Wide lumen metal stent in benign biliary stricture

In the last 10 years 44 patients with malignant stricture and 37 patients with benign stricture were diagnosed and managed in our unit. For both types of strictures we applied either a surgical, endoscopic or combined approach for managing these patients. In two patients with benign biliary stricture we performed endoscopic dilatations and/or single or double stenting repeatedly and despite performing the procedure [five times in one and 11 times in the other] and with the use of 7 or 10 French plastic stents, the outcome was disappointing and strictures were refractory to dilatation and long-term stenting. In these two cases we inserted large lumen metal stents with excellent outcome and no recurrence of cholangitis or any cholestasis. To our knowledge this was the first report on the use of metal stents in benign biliary strictures in Saudi Arabia

Causes of upper gastrointestinal bleeding: Experience at a major hospital in Riyadh

Over a period of 14 years, 1246 patients had emergency gastroscopy because of upper gastrointestinal tract [UGIT] bleeding. The endoscopic findings in these patients showed duodenal ulcer disease [DUD] in 364 [29.2%] was the most common followed by esophageal varices in 302 [24.2%], erosive gastritis in 198 [15.9%], gastroesophageal reflux disease [GERD] in 156 [12.5%], gastric ulcer in 69 [5.5%], and normal [negative] endoscopy in 132 [10.6%]. Only 65 [21.5%] patients with varices had active bleeding from the esophageal varices, 10 [3.3%] from the gastric varices and in 34 other patients with varices [11.3%], the bleeding was mainly from associated gastropathy. Eighty-six patients [23.6%] with DUD had active bleeding at endoscopy; 66 [80.5%] of these had ulcers showing stigmata of recent hemorrhage. Of those who had active bleeding, the source of the bleeding could not be identified in only five