Endoscopic findings in acute upper gastrointestinal hemorrhage at King Hussein Medical Center

To find out the diagnosis in patients presenting with acute upper gastrointestinal hemorrhage at King Hussein Medical Center. A total of 1118 cases of acute upper gastrointestinal hemorrhage patients aged over 16 years who underwent upper endoscopy over a six year-period at King Hussein Medical Center were studied. Most endoscopies were done within 24 hours from the occurrence of the gastrointestinal bleeding. Patients were divided into different age groups to compare the frequency of upper gastrointestinal hemorrhage between males and females in each group. The total number of patients was also divided into 2 subgroups: those below 50 years and above 50 years to compare the distribution of the endoscopic findings between young and older age groups. Upper gastrointestinal bleeding was more common in men at all age groups than that in women except in older patients [more than 70 years]. Eighty seven percent of the endoscopies were done for patients admitted to hospital through the emergency department, and 13% for patients who were already in hospital for some other reason. Sixty two percent of patients were aged over 50. The most common finding over all was duodenal ulcer [32%]. Normal endoscopy was reported in 21% of the cases. Other frequent sources of bleeding were stomach ulcers [18.5%], esophageal varices [5.2%], portal hypertensive gastropathy [0.6%]. Mallory-Weiss tears [3.3%], and gastric tumors [4.7%]. Gastric ulcers and malignancies were more common in older compared with younger age group [2 1.5%, 6.6% vs. 14%, 1.4% respectively]. Therapeutic endoscopic interventions were done in 17% of the patients; adrenaline injection for bleeding peptic ulcer in 16%. sclerotherapy for esophageal varices in 0.9% and banding in 0.1% patients. The frequency of acute upper gastrointestinal hemorrhage increases considerably with age. The most common finding for all age groups was duodenal ulcer. Malignancy was the most important finding in the older [> 50 years] age group

Behcet's disease: brain imaging findings

To evaluate the pattern and site of brain involvement in neuro-Behcet's disease. Twenty patients with Behcet's disease, four with neurological manifestations and 16 patients without neurological manifestations were evaluated. T1 weighted and T2 weighted magnetic resonance imaging as well as magnetic resonance angiography and magnetic resonance venography images were obtained for all patients. Non-enhanced axial computerized tomography was performed only for the four patients with neurological manifestations. Four out of 20 patients [20%] with neurological symptoms showed abnormal radiological findings. The changes were seen in the basal ganglia, thalamus, brain stem and cerebellum. The abnormal changes were high signal intensity in T2 weighted magnetic resonance imaging and low signal intensity in T1 weighted magnetic resonance imaging, the abnormalities on computerized tomography scan were low-density lesions. The magnetic resonance imaging for the other 16 patients [80%] neurological in asymptomatic were normal. Magnetic resonance imaging and computerized tomography play a major role in the diagnosis of brain involvement in Behcet's disease. The basal ganglia, thalamus, brain stem and cerebellum are the commonest sites of involvement. Imaging does not seem to be of value in neurologically asymptomatic patients