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All Journal journal of internal medicine E-Jurnal Medika Udayana Universa Medicina Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran MEDICINUS The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
I Ketut Mariadi
Division Of Gastroenterology And Hepatology, Department Of Internal Medicine, Udayana University/Sanglah General Hospital, Bali
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : MEDICINUS

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 Hepatic Encephalopathy in a Postpartum Patient with Chronic Hepatitis B: A Case Report  Priska Harsanti Devi; I Ketut Mariadi
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/7n0pqt23

Abstract

Decompensated liver cirrhosis in the postpartum period is rarely reported, particularly in association with chronic hepatitisvB infection. We presented the case of a 33-year-old woman who developed decreased level of consciousness one day afterdelivery. She had no prior history of chronic illness, although her father had passed away from complications of hepatitisvB. Clinical findings included jaundice, ascites, and hepatic encephalopathy. Laboratory results revealed reactive HBsAg, hypoalbuminemia, elevated liver enzymes, hyponatremia, hypokalemia, and markedly elevated total bilirubin. Abdominalultrasound demonstrated cirrhosis with splenomegaly and ascites. The patient was diagnosed with Child-Turcotte-Pughclass C cirrhosis with grade II ascites, grade II hepatic encephalopathy, chronic hepatitis B, and esophageal varices. She received supportive treatment including lactulose, albumin transfusion, and antiviral therapy with tenofovir, resulting inclinical and biochemical improvement after one month. This case highlighted the importance of early screening for hepatitis B during pregnancy to prevent potentially fatal postpartum hepatic decompensation.
Co-Authors Cokorda Agung Wahyu Purnamasidhi Derryl Ravertio Timothy Subroto Dewa Gde Agung Budiyasa Dewa Gde Agung Budiyasa Dewi, Ni Luh Putu Yunia Dewi, Ni Nyoman Gita Kharisma Dewi, Putu Itta Sandi Lesmana Dwijo Anargha Sindhughosa, Dwijo Anargha Gde Somayana Godfried Erycesar Yeremia Saragih Hendra Koncoro Hendra Koncoro Hendra Koncoro I Dewa Nyoman Wibawa I Gusti Agung Suryadarma I Nyoman Astika I Wayan Surya Ardiana Ida Ayu T risha Kundalini Ida Bagus Nyoman Wibawa IDN Wibawa Itta Sandi Lesmana Dewi Jemi Tubung Jessica Raphaela Pranata Kadek Mercu Narapati Pamungkas Kumbara, Cokorde Istri Yuliandari Krisnawardani Kuwai, Toshio Made Wardhana Magat, Renaldy Frederich Nathanael Mirdania, Yaditta N Purwadi Nyoman Purwadi Pamungkas, Kadek Mercu Narapati Pande Ketut Kurniari Prasenah Subramaniam Priska Harsanti Devi Putu Prathiwi Primadharsini Saturti, Tjokorda Istri Anom Triyanayasa, I Nyoman Tubung, Jemi Wayan Arlis Saputra Wibawa, Ida Bagus Nyoman Wira Gotera Yaditta Mirdania Yenny Kandarini Yuna Ariawan