scholarly journals The Predictive Value of Pre-Operative Symptoms Including Upper Gastrointestinal Endoscopy Before Laparoscopic Cholecystectomy for Elective Symptomatic Cholecystolithiasis

2015 ◽  
Vol 11 (4) ◽  
pp. 300-304 ◽  
Author(s):  
A Karmacharya ◽  
BR Malla ◽  
HN Joshi ◽  
RB Gurung ◽  
M Rajbhandari

Background It has always been a challenge to distinguish between upper gastrointestinal symptoms due to gall stones or any other causes. The persistence of abdominal symptoms even after cholecystectomy is highly discouraging for surgeons. Objective To evaluate the value of preoperative (UGE) as a routine investigative tool in patients with gall stone disease and to assess the outcome of cholecystectomy in patients with gallstones on preoperative abdominal symptoms.Methods This is a prospective study conducted on 96 cases at the Department of Surgery, Dhulikhel Hospital among ultrasonographically proven gall bladder stones irrespective of age and sex. After the examination, all the patients were subjected to UGE, and biopsy were obtained for histopathology if required. The statistical analysis were performed using spss version 16.Results Out of total patients, 84(87.5%) were females and 12(12.5%) were males with a M: F ratio of 1:7. Both the sexes were comparable in age groups. Out of total 96 patients, 53(55.2%) presented with typical pain and 43(44.8%) presented with atypical pain. All the patients were subjected to upper gastrointestinal endoscopy (UGE) and 53(55.2%) had normal findings and 43(44.8%) had various lesions. Patients with typical pattern of pain had normal endoscopic findings and those with atypical pain had pathology in upper gastroendoscopy (p<0.001). Serious pathology resulting to change of the planned treatment was found in three cases (3.12%). Among them two had gastric carcinoma and one had active peptic ulcer disease. The relief rate after the cholecystectomy was significant in patients with typical pain than among those with atypical pain (p<0.001). The commenest post cholecystectomy symptoms were heart burn (10%), abdominal discomfort (9%) and dyspepsia (7%).Conclusion Presence of atypical pain in patients with gall stones is highly likely to have other coexisting upper gastrointestinal pathologies. Hence, upper gastrointestinal endoscopy prior to elective cholecystectomy in patients with gall stones can be clinically helpful.Kathmandu Univ Med J 2013; 11(4): 300-304

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Onyedika Godfrey Okoye ◽  
Oluwole Olayemi Olaomi ◽  
Alexander M.E. Nwofor ◽  
Paul Jibrin ◽  
Cephas Shallangwa Batta ◽  
...  

Background. Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and has been linked to Helicobacter pylori (H. pylori) infection. This condition may be suspected on clinical grounds, but diagnosis is established using upper gastrointestinal endoscopy. Aims. To determine the correlation between the endoscopic and pathological findings among suspected PUD patients who have been referred for diagnostic upper gastrointestinal endoscopy in National Hospital Abuja. Methods. This is a hospital-based prospective study conducted among suspected PUD patients at National Hospital Abuja over a one-year period. Clinical, endoscopic, and histological findings were ascertained and documented. Data obtained were analyzed using SPSS version 21.0. Tests of significance were done using the chi-square test and Student t -test at 95% confidence intervals. Results. One hundred and thirty-two patients were included in the study. The ages ranged from 15 to 87 years, mean age 43.30 ± 11.94 years. Seventy-seven (58.3%) patients had abnormal endoscopic findings, of whom 37 (28.0%) had PUD. Prevalence of H. pylori infection was 42.2% and was found in 81.1% of PUD patients. H. pylori was significantly associated with confirmed PUD ( p < 0.001 ) and abnormal endoscopic findings ( p < 0.001 ). No association was found between normal endoscopic findings and histological findings ( p = 0.924 ). Conclusion. There is a poor correlation between clinical and endoscopic diagnoses of PUD. H. pylori was found to be significantly associated with PUD and abnormal endoscopic findings. Endoscopic facilities should therefore be made available and accessible for proper PUD diagnosis. Empirical treatment of H. pylori in patients with diagnosed PUD is strongly recommended.


2012 ◽  
Vol 13 (4) ◽  
pp. 180-183
Author(s):  
Ali Kagan Gokakin ◽  
Atilla Kurt ◽  
Gunduz Akgol ◽  
Boran Cihat Karakus ◽  
Mustafa Atabey ◽  
...  

1997 ◽  
Vol 4 (1) ◽  
pp. 29-33 ◽  
Author(s):  
T. Hauge ◽  
J. Persson ◽  
Å. Nilsson

Twenty-four chronic alcoholics admitted to hospital for detoxification after a drinking spree were examined by upper gastrointestinal endoscopy. Biopsy specimens were taken from corpus/fundus, antrum and duodenum for tissue histology (eosin stain). From the duodenum villus index and ultrastructure (scanning electron microscopy, SEM) were also performed. As a control group 12 subjectively healthy non-alcoholics referred to upper gastrointestinal endoscopy mainly for dyspepsia were chosen.Gastrointestinal symptoms were common in alcoholics (88%). Endoscopic and histological gastroduodenitis were not more common in the alcohol group. There was no correlation between gastrointestinal symptoms and endoscopic or histological gastroduodenitis in both groups. In the duodenum, 50% of the alcoholics and 82% in the control group had alterations by scanning electron microscopy. Ten of the 11 alcoholics with an abnormal ultrastructure had diarrhoea. In the control group dyspepsia (ulcus suspect) was correlated to a pathological SEM.


2021 ◽  
Vol 71 (3) ◽  
pp. 744-48
Author(s):  
Fayyaz Hassan ◽  
Khalil Ahmad ◽  
Saeed Bin Ayaz ◽  
Heyyan Bin Khalil

Objective: To determine the spectrum of findings in patients presenting for upper gastrointestinal (UGI) endoscopy and investigate role of age and gender. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology & Internal Medicine, Combined Military Hospital Kharian, from Jul 2017 to Mar 2019. Methodology: The data regarding 638 consecutive patients who underwent upper gastrointestinal endoscopy in the department were collected from the computer-based database and patients were stratified into two groups according to their age: ≤50 and >50 years. Results: The mean age was 50.2 ± 17.4 (range: 7-100) years. There were 431 males and 207 females. The commonest presenting complaint was decompensated chronic liver disease (CLD) 162 (25.4%). The upper gastrointestinal endoscopy was normal in 306 (48%) and abnormal in 332 (52%) patients. The commonest abnormality seen on upper gastrointestinal endoscopy was esophageal varices seen in 167 (26.2%) followed by non-specific gastropathy, and hiatal hernia seen in 28 (4.4%) and 21 (3.3%) patients respectively. No significant differences were observed among males and females for a positive upper gastrointestinal endoscopy. Significantly large number of patients of age >50 years had an abnormal upper gastrointestinal endoscopy (p<0.001). The commonest upper gastrointestinal endoscopic abnormalities were similar in both genders and age-groups. Conclusion: The commonest finding on upper gastrointestinal endoscopy were esophageal varices and non-specific gastropathies. Females and patients ≤50 years had a higher prevalence of a normal upper gastrointestinal endoscopy. The commonly observed upper gastrointestinal endoscopy findings were generally similar among the genders and the age-groups.


2013 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Bishal Khattri Chhetri ◽  
M S Paudel ◽  
Nabin Pokharel ◽  
Shadev Prasad Dhungana ◽  
Anuj Paudel ◽  
...  

  Introduction: Upper gastrointestinal (UGI) endoscopy includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real time assessment and interpretation of the findings encountered. An upper endoscopy is indicated in the diagnostic evaluation of signs and symptoms of a wide variety of gastrointestinal disorders. Besides there are some therapeutic implication of the endoscopy. This study was conducted to study the spectrum of diseases found during the upper gastrointestinal endoscopy in patient presenting in Lumbini Medical College and Teaching Hospital (LMCTH).   Methods: This was a retrospective observational study carried out in LMCTH. The endoscopic record book of the patients who underwent UGI endoscopy for various reasons from February 2011 to 2013 was analysed. The risk factor of smoking and alcohol was also included and analysed in the study.   Results: All together 550 upper GI endoscopy was performed in the two years. There were 290 males (52.72%) and females were 260 (47.38%). The mean age was 45.7 years (SD=17.9). Most of the patient belonged to the age group 41 to 80 years (71%). Among total patients, 209 (38%) of them were found to be macroscopically normal. Of those who had positive endoscopic findings; 165 (48.4%) had gastritis and 36 (10.6%) had duodenal ulcer, esophageal varices was in 30 (8.8%), gastric carcinoma in nine (2.6%) of cases. Cigarette smoking was significantly associated with the presence of peptic ulcer disease (p=0.01) and malignancy of gastrointestinal tract (p=0.03). Alcohol intake was non-significantly related to peptic ulceration (p=0.07) and malignancy of gastrointestinal tract (p=0.09).   Conclusion: Upper gastrointestinal endoscopy is a safe and useful procedure for investigating patients with gastrointestinal complains. Gastritis was the most common finding among the patients who had abnormal endoscopy followed by duodenal ulcer and esophageal varices.


2018 ◽  
Vol 56 (209) ◽  
pp. 504-509 ◽  
Author(s):  
Tanka Prasad Bohara ◽  
Uttam Laudari ◽  
Abishek Thapa ◽  
Shail Rupakheti ◽  
Mukund Raj Joshi

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.


2021 ◽  
Vol 8 (18) ◽  
pp. 1201-1205
Author(s):  
Koushik Chakma ◽  
Saumik Chakraborty ◽  
Avik Chakraborty

BACKGROUND Upper gastrointestinal bleeding (UGIB) is one of the common medical emergencies throughout the world that may require hospital admission and results in high patient morbidity and mortality. The presentation of UGI bleeding depends on the amount and location of haemorrhage. Upper gastrointestinal endoscopy (UGIE) is the preferred investigative procedure for UGIB because of its accuracy, low rate of complication, and its potential for therapeutic interventions. The present study has been carried out to evaluate the different aetiological causes of UGIB in a tertiary care centre in the North Eastern part of India and compare the same with other studies done globally. METHODS This was a hospital based observational study with cross sectional design carried out in the Department of Medicine at Tripura Medical College & DR BRAM Teaching Hospital, Agartala. Total 376 patients were selected for this study for over a period of 2 years from January 2017 to December 2018. Upper GI endoscopy was performed in all patients after hemodynamic stabilisation. Rockall scoring system was used in non-variceal cases to predict the mortality in patients with upper GI bleeding. RESULTS A total of 376 patients had endoscopy for UGIB which included 260 (69.1 %) males and 116 (30.9 %) females, and the mean age was 47.9 (± 17.0) years. The most common cause of UGIB was peptic ulcer disease (duodenal ulcer and gastric ulcer) consisting of 31.38 %, followed by erosive gastritis (23.94 %), oesophageal varix (11.17 %), portal hypertensive gastropathy (10.64 %), duodenitis (8.51 %). Gastrointestinal malignancy (gastric and oesophageal cancers) was reported in 3.98 % and rare causes of UGIB were Mallory-Weiss syndrome (1.86 %), and esophagitis (1.60 %). Among them 4.26 % of the patients had normal endoscopy findings. CONCLUSIONS In the present study, peptic ulcer disease was the most common cause of upper gastrointestinal bleeding, followed by erosive gastritis. Rockall score of more than 4 was numerically associated with increased incidence of mortality. KEYWORDS Upper Gastrointestinal Bleeding (UGIB), Upper Gastrointestinal Endoscopy (UGIE


2017 ◽  
Vol 11 ◽  
Author(s):  
Fahad A.S. Al-Eidan ◽  
Mohamed Alnaser ◽  
Sameera M. Aljohani ◽  
Mishal Al Johani ◽  
Ahmed El Hafi ◽  
...  

There is growing concern about <em>Helicobacter pylori</em> (<em>H. pylori</em>) resistance strains being the main agent contributing to eradication failure. In this study we evaluated the prevalence and antimicrobial susceptibility trends of <em>H. pylori</em> over a period of time. Over a period of seven years a total of 384 biopsy specimens were sent to the microbiology department and evaluated for culturing <em>H. pylori</em> and assess its susceptibility. Biopsy specimens that cultured and where bacterial susceptibility was determined were regarded as <em>H. pylori</em> positive, and specimens that failed to culture were considered <em>H. pylori</em> negative. A total of 221 patients with <em>H. pylori</em> positive were assessed and antimicrobial susceptibility was determined. The overall prevalence of <em>H. pylori</em> infections among Saudis undergoing upper gastrointestinal endoscopy, with indicated specimens, was 57.6%. Antimicrobial susceptibility was evaluated; overall clarithromycin resistance was found to be 4.5% and metronidazole resistance 52.5%. The number of clarithromycin resistant strains has increased significantly from 2.5% in 2008 to 10% in 2014 (PH. pylori infection is very common among Saudi patients with peptic ulcer disease. Resistance of <em>H. pylori</em> against clarithromycin and metronidazole has increased significantly over the seven-year period. This suggests a need to monitor the annual antimicrobial susceptibility pattern.


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