Upper gastrointestinal endoscopy; A study from a rural population of Sindh, Pakistan

Objective: To discuss common indications and findings on upper gastrointestinal endoscopy as well as to correlate these findings with alarm symptoms in the rural population of Gadap town, Sindh. Methods: This was a retrospective study on 1288 patients conducted in the medical ward of Fatima Hospital, Baqai Medical University. Patients’ demographics and other data related to the procedure were recovered from patients’ records. SPSS version 20 was used for statistical analysis. Results: Ratio of male and female patients was approximately 1:1. Majority of the patients were young, and most procedures were done as outpatients without the requirement of conscious sedation. Epigastric pain was the primary indication for upper GI endoscopy (62.6%). One third of the procedures performed did not report any pathological finding. Probability of a positive finding was more likely if a patient presented with dysphagia, heart-burn, hematemesis, vomiting, or for screening endoscopy (for varices). Patients who were diagnosed with esophageal candidiasis, esophageal varices or esophageal growth/ ulcer had reported one or more alarm symptoms in their history. Conclusions: Upper gastrointestinal endoscopy is a useful test to diagnose disorders of the esophagus, stomach and duodenum. However, it is an expensive procedure and therefore referring physicians should keep appropriate clinical indication and ethical considerations in mind before recommending such an investigation to their patients. doi: https://doi.org/10.12669/pjms.37.1.3297 How to cite this:Kamran M, Fawwad A, Haider SI, Hussain T, Ahmed J. Upper gastrointestinal endoscopy; A study from a rural population of Sindh, Pakistan. Pak J Med Sci. 2021;37(1):9-14. doi: https://doi.org/10.12669/pjms.37.1.3297 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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CandidaEsophagitis in an Immunocompetent Pregnant Woman

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s106474499300033x ◽

1993 ◽

Vol 1 (3) ◽

pp. 149-152 ◽

Cited By ~ 1

Author(s):

Jeffrey S. Greenspoon ◽

Seth Kivnick

Keyword(s):

Human Immunodeficiency Virus ◽

Weight Loss ◽

Candida Albicans ◽

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

Upper Gastrointestinal Endoscopy ◽

Second Trimester ◽

Increased Risk ◽

Immunodeficiency Virus ◽

Upper Gastrointestinal

Background:Nausea and vomiting are common during the first half of pregnancy and usually require only supportive measures. When symptoms are progressive and weight loss occurs, treatable causes should be sought by means of upper gastrointestinal endoscopy. We report a case of an immunocompetent gravida with invasiveCandida albicansesophagitis.Case:The immunocompetent primigravida developed progressive nausea, vomiting, epigastric pain, and a 4.1 kg weight loss during the second trimester of pregnancy. Treatment with metoclopramide and cimetidine for presumed gastroesophageal reflux was not effective. The patient had normal T-cell CD4 and CD8 subsets and was human immunodeficiency virus (HIV) antibody negative. Upper gastrointestinal endoscopy revealedC. albicansesophagitis which was treated with oral nystatin. The esophagitis had resolved completely when reassessed postpartum. The use of histamine2blockers is associated with an increased risk for fungal esophagitis and may have been a contributing cause in this case.Conclusion:Pregnant patients with persistent nausea, vomiting, and weight loss should be evaluated by endoscopy for fungal esophagitis.

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Acute Gastric Volvulus on Hiatal Hernia

Case Reports in Surgery ◽

10.1155/2020/4141729 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Abdessamad EL KAOUKABI ◽

Mohamed MENFAA ◽

Samir HASBI ◽

Fouad SAKIT ◽

Abdelkrim CHOHO

Keyword(s):

Hiatal Hernia ◽

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

Gastric Volvulus ◽

Upper Gastrointestinal Endoscopy ◽

Rare Entity ◽

Midline Laparotomy ◽

Acute Gastric Volvulus ◽

Upper Abdominal ◽

Upper Gastrointestinal

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

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Helicobacter pylori Infection: Clinical, Endoscopic, and Histological Findings in Lebanese Pediatric Patients

International Journal of Pediatrics ◽

10.1155/2020/4648167 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

F. AL Kirdy ◽

M. Rajab ◽

N. El-Rifai

Keyword(s):

Helicobacter Pylori ◽

Gastrointestinal Endoscopy ◽

Pediatric Patients ◽

Epigastric Pain ◽

Demographic Data ◽

Upper Gastrointestinal Endoscopy ◽

Histopathological Findings ◽

Increased Risk ◽

H Pylori ◽

Upper Gastrointestinal

Background. Helicobacter pylori (H. pylori) is a common and universally distributed bacterial infection. However, in children, active gastritis and ulcer are rarely seen. Objectives. The aims of this study were to establish the prevalence of H. pylori infection and to compare the clinical, endoscopic, and histopathological findings between infected and noninfected pediatric patients at Makassed General Hospital. Methods. Patients aged between 1 month and 17 years who underwent upper gastrointestinal endoscopy from January 2011 to January 2017 were included. The diagnosis of H. pylori was confirmed by a CLO test and/or its presence on biopsy specimens. Demographic data, clinical characteristics, endoscopic and histopathological findings, and gastritis score were recorded retrospectively. Results. During the study period, 651 children underwent upper gastrointestinal endoscopy. The main indication was abdominal pain (61%). The prevalence of H. pylori infection was 16.5%. The infection was most commonly seen among children aged between 6 and 10 years (43%). A large number of family members were associated with increased risk of infection (4.8±1.5 versus 5.2±1.8; p<0.05). Epigastric pain was more associated with H. pylori (61.3% versus 14.6% in noninfected patients; p<0.05). Nodular gastritis was commonly seen in infected patients (41.5% vs. 7.9%; p<0.05). Mild and moderate gastritis was seen more in infected versus noninfected patients (mild: 53.8% vs. 14%; moderate: 27.4% vs. 2.4%, respectively). Conclusion. Although epigastric pain was associated with H. pylori, other diagnoses should be considered since the infection are rarely symptomatic in children. Antral nodularity was associated with H. pylori infection; however, its absence does not preclude the diagnosis.

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Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding

Journal of Nepal Medical Association ◽

10.31729/jnma.3121 ◽

2018 ◽

Vol 56 (209) ◽

pp. 504-509 ◽

Cited By ~ 1

Author(s):

Tanka Prasad Bohara ◽

Uttam Laudari ◽

Abishek Thapa ◽

Shail Rupakheti ◽

Mukund Raj Joshi

Keyword(s):

Odds Ratio ◽

Gastrointestinal Endoscopy ◽

Upper Gastrointestinal Endoscopy ◽

Positive Finding ◽

Significant Finding ◽

Cross Sectional ◽

Abdominal Symptoms ◽

Clinically Significant ◽

Upper Abdominal ◽

Upper Gastrointestinal

Introduction: Upper Gastrointestinal Endoscopy(UGIE) is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for UGIE and have shown that inappropriate indications range from 5% to 49%. The unnecessary UGIE expose patients to the risk. The number of UGIE is rising in our region and we assume so is the number of unnecessary UGIE. With an aim to evaluate the appropriateness of the indications of UGIE and compare its association with positive findings, we conducted a cross-sectional descriptive study. Methods: All patients undergoing diagnostic UGIE during the study period were included in the study. Appropriateness of indications for UGIE was defined as per American Society for Gastrointestinal Endoscopy(ASGE) criteria as “appropriate” and “inappropriate”. UGIE endoscopy findings were classified as “significant” and “insignificant” based on endoscopy findings. The extent of this association between the appropriateness of indications and UGIE findings was expressed as the odds ratio (OR) of finding a relevant diagnosis in patients with an ‘‘appropriate’’ indication compared with those with an ‘inappropriate’’ indication. Results: Seventy-nine patients were included in the study. Fifty- two (65.8 %) of the indications were considered appropriate as per ASGE guidelines. Thirty-three (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 (95%CI:1.773 – 13.890, p=0.002) which is statistically significant. Conclusions: Appropriate indications have significantly higher rates of clinically significant findings. Use of guidelines may decrease the number of unnecessary procedures.

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Successful Endoscopic Resection of an Early Carcinoma of the Duodenum

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.5.239 ◽

1999 ◽

Vol 5 (4) ◽

pp. 239-244 ◽

Cited By ~ 1

Author(s):

Tomoko Tada ◽

Jyunya Arai ◽

Akihiko Ohta ◽

Kouitirou Satoh ◽

Katuya Hattori ◽

...

Keyword(s):

Biopsy Specimen ◽

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

Early Carcinoma ◽

Upper Gastrointestinal Endoscopy ◽

Depth Of Invasion ◽

Tubular Adenoma ◽

Group Iii ◽

Large Size ◽

Upper Gastrointestinal

We describe a patient in whom an early carcinoma of the duodenum was able to be resected endoscopically. A 77-year-old man presented with epigastric pain. Upper gastrointestinal endoscopy revealed a mass in the duodenum, and the patient was admitted. A whitish nodular aggregated lesion, measuring 20 mm in diameter, was found in the second portion of the duodenum. Examination of a biopsy specimen showed a Group III tubular adenoma. Endoscopic ultrasonography showed that the lesion was confined to the mucosa. The large size of the lesion suggested the possibility of malignancy. Endoscopic mucosal resection was therefore performed. Histopathologically, the diagnosis was carcinoma in adenoma. The depth of invasion was mucosal. We conclude that endoscopic muosal resection can be used to treat mucosal lesions arising in the duodenum.

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Primary Pancreatic Diffuse Large B-Cell Lymphoma Involving the Stomach

Korean Journal of Medicine ◽

10.3904/kjm.2020.95.4.281 ◽

2020 ◽

Vol 95 (4) ◽

pp. 281-286

Author(s):

Ji Young Park ◽

Tae Joo Jeon

Keyword(s):

Gastrointestinal Endoscopy ◽

Epigastric Pain ◽

B Cell Lymphoma ◽

Needle Aspiration ◽

Pancreatic Mass ◽

Upper Gastrointestinal Endoscopy ◽

Rare Presentation ◽

Pancreas Head ◽

Pancreatic Lymphoma ◽

Upper Gastrointestinal

Primary pancreatic lymphoma (PPL) is extremely rare, comprising fewer than 1% of non-Hodgkin lymphomas. The most common histological subtype of PPL is diffuse large Bcell lymphoma (DLBCL). A 46-year-old man presented with indigestion, epigastric pain, and weight loss for 2 months. Abdominal computed tomography showed a well-defined hypodense mass located at the pancreas head involving the stomach, as well as enlargement of several mesenteric and perigastric lymph nodes. Histological examination was performed by upper gastrointestinal endoscopy of the stomach and endoscopic ultrasound-guided fine-needle aspiration and biopsy of the pancreatic mass. Histology of the pancreatic mass and the stomach revealed pancreatic DLBCL, involving the stomach. The patient received chemotherapy and is currently in complete remission. We report a rare presentation of DLBCL, appearing as a primary pancreatic tumor involving the stomach, which we presume is the first such report in South Korea.

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