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Chronic Liver Disease: Liver Cirrhosis and Diagnostic Features: Liver Cirrhosis and Diagnostic Features

Authors:

Abstract

Chronic Liver diseases can cause liver cirrhosis, a late stage when the normal liver tissue becomes scar tissue, irreversibly damaging liver. Objective: To determine the causes of liver cirrhosis in different patients using computed tomography (CT). Methods: It is a cross-sectional study conducted in the Radiology Department of Private Hospital Gujrat, Pakistan from 1, August 2022 to 30, November 2022. Abdominal non-contrast CT of the patients was performed in a supine position. A sample size of 82 patients has been calculated via a convenient sampling technique using a mean approach from previous related articles. Patients with renal stones on CT KUB were excluded. The data was analyzed using SPSS version 26. Results: Liver cirrhosis seen to be more common in men 65(79.3%) than women 17(20.7%). Liver cirrhosis is seen to be more common at the age of 30-39years 51(62.2%), followed by 40-49years 29(35.4%), and 18-29years 2(2.4%). Most common cause of liver cirrhosis is hepatitis C 39(47.6%). The most common symptom in liver cirrhosis is loss of appetite 34(41.5%), followed by weight loss 23(28.0%). The most common finding is a change in liver volume 33(40.2%), followed by coarse liver 26(31.7%). Conclusions: Liver cirrhosis is seen commonly in men in the age range of 42 to 54 years. The most common symptoms of liver cirrhosis are loss of appetite followed by weight loss. One of the best modalities to rule out chronic liver disease specifically liver cirrhosis is CT scan.
Orıgınal Artıcle
When cirrhosis reaches a late stage, normal liver tissue is
replaced with scar tissue, irreversibly damaging the liver.
The liver's healthy functioning is maintained by scar tissue
[1]. Cell healing comes next, and the end outcome of the
repair process is tissue scarring. Cirrhosis in its advanced
stages is fatal. Liver dysfunction develops over time as a
result of liver cirrhosis [2]. The patient has the end-stage
liv er dise ase when the li ver event ually sta rts to
decompensate. The liver functions to process the diet and
medications and normal function of creating protein get
decreased by scarring. And when the time passes, with age
the risk of GI bleeding and hepatocellular carcinoma
become high risk, which also leads to portal hypertension
in some patients. Interferon therapy can help extend
enough liver function in instances of cirrhosis when the
DOI: https://doi.org/10.54393/pjhs.v4i01.511
Dar AJ et al.,
Chronic Liver Disease: Liver Cirrhosis and Diagnostic Features
1* 2 3 1 1
Ali Junaid Dar , Akash John , Abid Ali , Arooj Ansar and Sheza Azam
¹Department of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Gujrat Campus, Pakistan
²Department of Radiological Sciences and Medical Imaging Technology, The University of Chenab, Gujrat, Pakistan
³Department of Allied Health Sciences, The University of Chenab, Gujrat, Pakistan
liver is still adjusting, especially in those brought on by
hepatitis C virus infection. Determining each patient's
stage of cirrhosis and closely monitoring the course of the
illness is therefore crucial [3]. According to estimates, one
in 400 Americans has cirrhosis of the liver. The people aged
45 to 54, who make up around 1 in 200 of the population, are
most likely to have cirrhosis. Cirrhosis is the sixth leading
cause of death in the US for those aged 25 to 64, and it
results in over 26,000 fatalities each year [4, 5]. Some
common symptoms of cirrhosis are drinking alcohol for a
long time, hepatitis virus, diabetes, obesity, and drug
injection with sharing needles. Hepatic cirrhosis is not
cancer but cirrhosis affects the majority of those with liver
cancer. You run a higher chance of developing liver cancer
if you have cirrhosis [6]. Hepatitis B and C frequently result
Liver Cirrhosis and Diagnostic Features
I N T R O D U C T I O N
Chronic Liver diseases can cause liver cirrhosis, a late stage when the normal liver tissue
becomes scar tissue, irreversibly damaging liver. Objective: To determine the causes of liver
cirrhosis in different patients using computed tomography (CT). Methods: It is a cross-sectional
study conducted in the Radiology Department of Private Hospital Gujrat, Pakistan from 1, August
2022 to 30, November 2022. Abdominal non-contrast CT of the patients was performed in a
supine position. A sample size of 82 patients has been calculated via a convenient sampling
technique using a mean approach from previous related articles. Patients with renal stones on
CT KUB were excluded. The data was analyzed using SPSS version 26. Results: Liver cirrhosis
seen to be more common in men 65(79.3%) than women 17(20.7%). Liver cirrhosis is seen to be
more common at the age of 30-39years 51(62.2%), followed by 40-49years 29(35.4%), and 18-
29years 2(2.4%). Most common cause of liver cirrhosis is hepatitis C 39(47.6%). The most
common symptom in liver cirrhosis is loss of appetite 34(41.5%), followed by weight loss
23(28.0%). The most common nding is a change in liver volume 33(40.2%), followed by coarse
liver 26(31.7%). Conclusions: Liver cirrhosis is seen commonly in men in the age range of 42 to 54
years. The most common symptoms of liver cirrhosis are loss of appetite followed by weight
loss. One of the best modalities to rule out chronic liver disease specically liver cirrhosis is CT
scan.
A R T I C L E I N F O A B S T R A C T
How to Cite:
Junaid Dar, A. ., John, A. ., Ali, A. ., Ansar, A. ., & Azam,
S. . (2023). Chronic Liver Disease: Liver Cirrhosis and
Diagnostic Features: Liver Cirrhosis and Diagnostic
Features. Pakistan Journal of Health Sciences, 4(01).
https://doi.org/10.54393/pjhs.v4i01.511
Key Words:
CLD, Liver, Cirrhosis, Diagnosis, Hepatitis, Nodular
Margins
*Corresponding Author:
Ali Junaid Dar
Department of Allied Health Sciences, The University
of Lahore, Gujrat Campus, Pakistan
alunaiddar00@gmail.com
Received Date: 11th January, 2023
Acceptance Date: 29th January, 2023
Published Date: 31st January, 2023
PAKISTAN JOURNAL OF HEALTH SCIENCES
https://thejas.com.pk/index.php/pjhs
Volume 4, Issue 1 (January 2023)
PJHS VOL. 4 Issue. 1 January 2023
Copyright © 2023. PJHS, Published by Crosslinks International Publishers
30
of 82 patients has been calculated via a convenient
sampling technique using a mean approach from previous
related articles [15, 22]. This study was conducted on 82
patients with normal and abnormal abdominal CT ndings.
Patients with renal stones on CT KUB were excluded. The
data interpreted and analyzed on SPSS 26.0.
M E T H O D S
in cirrhosis, which increases the risk of liver cancer in those
who have them. Cirrhosis, which raises the risk of liver
cancer, can result from any cause of liver illness [7]. Even if
one person is having liver cirrhosis, there is no need to seek
emergency medical attention [8]. But as cirrhosis worsens,
mo re sc arr ing develo ps, and li ver functio n ke eps
deteriorating. Liver failure may eventually develop into a
life-threatening condition [9]. Early signs of cirrhosis
include loss of appetite, fatigue or weakness, nausea,
fever, and a sudden drop in weight [10, 11]. Simple bleeding
and bruises, skin or the whites of your eyes having a yellow
tint, rough skin, edema (swelling) in your ankles, foot, and
legs, uid accumulation in your abdomen, urine with a
brownish or orange tint, stool with blood in it, confusion,
brain fog, memory loss, and personality changes are other
more well-known symptoms of cirrhosis that start to
appear as liver function declines [12-14]. The Child-Pugh
classication is used clinically in the evaluation of the
severity in liver cirrhosis for the patients with CLD and its
consequences includes radiologic examination heavily. In
these individuals, computed tomography (CT) is more
frequently employed, and in some limited circumstances,
MRI, where indicated. A few authors have looked at using
MRI to grade the severity of cirrhosis, but no study has
compared CT and MRI for this purpose so far [15, 16]. This
study sought to evaluate the use of abdominal CT for
assessing the degree of cirrhosis owing to viral hepatitis.
During a physical examination, a doctor will look for the
following signs and symptoms of cirrhosis and Imaging
examinations show the internal anatomy of liver [17, 18].
These tests can also show how much scarring you have,
how much fat is in your liver, and how much uid is in your
abdomen. The liver's stiffness and fat content are
determined by a specialized ultrasound procedure called
transient elastog raphy. A n en doscopic retrograde
cholangiopancreatography and/or upper endoscopy may
be recommended in order to check for bile duct issues as
well as varices or bleeding in the esophagus, stomach, or
intestines [19-22]. This study determined the role of a CT
scan in assessing liver cirrhosis. CT is a non-invasive,
three-dimensional modality that is used to assess a
patient's liver changes at a very large scale. There will be no
superimposition of the organs in this modality and a
detailed image will be obtained.
It is a cross-sectional study conducted in the Radiology
Department of Private Hospital Gujrat, Pakistan. This study
was held during the period of four months from 1, August
2022 to 30, November 2022. Data for this research was
evaluated on a CT scan machine after informed consent
from the patients. Abdominal non-contrast CT of the
patients was performed in a supine position. A sample size
PJHS VOL. 4 Issue. 1 January 2023 31
Copyright © 2023. PJHS, Published by Crosslinks International Publishers
R E S U L T S
A sample size of 82 patients has been calculated via a
convenient sampling technique using a mean approach
from previous related articles. This study was conducted
on 82 patients with normal and abnormal abdominal CT
ndings. Patients with renal stones on CT KUB were
excluded. Figure 1 shows the age of the patients. The age of
the patients is categorized into three groups. Liver
cirrhosis is seen to be more common at the age of 30-39
years 51(62.2%), followed by 40-49years 29(35.4%), and 18-
29 years 2(2.4%).
62%
35%
3% 18-29
30-39
40-49
Figure 1: The age of the patients
Figure 2 shows the gender of the patients. Most of the
patients diagnosed with liver cirrhosis on CT were male
65(79.3%) while females were only 17(20.7%). Liver
cirrhosis is seen to be more common in men than women.
79%
21%
Female
Male
Figure 2: The gender of the patients
Table 1 shows the causes of liver cirrhosis in patients. Most
common cause of liver cirrhosis is hepatitis C 39(47.6%),
followed by alcoholic liver disease 17(20.7%), hepatitis B
14(17.1%), fatty liver disease 10(12.2%), and other 2(2.4%).
Hepatitis b
Hepatitis c
Alcoholic liver disease
Fatty liver disease
Other
Total
Causes n (%)
Table 1: Causes of liver cirrhosis
14 (17.1%)
39 (47.6%)
17 (20.7%)
10 (12.2%)
2 (2.4%)
82 (100%)
DOI: https://doi.org/10.54393/pjhs.v4i01.511
Dar AJ et al., Liver Cirrhosis and Diagnostic Features
Table 2 shows the ndings of liver cirrhosis on CT in
patients. The most common nding is a change in liver
volume 33(40.2%), followed by coarse liver 26(31.7%),
heterogeneous liver 13(15.9%), nodular liver surface
7(8.5%), and small PV diameter 3(3.7%).
PJHS VOL. 4 Issue. 1 January 2023 32
Copyright © 2023. PJHS, Published by Crosslinks International Publishers
C O N C L U S I O N S
Liver cirrhosis is seen to be more common in men at the age
of 42 to 54 years. One of the best modalities to rule out
chronic liver disease specically liver cirrhosis is CT scan.
Coarse liver
Heterogeneous liver
Nodular liver surface
Change in volume of the liver
Small portal vein diameter
Total
Findings n (%)
Table 2: Findings of liver cirrhosis on CT
26 (31.7%)
13 (15.9%)
7 (8.5%)
33 (40.2%)
3 (3.7%)
82 (100%)
D I S C U S S I O N
Liver dysfunction develops over time as a result of liver
cirrhosis. The patient has end-stage liver disease when the
liver eventually starts to decompensate. This cross
sectional study was conducted to evaluate liver cirrhosis
using CT scan, which is a non-invasive, three-dimensional
modality causing no superimposition of the organs. The
current study found that Liver cirrhosis is most commonly
observed in the age group of 30-39 years as 51(62.2%) and
majority of them were males such as 65(79.3%). A
systematic review in 2014 by Bertolotti et al. included
population-based and large cohort studies from three
continents and studied more than 10 studies in which he
formulated that only 1.2% of people under the age of 19 had
FL, and the prevalence rose with age to a maximum of
25.6% in age groups beginning at 30 to 40 years. In that
review, a mul tivariate analysis reveale d a positive
correlation between the prevalence of FL and a number of
risk factors, including male gender, which is relates to the
results of the current study [23, 24]. The current research
reveals that the Liver cirrhosis in patients cause of liver
cirrhosis is hepatitis C 39(47.6%), followed by alcoholic liver
disease 17(20.7%), hepatitis B 14(17.1%), and fatty liver
disease 10(12.2%). A similar study in United States by
scagoline et al. in 2015 found that 633,323 individuals in
United States had cirrhosis about 0.27%. Cirrhosis with
diabetes, alcohol abuse, hepatitis C and B was co related ,
and cirrhosis was the fraction of 53.5% from mainly
hepatitis C [25]. A recent seminar is published in 2021 on
liver Cirrhosis the relevancy with our current results such
as Cirrhosis is extremely common around the world and
may result from a variety of factors, including obesity,
NAFLD, excessive alcohol intake, hepatitis B or C , and
autoimmune disorders [26]. Another common nding in
the present study is a CT evaluation shows the change in
liver volume and coarse liver due to chronic liver disease
which is also supported by the Yeom et al in 2015 said that
liver cirrhosis and its early morphological abnormalities
such as changes in liver volume and coarse liver can be
detected by computed tomography [27].
The authors declare no conict of interest
C o n i c t s o f I n t e r e s t
The authors received no nancial support for the research,
authorship and/or publication of this article
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DOI: https://doi.org/10.54393/pjhs.v4i01.511
Dar AJ et al., Liver Cirrhosis and Diagnostic Features
... This is similar to the other studies in Pakistan. [20][21][22][23] The higher proportion of male patients may be due to increased risk factors to males posed by barbers etc. In the current series, most of the cases belonged to Child Pugh Class C (45%) while 27% fell in Child Pugh class A. The study, done in Jinnah Postgraduate Medical Centre Karachi, similarly showed higher proportion of patients in Child class C. 15 This may be due to the bias that tertiary care centers mostly receive patients at an advance stage of disease. ...
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