Profile of extrahepatic portal venous obstruction [EHPVO] in a tertiary care hospital in Pakistan

To study the clinical and laboratory profile of patients with EHPVO in a tertiary care hospital of Pakistan and to differentiate EHPVO from cirrhosis of liver and to see the effect on liver function tests. This is a prospective observational study conducted at Department of Gastroenterology, Pakistan Institute of Medical Sciences, Islamabad.Twenty five patients of 12-55 years of age with the features of portal hypertension were included in this study. After careful history and physical examination patients were subjected for laboratory investigations including liver function test, renal function test, blood CP, PT, APTT, HbsAg and anti HCV, other specialized procedures including endoscopy, liver biopsy and ultra sound was also done in all patients. Portal vein thrombosis was the predominant cause of EHPVO, accounting for 88% of cases. All patients were presented with upper GI bleeding, splenomegaly was observed in 88% of patients. None of the patients had clinical, biochemical or liver biopsy evidence of chronic liver disease. The diagnosis of extra hepatic portal venous obstruction and differentiation from cirrhosis can be easily made by characteristic clinical features, normal liver function tests and doppler ultrasound. Portal vein thrombosis [PVT] is the predominant cause of EHPVO in Pakistani patients, as seen at this tertiary care hospital in Pakistan

Review of upper GI endoscopies January 1987 to December 1992

4599 upper G.I. Endoscopies were performed at PIMS [Gastroenterology Unit] between January, 1987 to December, 1992 [6 years]. 2306 [50.14%] patients were male and 2293 [49.86%] female main presenting complaints were epigastric pain 1852 [40.26%] haemetemesis 750 [16.30%] dysphagia 485 [10.54%], persistent vomiting 310 [6.74%] and nonspecific dyspepsia 633 [13.76%], non acidpeptic symptoms 569 [12.37%] about 72% procedures [3351/4599] were remarkable of a definitive diagnosis. The incidence of portal hypertension was found to be higher than acidpeptic disease [APD] in the local population. The data has been analysed

Celiac disease complicated by lymphoma

Celiac disease has world wide distribution. It is caused by gluten containing substances like wheat, barley and rye. These patients present with anemia, weight loss, diarrhea and abdominal pain. Small bowel biopsy will show villus atrophy. Patients are treated with gluten free diet and histological improvement is noted. Three main complications of celiac disease are malignancy, ulcerative jejunoileitis and neuropathy. A case of celiac disease complicated by lymphoma is presented

Pseudocyst of pancreas

Pancreatic pseudocyst is an important complication of pancreatitis from any cause. Its incidence has increased from 10% to 50%. This is probably because of newer and more sensitive imaging techniques. A wide spectrum of complications have been reported to occur in patients with untreated pancreatic pseudocysts. A case of pancreatic pseudocyst complicated by intracystic haemorrhage and infection is presented