Clinical Characteristics, Etiology, and Prognostic Scores in Patients with Acute Decompensated Liver Cirrhosis.

BACKGROUND: Chronic liver disease and cirrhosis contribute significantly to global mortality, with limited improvements despite medical advancements. This study aims to evaluate acute decompensation of liver cirrhosis characteristics, etiology, and survival outcomes in Oman. In addition, we examined the accuracy of prognostic scores in predicting mortality at 28 and 90 days. METHODS: We conducted a retrospective analysis of 173 adult patients with acute decompensation of liver cirrhosis at Sultan Qaboos University Hospital in Oman. We collected demographic, clinical, and biochemical data, including etiology, prognostic scores (CTP, MELD-Na, CLIF-C), and health outcomes. RESULTS: Alcohol (29.5%), hepatitis C (27.75%), and hepatitis B (26.74%) were the predominant causes of liver cirrhosis in our cohort. Hepatic encephalopathy, mechanical ventilation, and admission to the intensive care unit were strongly associated with an increased mortality rate. The 1-year readmission rate stood at 42.2%. Liver transplantation was performed in 4.1% of cases. The overall mortality rate was approximately 40% during the follow-up period, and the cumulative 28-days and 90-days mortality rates were 20.8% and 25.4%, respectively. Prognostic scores (CTP, MELD-Na, CLIF-C) effectively predicted 28- and 90-day mortality, with CLIF-C demonstrating superior performance (AUROC 0.8694 ± 0.0302 for 28-day mortality and AUROC 0.8382 ± 0.0359 for 90-day mortality). CONCLUSION: Alcohol and viral hepatitis are the leading causes of liver cirrhosis in our study. Hepatic encephalopathy is a significant predictor of poor outcomes. Prognostic scores (CTP, MELD-Na, CLIF-C) have valuable predictive abilities for short-term mortality. These findings highlight the importance of public strategies to reduce alcohol consumption and the need for the comprehensive management of liver cirrhosis in Oman. Early diagnosis and intervention can improve clinical outcomes and support the establishment of a national organ transplantation program to address the healthcare challenge effectively.

Mucinous Cystic Neoplasm of the Pancreas in Pregnancy: A Case Report.

Mucinous cystic neoplasms (MCNs) of the pancreas are rare epithelial neoplasms, characterized by an inner epithelial layer and an ovarian-type sub-epithelial stroma. These lesions are typically benign but can pose challenges during pregnancy due to their rapid growth potential, associated risk of malignant transformation, and complications such as pancreatitis. We present a case of a 39-year-old pregnant female with a history of recurrent acute pancreatitis, diagnosed with an MCN during pregnancy. Diagnostic procedures were deferred until after delivery, followed by successful distal pancreatectomy. This case underscores the importance of individualized management strategies in pregnant patients with pancreatic MCNs, balancing the need for timely intervention with maternal and fetal safety. Long-term follow-up is generally unnecessary for MCNs without associated invasive carcinoma, emphasizing the favorable prognosis of these lesions following complete surgical resection.