accuracy of multi-detector row computerized tomography in staging rectal cancer compared to endoscopic ultrasound

Our aim was to evaluate the diagnostic accuracy of multi-detector row computerized tomography [MDCT] in staging of rectal cancer by comparing it to rectal endoscopic ultrasound [EUS]. We prospectively included all patients with rectal cancer referred to our gastroenterology unit for staging of rectal cancer from December 2007 until February 2011, 53 patients whose biopsy had proven rectal cancer underwent both MDCT scan of the pelvis and rectal EUS. Both imaging modalities were compared and the agreement between T- and N-staging of the disease was assessed. We staged 62 patients with rectal cancer during the study period. Of these, 53 patients met the inclusion criteria and were evaluated [25 women and 28 men]. The mean age was 57.79 +/- 14.99 years [range 21-87]. MDCT had poor accuracy compared with EUS in T-staging with a low degree of agreement [kappa = 0.26], while for N-staging MDCT had a better accuracy and a moderate degree of agreement with EUS [kappa = 0.45]. MDCT has a poor accuracy for predicting tumor invasion compared to EUS for T-staging while it has moderate accuracy for N-staging

Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

Metabolic bone disease is common in patients with inflammatory bowel disease [IBD]. Our aim was to determine the frequency of bone loss among Saudi patients with IBD and possible contributing risk factors. We retrospectively reviewed Saudi patients with IBD, between 18 and 70 years of age, who had bone mass density [BMD] determined by dual-energy X-ray absorptiometry scanning at one of three hospitals in the Kingdom of Saudi Arabia from 2001 to 2008. Case notes and BMDs results were carefully reviewed for demographic and clinical data. Low bone mass, osteopenia, and osteoporosis were defined according to the WHO guidelines. Predictive factors for BMD were analyzed using group comparisons and stepwise regression analyses. Ninety-five patients were included; 46% had Crohn's disease [CD] and 54% had ulcerative colitis [UC]. The average age was 30.9 +/- 11.6 years. Using T-scores, the frequency of osteopenia was 44.2, and the frequency of osteoporosis was 30.5% at both lumbar spine and proximal femur. Only 25.3% of patients exhibited a BMD within the normal range. Our both lumbar spine and proximal femur. Only 25.3% of patients exhibited a BMD within the normal range. Our results revealed a positive correlation between the Z-score in both the lumbar spine and the proximal femur and body mass index [BMI] [P=0.042 and P=0.018, respectively]. On regression analysis BMI, age, and calcium supplementation were found to be the most important dependent predictors of BMD. Saudi patients with IBD are at an increased risk of low BMD and the frequency of decreased BMD in Saudi patients with CD and UC were similar. BMI and age were the most important independent predictors of low BMD

Presenting features of childhood-onset inflammatory bowel disease in the central region of Saudi Arabia

To investigate the presenting features of childhood-onset inflammatory bowel disease [IBD] in the central region of Riyadh, Saudi Arabia and to compare with those reported in the literature. This is a retrospective review of medical records of children below 18 years of age at onset of symptoms with confirmed diagnosis of IBD for age, gender, family history, presenting clinical and laboratory findings in the Divisions of Pediatric and Adult Gastroenterology, King Khalid University Hospital [which provides free health care] and the Department of Gastroenterology Al Mofarreh Poly Clinic, Riyadh, Saudi Arabia, between January 1993 and December 2010. Two hundred and eighteen children diagnosed with IBD with predominance of males in Crohn's disease [CD] [56%] and females in ulcerative colitis [UC] [59%]. There was no significant difference between UC and CD regarding age of onset of symptoms [p=0.347]; however, the difference in the age at presentation and age at final diagnosis were significant [p=0.027 and p=0.008]. There was a significant increase of IBD diagnosis from the period 1993-2001 to 2002-2010 [p<0.0001]. The family history was positive in 15.3%. The presenting clinical features and laboratory abnormalities are similar to those reported in other populations. Further studies are needed to establish the incidence and prevalence

Histological and laboratory features of patients undergoing liver biopsy at a University Hospital in Central Saudi Arabia

To identify the most common liver pathologies seen in our center, to find the prevalence of advanced fibrosis and cirrhosis in patients with chronic hepatitis B and C, and to correlate the histological and laboratory features of the most common diseases and compare between them. Liver biopsy procedures performed in our Gastroenterology Unit at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia were traced from records between the years 1997-2003. Clinical, histopathological, and laboratory features were recorded. We identified 574 liver biopsies during the study period. Of the 502 included patients, males were 58.6%. The mean age of the patients was 43.5 years. Approximately half of the biopsies [49%] were performed for patients with hepatitis C, followed by hepatitis B, for which 17% of the biopsies were performed. Patients with hepatitis B were approximately 10 years younger than patients with hepatitis C [p=0.01]. They were 10% more likely to be males. In terms of fibrosis, only approximately 17% of patients with hepatitis B and 27% of patients with hepatitis C had advanced fibrosis. Most liver biopsies performed in our center are performed for patients with hepatitis C. Rates of advanced fibrosis in our series are significantly lower than what was previously reported in other studies