Cirrhosis and Its Complications at the Donka National Hospital of Conakry

Introduction: Patients with liver cirrhosis have a very high risk of complications. Method: This was a descriptive and analytical cross-sectional study covering all cirrhotic patients hospitalized in our department during the study period. It was carried out from January 1, 2022 to March 30, 2023, i.e. 13 months in hospitalization in the hepato-gastroenterology department of the Donka national hospital of the Conakry University Hospital. The aim of this work was to study cirrhosis and its complications based on clinical and paraclinical data collected in cirrhotic patients followed in our department. Results: The prevalence of cirrhosis in our department was 28.28%. There were 110 men (55%) and 90 women (45%); i.e. a M/F sex ratio of 1.22. The average age of our patients was 43 years with extremes of 22 and 72 years. The main reasons for hospitalization were: edemato-ascitic syndrome 60.71%, abdominal pain 21.43%, digestive bleeding 18.28%, hepatomegaly 7.14%, jaundice 3.57%, disorders of consciousness (hepatic encephalopathy) 3.57%. The main complications of cirrhosis were: ascites associated with edema in 60.71%, hepatic encephalopathy in 23%, digestive hemorrhage 18.28%, infection of ascitic fluid (13.03 %), hepatocellular carcinoma (10%), hepatorenal syndrome (3.20%). The etiologies of cirrhosis were: viral B (57.14%), viral C (10.71%), mixed alcohol + HBV (10.71%), alcoholic (7.86%), HBV + HCV co-infection (3.57%), HBV+HDV co-infection (1%), autoimmune (3%) and of undetermined cause (6%). Esophagogastroduodenal endoscopy showed esophageal varices in 67% of cases. The main circumstances of death were: digestive hemorrhage (25.32%), infectious shock (26.58%), encephalopathy hepatic (25.32%), hepatorenal syndrome (12.66%) and hepatocellular carcinoma (10.12%). Conclusion: Cirrhosis is the ultimate consequence of most chronic liver diseases, most often linked to chronic viral hepatitis B and C, excessive alcohol consumption or non-alcoholic steatohepatitis (NASH). It is a real public health problem with increasing incidence worldwide and one of the leading causes of death. Complications of cirrhosis are the consequences of hepatocellular insufficiency and/or portal hypertension and/or hepatocellular carcinoma. The difficult-to-access curative treatment which is liver transplantation; hence the interest in prevention based on the fight against the etiological factors of cirrhosis; in particular the promotion of vaccination against viral hepatitis B.