Experience of liver disease at a University Hospital in Western Saudi Arabia

OBJECTIVE: The aim of this retrospective study is to review the pattern of hepatic diseases seen in our setting at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia and to assist us in appreciating the hepatic prototype in our region.

METHODS: Our study consisted of 246 consecutive liver biopsies. Lesions were studied considering histological type, age and gender of the patients and anatomic location. Distribution of hepatic lesions were classified into 4 categories as 1. Chronic inflammatory lesions, 2. Cirrhotic lesions, 3. Neoplastic hepatic lesions and 4. Pediatric and hereditary hepatic lesions.

RESULTS: Chronic inflammatory lesions comprised of 123 (50%) cases (mean age 38.1), most commonly reported being chronic hepatitis 82 cases (33.3%, mean age 42). Among these patients with chronic hepatitis, 59 cases were positive for hepatitis C virus (HCV), 21 cases were positive for hepatitis B virus (HBV) and 2 cases had both HCV and HBV. Twenty cases were diagnosed with cirrhosis (mean age 38.2). Among these cirrhotic lesions 16 cases were positive for HCV, 4 cases were positive for HBV. Neoplastic lesions were mostly malignant and comprised of 41 (15.5%) cases (mean age 44.7), with only one benign lesion diagnosed as benign hemangioma (age 48 years). Among malignant lesions, the majority were metastatic lesions, 18 were adenocarcinoma metastasis, all with primary from the gastrointestinal tract (mean age 46.6) and 12 with lymphomatous metastasis (mean age 41.2). There were 10 cases of hepatocellular carcinoma (mean age 43). Pediatric hepatic lesions comprised of 35 (14.2%) cases with the most common lesion being extrahepatic bile duct obstruction in 6 cases (mean age 2 months).

CONCLUSION: Chronic active hepatitis was the most common inflammatory lesion, metastatic carcinoma was the most common neoplastic lesion and extrahepatic bile duct obstruction was the most common pediatric lesion of the liver.