Accuracy of clinical diagnosis of liver diseases at Ibadan

Liver diseases are a major cause of morbidity and mortality in Africa and rest of the world. The contribution of specific liver disease to overall mortality has not been well documented in Nigeria.

To study aimed at determining the relative frequency of liver diseases seen at autopsy and the accuracy of ante-mortem clinical diagnosis of liver diseases relative to post-mortem findings at the University College Hospital (UCH), Ibadan.

A retrospective study of autopsies performed at the Pathology Department of the UCH, Ibadan between January 1991 and December 2000. Information obtained from the autopsy records included age, sex, ante-mortem clinical diagnosis, and post-mortem diagnosis. The data were analysed for frequencies, means, proportions and sensitivity.

A total of 4,604 post-mortem examinations were performed over the 10-year-period with an annual average of 460.4. Of this, 3,408 (74.02%) were coroner's while 1,196 (25.98%) were routine. There were 75 autopsy diagnosis of liver disease accounting for 6.27% of the total routine autopsies and a frequency of 7.5 per annum. The liver cases at autopsy were made up of 53 (70.7%) males and 22 (29.3%) females with those in the age range 40 - 49 years accounting for about one quarter of all. There was positive correlation of the Clinical diagnoses with post-mortem diagnoses in 33 (44%) but discordance in 42 (56%) of cases.

The concordance between ante-mortem clinical diagnosis and post-mortem diagnosis of liver disease is rather low. There is a need to provide facilities for efficient diagnosis of liver diseases.