Pattern of upper gastro intestinal malignancies in northern Punjab

To record the number of cases of carcinoma of stomach, geographical location and histological diagnosis presenting to a hospital in northern Punjab. This study was conducted at the department of medicine [GI unit] Fauji Foundation Hospital Rawalpindi. All the patients who underwent upper GI endoscopy and were found to have an upper GI malignancy on histopathology were reviewed for part of the gut involved. Patient demographics including age, sex, and place of residence, clinical presentation, and subsequent histologic diagnosis were recorded. During the study period, 302 cases of upper GI malignancy were seen at our institution, 83 [14.8%] were in patients 40 years of age or younger. Mean patient age was 58 years. The lesion was distal in 43%, proximal in 20% and 7% involved the entire stomach. In 9.8% of the cases, lesser curve was the site. The tumor was located in the upper third, middle third and lower third in 33, 22 and 34.6% respectively. The common presenting symptom in case of carcinoma of stomach was pain epigastrium. Dysphagia was the major subjective complaint in cases of esophageal carcinoma. The common malignant tumor in males was carcinoma of stomach and in females carcinoma of esophagus. Endoscopic screening in subjects suspected of upper gastrointestinal malignancy results in a significant yield of carcinoma. The gastric tumor in distal location [non cardia cancer] is still more common. Asian race is no different from other races as far as the ca stomach is concerned

Intrabiliary rupture of hepatic hydatid cyst: role of ERCP

We report a case of hepatic hydatid cyst presenting with obstructive jaundice following cholecystectomy. ERCP showed intrabiliary cyst rupture with biliary obstruction due to cyst remnants. Endoscopic sphincterotomy was performed and cyst debris removed with complete resolution of symptoms

Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice

To evaluate the role of endoscopic retrograde cholangiopancreatography [ERCP] in patients with obstructive jaundice. Design: A retrospective, observational study. Place and Duration of Study: The study was carried out at Valley Clinic, Rawalpindi, from January 1999 to January 2002. Subjects and Two-hundred and twenty-six patients, who underwent ERCP for evaluation of obstructive jaundice were included. ERCP in each case was performed with standard technique and the findings were recorded. Therapeutic procedures like sphincterotomy, Dormia extraction for stone, and stent placements were performed whenever indicated. Of the 226 patients, 117 [51.8%] were males, and 109 [48.2%] females, their mean age being 51.8 ' 16.6 years. Common bile and pancreatic ducts were visualized in 81.8% and 68.1% patients respectively. Growth/masses and stones were commonest causes of obstructive jaundice. Choledocholithias was common in males, while biliary channel related growth/masses were common in females [p-value = 0.03]. Common bile duct stone clearance rate was 88%, stenting was highly successful in patients with growth and strictures. ERCP related complications were noted in 11 [4.8%] patients. ERCP is an important diagnostic and therapeutic modality for evaluation of patients with obstructive jaundice. Growth/masses and stones are common causes of obstructive jaundice which can be diagnosed and treated with ERCP