Esophageal stricture Post endoscopic injection sclerotherapy

Post endoscopic sclerotherapy esophageal stricture is usually not fatal but may require several sessions of esophageal dilation as an effective palliative treatment yet has its own complications. The purpose of this study is to find out the predictors of sclerotherapy esophageal stricture. This is a cross sectional descriptive study of the esophageal stricture post sclerotherapy for the patients who were managed in the period from January 2000 through the June 2007 in endoscopic department at Ibn Sina Hospital. Post endoscopic sclerotherapy symptoms, signs, diagnostic and therapeutic methods were analysed to find out possible predictors of developing benign esophageal stricture. A 33 out of 10133 patients who had sclerotherapy were found to have esophageal stricture and were included in this study. 91% of them were males, 88% were <60years old and most of them were cases of hepatic periportal fibrosis. Only two patients had esophageal varices secondary to viral hepatitis B liver cirrhosis. Their presentation was commonly with difficulty in swallowing and few cases presented with food impaction. The majority of patients were treated with wire guided endoscopic Savary Gilliard dilation. Esophageal stricture following endoscopic injection sclerotherapy is a known morbidity; however the rate of these strictures is fairly acceptable. High dose of sclerotherapy in fewer sessions over a short period are potential predictors of esophageal stricture

Fatty liver disease in sudan is not alcohol related

The finding of fatty liver disease [FLD] has generally been assumed to be a consequence of ethanol ingestion. However, non- alcoholic fatty liver disease [NAFLD] was identified as a specific entity. Although FLD is generally nonprogressive or only slowly progressive, cirrhosis and HCC can develop. The aim of this study is to find out the prevalence, clinical presentation and aetiology of FLD in Sudanese patients This is a descriptive cross sectional study which included 100 patients with FLD detected by ultrasonography at the national center for gastro-intestinal and liver diseases. Data was collected using a well designed questionnaire and results were analyzed by using SPSS computer system. Out of 1800 patients with liver disease, 100 were found to have FLD. These have no sex difference. Their mean age was 49.8 +/- 15.2 years. The main presenting symptoms were upper abdominal pain [60%] and fatigability in [41%]. while [7%] were asymptomatic. Hepatomegaly was clinically detected in [44%]. Ninety out of these 100 patients had non alcoholic fatty liver disease [NAFLD]. In this group [42%] were diabetics and [55%] had hyperlipidemia. A BMI of > 25kg/m2 was detected in 47% of patients. In patients with FLD and a BMI <18kg/m2 underlying diagnoses were made. Six patients had liver biopsy only two of them proved to have NASH. Fatty liver disease is not uncommon in Sudan and most of the patients' diseases are non-alcohol related