Pattern of chronic liver disease in the eastern province of Saudi Arabia. A hospital-based clinicopathological study.

During the period 1982-1990, 544 patients with clinical evidence of liver disease were admitted to King Fahd University Hospital, Al-Khobar, Saudi Arabia. Besides routine laboratory and sonographic investigations, all were subjected to either a needle liver biopsy, laparoscopy or a laparotomy. The tissue diagnoses were as follows: liver cirrhosis 17.3%, periportal fibrosis 14.3%, metastatic cancer 12.9%, primary hepatoma (hepatocellular carcinoma: HCC) 12.1%, hepatic granuloma 11.2%, chronic active hepatitis 7.7%, chronic persistent hepatitis 2.2%, fatty liver 7.2%, hydatid liver disease 4.6% and others 2.8%. In 7.7% the histology was normal. These results will be discussed and compared with results reported in local and international literature.

Pituitary resistance to L-thyroxine after thyroidectomy. A case report.

The clinical and laboratory findings in a 29-year-old Saudi Arabian woman were compatible with a state of resistance to thyroid hormones by the pituitary gland. Symptoms of hypothyroidism, amenorrhoea and secondary infertility developed 10 years after partial thyroidectomy for an euthyroid goitre. Before therapy, serum thyroxine (T4) and thyroid-stimulating hormone (TSH) values were elevated; serum tri-iodothyronine (T3) value was at the upper limit of normal while %T3 resin uptake and serum free T4 level were both normal. Treatment with L-thyroxine 150 micrograms/dl was not effective. After this was increased to 200 micrograms/d, serum T4 value rose, TSH was still elevated and there was improvement in symptomatology, and a return of both menses and fertility.

Digestive system malignancies in the eastern province of Saudi Arabia: an analysis of 158 patients.

Retrospective evaluation of 158 patients with digestive system neoplasms was carried out. The disease pattern was compared to that noted in other parts of Arabia, other Middle East countries, Africa, and the West. An attempt was made to analyze potential aetiological factors in the Saudi population. At all cancer sites of the digestive system the male to female ratio was 3:1. Generally more younger patients with advanced cancer were encountered than reported in series from the Western hemisphere. The poor results of therapy were generally attributed to the advanced stage at presentation. The high frequency of GIT cancer and in particular the apparently rising incidence rate of colorectal cancer was attributed to dietary habits and the changing lifestyle of the population. Hepatitis B viral infection was the likely cause of primary hepatocellular cancer (PHC) although dietary factors could not be ruled out. Schistosomiasis was found not to play a role in the causation of either PHC or colorectal cancer.

The pattern of colonic diseases in the Eastern Province of Saudi Arabia.

The purpose of this paper is to highlight the incidence and scope of lower gastrointestinal tract (GIT) diseases in the Eastern Province of the Kingdom of Saudi Arabia. Between August 1981 and April 1984, 288 patients with significant complaints and physical signs attributable to the lower GIT were prospectively evaluated. A complete patient history was taken in each case followed by physical examination, routine laboratory studies and a sigmoidoscopic examination. In 128 patients (44.5%), sigmoidoscopy and rectal and/or colonic biopsies did not reveal any pathological abnormalities. These patients were considered to have various disorders such as irritable bowel syndrome or parasitic infestation. Eighty-one patients (28%) were found to have mild to moderate non-specific colitis or proctitis. In another 49 patients (17%) the diagnosis of schistosomiasis mansoni was made. Ulcerative colitis and colorectal carcinoma were detected in only 11 (4%) and 4 (1.5%) patients respectively. In the remaining 15 patients (5%), other lower GIT diseases were found. Comparative analysis of the disease pattern in our series has demonstrated some differences from other series from within the Kingdom and also from other countries.