ABSTRACT
In contrast to the experience in the adults, there are limited data concerning the efficacy and safety of upper gastrointestinal endoscopy (UGIE) in paediatric patients. The information on this procedure is very scanty from non-western countries. We analysed 72 children evaluated in Gizan, Saudi Arabia, an area of high endemic hepatitis B and chronic liver disease. The indications comprised abdominal pain (49%), UGI bleeding (24%) and evaluation of suspected portal hypertension. No abnormality was detected in 33 (46%). Mucosal inflammatory lesions (oesophagitis, gastritis and duodenitis) are the commonest abnormal lesions, occurring in 24 (33%). Duodenal ulcer (4 cases) and gastric ulcer (1 case) were relatively few. No case of malignancy was found. Sclerotherapy for variceal bleeding was effective in 4 patients. Helicobacter pylori was detected in 12 of 23 patients and associated with histologically identified gastritis in the majority of these cases. It is concluded that paediatric UGIE is safe and useful in the diagnosis and therapeutic intervention for UGI diseases in children. Our findings provide additional information on the pattern of diseases among Saudi Arabian children.
Subject(s)
Adolescent , Child , Child, Preschool , Endoscopy, Gastrointestinal , Female , Gastrointestinal Diseases/diagnosis , Humans , Infant , Male , Saudi ArabiaABSTRACT
Serologic markers for HBV, HDV, HIV-1 and HTLV-1 were tested in 42 patients with a primary hepatocellular carcinoma (PHC); 19 with a malignancy of epithelial origin (EPM) and 16 with a non-epithelial malignancy (NEPM) in the Gizan Area of Saudi Arabia. HBV exposure in 77 PHC, EPM and NEPM patients was 92.2 per cent for any marker (overall) while 75.3 per cent positive for HBsAg. 3.9 per cent positive for anti-HBc and 12.9 per cent positive for anti-HBs. There was no inter PHC, EPM, NEPM or intersex variation for an individual marker or total HBV exposure. Among HBsAg-positives, 9 of the 12 PHC tested, 7 of the 10 EPM, 1 of the 9 NEPM were anti-D IgG positive. The HDV prevalence was the lowest in NEPM (p < 0.01). In patients with a malignancy, all HBV and HDV markers were higher than those of control population, even though anti-HBs was lower (p < 0.001). The probable contribution through different viruses in pathogenesis of malignancies of different types should be ascertained through polymerase chain reaction for viral components, oncogenes, etc. on tumourous biopsy tissues. The aggravation in PHC morbidity in HBV hyperendemic foci through HIV infection should be monitored through tests for unintegrated and integrated viral DNA in tumorous and non-tumorous tissues.