Study of the correlation between Helicobacter pylori infection and Hepatic Encephalopathy in patients with Liver Cirrhosis

Background and study aim: Ammonia plays a major role in hepatic encephalopathy pathogenesis. Most of ammonia is known to be produced by the action of colonic bacteria which possess a urease enzyme activity. H. pylori which infects the stomach possesses a stronger urease activity which produce a large amount of ammonia that may precipitate hepatic encephalopathy (HE). The aim of the present study is to determine the correlation between Helicobacter pylori infection and HE in patients with liver cirrhosis.Patients and Methods: One hundred patients (50 patients of liver cirrhosis with hepatic encephalopathy and 50 patients of liver cirrhosis without hepatic encephalo-pathy) were evaluated for presence of H. pylori by stool antigen test (ELISA method) and for blood ammonia level estimation.Results: Prevalence of H. pylori infection in the study groups (patients of liver cirrhosis with and without hepatic encephalopathy) was 70% (liver cirrhosis with hepatic encephalopathy group (A) 80%, and liver cirrhosis without hepatic encephalopathy group (B) 60%). Mean blood ammonia levels were: 82.14± 47.9 mmol/l for group A (liver cirrhosis with hepatic encephalopathy) and 36.44± 17.9 mmol/l for group B (liver cirrhosis without hepatic encephalopathy). Prevalence of H. pylori and blood ammonia level were found significantly increasing with the severity and the degree of hepatic encephalopathy.Conclusion: There is a significant association between H. pylori and hepatic encephalopathy in patients with liver cirrhosis. There may be a role of anti-H. pylori therapy in patients of hepatic encephalopathy and should be investigated further

Hepatite fulminante associee a un traitement antituberculeux: entite clinique grave mais pas toujours fatale

L'hepatite fulminante est definie par l'association de signes d'encephalopathie hepatique a une chute du taux de prothrombine inferieur a 50survenant moins de deux semaines apres l'apparition d'un ictere. Elle est grave et mortelle en absence de transplantation hepatique. Cependant; nous rapportons un cas d'hepatite fulminante d'evolution favorable sous traitement medical seul. Il s'agissait d'un cas secondaire a un traitement antituberculeux qui a ete arrete tout de suite et remplace par un lavement au lactulose des l'apparition des signes d'encephalopathie hepatique. L'evolution etait marque par un retour progressif de l'etat de conscience a la normale et une amelioration nette du bilan hepatique

Management of fulminant hepatic failure with Mannitol. [short communication]

Eight patients with fulminant hepatic were managed conservatively using intermittent infusion of 20 percent mannitol. All but one case regained consciousness within seven days of commencement of the mannitol infusion. All have maintained normal hepatic function over a period of twelve to eighteen months. Mannitol still remains an effective treatment modality in centres where newer and sophisticated methods of therapy are now available

Extra-hepatic biliary atresia preoperative and surgical assessment in 25; cases seen in Zaira

Admission in a seven year period of 25 infants with biliary atresia. We note that prelaparatomy percutaneous liver established the diagnosis of extrahepatic biliary atresia; which were confirmed at laparatomy. Fifty percent of the patients had liver cirrhosis before surgery. Therefore; bile drainage was not established in any of the 25 patients following hepatic surgery. Six (24 percent) died of hepatic failure during the period of follow-up. Factors responsible for the poor success rate of surgery included late presentation and grossly non correctible lesions