and liver failure. Extensive investigation revealed no other etiology for liver disease apart from schistosomiases. The diagnosis of hepatopulmonary syndrome was based on clinical grounds, as well as abnormal arterial blood gases and positive contrast echocardiography. The patient underwent orthotopic liver transplantation, which was initially successful, but then died of respiratory complications and multi-organ failure on day 42 post-transplant. To the authors' knowledge this is the first report of hepatopulmonary syndrome associated with schistosomal liver disease
Role of Endoscopic Retrograde Cholangiopancreatography Before and After Laparoscopic Cholecystectomy
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