Saudi Journal of Gastroenterology
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   2003| January-April  | Volume 9 | Issue 1  
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Perspective on the Saudi council for health specialities
Hussein Al-Freihi
January-April 2003, 9(1):1-5
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Splenic epithelial (epidermoid) cyst
Hedayat Riazi, Mohammed Reza Kohsari, Saba Hoda
January-April 2003, 9(1):20-22
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Diagnosis of regional enrteritis (Crohn disease)
Mohamed Zakaria Khalil
January-April 2003, 9(1):6-10
Regional enteritis (Crohn disease) may present a diagnostic problem that needs to be solved by clinicians practicing in areas known to be endemic for tuberculosis. The similarity in clinical presentation between the two disorders makes it difficult to reach a diagnosis. Furthermore, the use of steroids in treating patients with Crohn disease may be harmful if the underlying diagnosis is Tuberculosis. This article is aimed to help physicians to distinguish Crohn disease from intestinal Tuberculosis. The treating physician would be able to use and interpret different diagnostic modalities tailored to the history and physical examination. The use of ASCA, a new serological marker, in the diagnosis of Crohn disease may facilitate the management of such patients
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Budd chiari syndrome: Experience at King Faisal specialist hospital and research centre, Riyadh, Saudi Arabia
Shadia Hamad Al Himali, Abdullah Mohammed Al Osaimi, Saleim Tawfiq Dahab, Mohammed Sultan Khuroo, Hamad Ibrahim Al Ashgar
January-April 2003, 9(1):11-14
Background: Budd-chiari syndrome (BCS) is rare disorder, varied in etiology, inconsistent in presentation, unpredictable in progression, and challenging in therapy. Aim of study: The aim of this study is to review experience of Budd-Chiari syndrome at KFSH, Riyadh; over a ten-year period. Methods: In a retrospective study using a computer data search of the medical records from May 1990 to May 2000, 43 patients' charts suspected of BCS were reviewed. 29 patients were found to have BCS, diagnosed by Doppler ultrasound, venography, MRI, or CT with or without liver biopsy. Findings: Of the 29 patients, 18 were male (62.1%) and I 1 were female (37.9%); mean age was 35.4 (range 17-69 years). Nine patients had Behcet's disease; seven patients had malignancy (five HCC, one melanoma and one hypernephroma). Eight patients had antiphospholipid syndrome, two patients had no known cause and three (one related to trauma, the other related to protein C deficiency and the third related nephrotic syndrome). Nineteen patients presented acutely with abdominal pain, progressive ascites and hepatomegaly. Ten patients had subacute presentation mimicking cirrhosis of liver. Five patients had web in the intrahepatic IVC or ostium HV and the remaining 24 patients had thrombosis of hepatic veins. Five patients received surgical shunts, three had balloon dilatation of webs, 11 had anticoagulant therapy and seven patients had symptomatic treatment. Eleven patients died, six of them had malignancy, two died while awaiting liver transplantation and three died with fulminant hepatic failure. Fourteen patients are still on follow-up. Conclusion: Budd Chiari syndrome in Saudi Arabia is related to a defined cause in majority of patients (92%). Behcet's disease is a dominant cause of BCS in Saudi Arabia. This is in contrast to world literature where around 50% of patients are of unknown etiology
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Gammaglutamyl transpeptidase activity in patients with schistosomiasis
Mohammad Abdullah Al Mofarreh, Ahmed Yahia Al Akwaa, Ibrahim Abdulkarim Al Mofleh
January-April 2003, 9(1):15-19
Background: Schistosoma mansoni infestation may induce liver fibrosis and portal hypertension, with possible elevation of liver enzymes. Aim of the study: The aim of this study was to evaluate the serum gammaglutamyl transpeptidase (GGT) activity in a group of non-alcoholic and non-obese patients with hepatointestinal schistosomiasis. Patients and methods: Medical records of 174 patients diagnosed to have hepatointestinal schistosomiasis on the basis of clinical and laboratory data were reviewed. Body mass index (BMI) was calculated for all patients. Direct stool smear and formol-ether concentration (FEC) methods and hematological and biochemical blood tests were performed. Other studies including abdominal ultrasonography, upper and lower gastrointestinal endoscopy was also performed when feasible. All (174) patients were adults with male to female ratio of 3.8:1. BMI was similar in both groups. Patients were divided into two groups: group 1 (57) with elevated GGT and group 2 (117) patients with normal GGT. Both groups had positive indirect hemagglutination test (IHA) for schistosomiasis. Other causes of liver disease were excluded. Results: Group 1 had significant elevation of alanine aminotransferase (ALT), alkaline phosphatase (ALP) and reduction in platelets (p <0.001), low albumin and high globulin levels (p <0.01) compared to group 2. Abnormal ultrasonographic findings were more frequently encountered in group 1 (p <0.001). Conclusion: The above data indicated that GGT elevation was most likely secondary to hepatobiliary involvement by Schistosoma mansoni and may indicate chronicity. Therefore schistosomiasis has to be considered in our community whenever GGT is elevated in non­alcoholic population
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Hepatoid gastric adenocarcinoma
Mohamed Ismail Yasawy, Dalal Moh'd Tamimi, Abdulaziz Al-Quorain, Lade Wosornu, Abdulmohsen Al-Mulhim, Hazim Zakaria
January-April 2003, 9(1):23-25
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