ABSTRACT
Gastric malignancies carry poor prognosis, because they commonly present at an advanced stage. To find out mode of presentation and its impact on the outcome and management of gastric cancer and to find if there are changes in trends of gastric malignancies over the last decade. A review of 53 patients with gastric malignancies, treated at Ibn Sina Hospital from August 2010 through August 2011. Their demographic data, pattern of clinical presentation, histopathology grading and staging, type of management and hospital mortality were studied. Statistical analysis: Data was fed to Statistical Package for Social Sciences. Means and correlations were computed where appropriate. One sample t-test was performed. Statistical significance was taken at P = 0.05. Out of 53 patients males comprise 30[56.6%] males. The peak frequency was at the age group 55-70 years. Patients from the Northern Region of Sudan constituted 34%. Adenocarcinoma comprised 43[81.3%], GIST 8[15%], lymphoma 1[1.9%] and carcinoid 1[1.9%]. Epigastric pain was the commonest symptom in 47[88.7%] patients. Smoking and snuff [Tombak] and high salt diet were found in 7.5% and 5.7% and 3.8% patients respectively. Blood group A and O was found in 22.6% and 60.4% respectively. Family cancer syndrome was found in 11.3% patients. Malignancies of the antrum constitute 27[65.85%], cardia 4[9.8%], body 7[17.1%], and whole stomach 3[7.3%] patients. There were only 6.25% clinically early cases. Potentially curative resection was attempted in 31.7%. The mean hospital stay was 12 days. Patients presented at stage III and IV comprise 30 [93.75%] out of 32 carcinoma patients. The hospital morbidity was 13[24.6%] patients and mortality 4[7.5%] patients. When compared with results from same hospital there is improvement in outcome over a decade
ABSTRACT
Surgeons are expected to deal with expect some failure of ERCP in extraction of missed CBD stones. Re-do surgery is difficult; however surgeons have to stand for it. To audit the outcome of ERCP in extraction of CBD stone for patients referred to Ibn Sina Teaching Hospital. This is prospective, hospital based study; carried in the period from January 2009 to June 2010 in Ibn Sina Teaching Hospital .A total of 119 patients referred for ERCP extraction of CBD stones were studied. Male to female ratio was 1:5. The mean age [ +/- SD] is 55.4 [ +/- 17.57]. Post cholecystectomy missed stones were 7[6%], post CDB exploration retained stones were 4[3.4%] and re-do ERCP was done in 9[7.6%] patients. Failure of stone extraction occurred in 10[25%] cases due to failure of cannulation while another 10[25%] cases had multiple impacted stones and nine [22.2%] had too big stone to be extracted. In addition, five [12.5%] cases had CBD stricture, and the procedure was not completed because of bleeding in two cases and impaction of the dormia basket in two [5%] cases. The success of redo ERCP is seven out of nine cases. Complication occurred in seven [5.88%] patients. These were bleeding in two [1.68%], cholangitis in one [0.84%] CBD and retro-peritoneal duodenal perforations in two [1.68%] and retained dormia basket in two [1.68%] cases. The mortality rate was one [0.8%] patient. ERCP, at Ibn Sina Hospital, has success rate in stone extraction in 79[66.4%] and complication rate in seven [5.88%] patients. About one third of cases attending ERCP for stone extraction were referred back for open exploration of CBD