ABSTRACT
A 35 year old female presented with pain abdomen, massive hematemesis and signs of portal hypertension. Death occurred despite of all efforts to manage shock & hematemesis by endoscopic sclerotherapy. Clinical autopsy revealed gangrene of small intestine with mesenteric vein thrombosis; oesophageal varices; hepatoportal sclerosis (HPS) of liver with regenerative nodules and chronic venous congestion of spleen. Histopathology of liver is essential for diagnosis of HPS & to rule out other disease process. Gangrene intestine in HPS is a rare presentation
ABSTRACT
Neoplasms of upper gastrointestinal tract, especially malignancy, are one of the leading causes of death worldwide. The advent of endoscopy has greatly facilitated the detection and diagnosis of gastrointestinal lesions. Although it has been shown that the combined use of cytology and biopsy renders the highest probability of detecting malignancy, the merit of routine brush cytology has been questioned since it appears to duplicate biopsy. This study is undertaken to correlate the findings of brush cytology with tissue biopsy and the feasibility of the procedure as an adjunct in diagnosis of upper gastrointestinal tract neoplasms. Seventy-five patients with upper gastrointestinal tract symptoms were subjected to endoscopy in a period of two years. Brushing was done before the biopsy was taken from the suspected lesions and cytological findings were compared with that of biopsy. Of the 75 cases, brush cytology was positive for malignancy in 65 cases (86.66%) and biopsy was positive in 58 cases (77.33%); the sensitivity of the study was 98.03%. Thus, brush cytology is a useful adjunct to biopsy in the diagnosis of upper gastrointestinal tract malignancy. With the inclusion of a "suspicious" category in the reporting of the smears, malignancy can be detected early, and if possible, patient management can be altered.