Frequency of Gall‐Bladder Wall Thickness in Patients Suffering from Liver Cirrhosis

Aim: To evaluate the frequency of gall bladder wall thickness in patients suffering from liver cirrhosis. Study design: Cross-sectional study Place and duration of study: Department of Internal Medicine, Bolan Medical Complex Hospital, Quetta from 01-01-2020 to 31-012-2020. Methodology: Sixty eight diagnosed patients of liver cirrhosis, age ranging between 20 to 60 years, were randomly selected from indoor patient department and they were further evaluated for gall bladder wall thickness.The diagnosis of liver cirrhosis and portal venous hypertension was made by ultrasonography of abdomen, especially hepatobiliary system. The gall bladder wall thickness is also evaluated by ultrasonography. Results: Mean age of the patients was 41.22±8.93 years. There were 35(51.5%) males while female patients were 33(48.5%). The mean duration of symptoms was 6.32±0.57 weeks. The duration of symptoms was ≤6 weeks in 45(66.2%) of patients, while 23(33.8%) of patients were having duration of symptoms >6 weeks. Twenty 20(29.4%) cases of liver cirrhosis patients were presented with gall bladder wall thickness, while rest 48(70.6%) were presented with normal gall bladder wall thickness on USG. Conclusion: The gall‐bladder wall thickness is very common finding associated with liver cirrhosis. It requires no surgical intervention or any other specific medical therapy. Keywords: Gall‐bladder wall thickness; liver cirrhosis; portal venous hypertension; hypoalbuminemia.

Pregnancy with extrahepatic portal venous hypertension

We are reporting a case of pregnancy with extrahepatic portal venous hypertension. Portal hypertension in pregnancy is an uncommon event. It presents a challenge to the obstetrician in management as physiological hemodynamic changes associated with pregnancy worsen with portal hypertension. Thus, increasing risk of life threatening complications like variceal haemorrhage and hepatic decompensation to many folds during pregnancy. Management requires knowledge of effects of portal hypertension on maternal and fetal outcome and vice-versa.

Treatment of Acute Hemorrhage from Esophageal Varices in Cirrhotic Patients.

Cirrhosis describes the end stages of chronic inflammation and progressive scarring of the liver and may lead to hepatocellular dysfunction and portal venous hypertension. Liver cirrhosis in itself is a major cause of mortality worldwide, accounting from more than 1 million deaths in 2010. Esophageal varices are common in cirrhosis such that Christensen et al. documented their occurrence in 90% of patients with cirrhosis within 10 years of follow up, 40% experiencing variceal bleeding. Acute hemorrhage from esophageal varices will classically appear as hematemesis and/or melena in patients with a history of cirrhosis. It is most often diagnosed by performance of an EGD which will reveal actively bleeding varices. Because of the high rate of morbidity and mortality associated with esophageal variceal bleeding, one must have a high index of suspicion in any patient with chronic liver disease or cirrhosis. As such, empiric management for variceal hemorrhage should be initiated any time this diagnosis is considered.