Diagnostic Approach In Patients With Liver Diseases In Rural Tanzania

Abstract

The study represents an analysis of 80 patients admitted for liver disorders to a rural Tanzanian hospital in 1983. 51 males and 29 females were admitted to the study and were examined by clinical examination, liver function tests, serology, laparoscopy and histology. Their ages varied from 15 to 70 years with an average age of 40. 52 out of 80 patients had a complete step by step diagnostic approach of their liver problem. It was possible to establish a final diagnosis by clinical findings in 46 %, by additional laparoscopy in 25% and by histology in the remaining 29% of cases. Laparoscopy together with clinical examination and some laboratory tests, but without histology (not always possible in rural, tropical countries) provided important diagnostic information in 9 cases out of 10. Clinical examination, laparoscopy and histology are accurate and have a low complication rate.

By this type of approach, it is possible to rapidly establish the diagnosis of liver diseases occurring in a rural tropical area. Hence, our findings serve as a basis to guidelines on diagnosis and management of hepatic disorders in rural hospitals and dispensaries.