ABSTRACT
This study was carried out to investigate the endoscopic and histopathological findings in AIDS patients in Mulago Hospital, in Uganda who present with upper gastrointestinal symptoms. Any observed morphological changes were biopsied. Duodenal contents were aspirated in each case for microscopic examination. Vomiting was reported in 100% of the patients, dysphagia and epigastric pain were reported in 89%. Other symptoms reported in decreasing frequency were odynophagia 46%, retrosternal chest pain 40%, haematemesis 10%, and hiccough 3%. Up to 74% of the patients had morphological changes in the oesophagus, while 28% showed changes in the stomach. Only 15% demonstrated changes in the duodenum. Duodenal aspirate revealed giardia lamblia 22%, Acid fast bacilli 7% and cryptosporidium 5%. Endoscopic findings were mostly observed in the oesophagus. Candida was the main pathogen detected. Also atrophic gastritis is a recognizable finding in these patients.
PIP: 50-90% of people with AIDS experience disease of the upper gastrointestinal tract during the course of their illness, such as opportunistic infections, cytomegalovirus, Herpes simplex virus, and malignant neoplasms. This paper reports the endoscopic and histopathological findings among 100 AIDS patients in Mulago Hospital, Kampala, Uganda, who presented with upper gastrointestinal symptoms. The diagnosis of AIDS was based upon the World Health Organization clinical definition for AIDS. Observed morphological changes were biopsied, while duodenal contents were aspirated in each case for microscopic examination. Vomiting was reported among all patients, dysphagia and epigastric pain in 89%, odynophagia in 46%, retrosternal chest pain in 40%, haematemesis in 10%, and hiccough in 3%. Up to 74% of the patients had morphological changes in the esophagus, while 28% showed changes in the stomach. Only 15% demonstrated changes in the duodenum. Duodenal aspirate revealed giardia lamblia among 22%, acid fast bacilli in 7%, and cryptosporidium in 5%. Endoscopic findings were mostly observed in the esophagus. Candida was the main pathogen detected. Atrophic gastritis was also a recognizable finding among these patients.
