Accuracy of clinical diagnosis of liver diseases at Ibadan.

BACKGROUND: 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. OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.