BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patie...BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the oesophagus.AIM To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive stricture.METHODS This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children's Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and dysplasia.RESULTS The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance(potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessionswas 37.2 ± 14.9. Histopathological examination of the specimens showed that 85%of patients had evidence of chronic oesophagitis(group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia(group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients(2%)had mild squamous dysplasia(group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's iodine.CONCLUSION The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepithelial inflammatory cellular infiltration and dysplasia. Dysplasia is one of the complications of postcorrosive oesophageal stricture.展开更多
BACKGROUND Studies in Africa,Asia,and Latin America are needed to provide a comprehensive picture of the global incidence of celiac disease(CD).AIM To describe the serology,endoscopic and histological findings in typi...BACKGROUND Studies in Africa,Asia,and Latin America are needed to provide a comprehensive picture of the global incidence of celiac disease(CD).AIM To describe the serology,endoscopic and histological findings in typical and atypical presentations of pediatric CD at a tertiary referral hospital in an African low/middle income country(LMIC).METHODS This observational study was conducted on 199 patients with CD from 2010 to 2019.The patients were divided into typical and atypical groups according to the presenting symptoms including 120 and 79 patients respectively.Serology,upper gastrointestinal endoscopy with duodenal biopsy were performed for patients who had symptoms suggestive of CD.The severity of the intestinal damage was graded according to the histo-pathologic Marsh-Oberhuber classification.RESULTS Chronic diarrhea was the main intestinal presentation in the typical group.Anemia was the most common extraintestinal symptom in both the typical and atypical group.Marsh-Oberhuber type 3b and 3c was significantly higher in the seropositive patients with a P value of 0.007.A significant correlation was observed between the histological grade of the biopsied duodenal mucosa and the clinical presentation(P<0.001).Age was significantly higher in the atypical group(P value<0.001).CONCLUSION Although typical CD was observed in 120 patients in this study,the clinical variability of the condition was frequently observed.Age only was a significant predictor for the appearance of atypical CD.Therefore,CD presentations in LMIC are not different from industrialized countries.展开更多
文摘BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the oesophagus.AIM To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive stricture.METHODS This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children's Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and dysplasia.RESULTS The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance(potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessionswas 37.2 ± 14.9. Histopathological examination of the specimens showed that 85%of patients had evidence of chronic oesophagitis(group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia(group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients(2%)had mild squamous dysplasia(group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's iodine.CONCLUSION The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepithelial inflammatory cellular infiltration and dysplasia. Dysplasia is one of the complications of postcorrosive oesophageal stricture.
文摘BACKGROUND Studies in Africa,Asia,and Latin America are needed to provide a comprehensive picture of the global incidence of celiac disease(CD).AIM To describe the serology,endoscopic and histological findings in typical and atypical presentations of pediatric CD at a tertiary referral hospital in an African low/middle income country(LMIC).METHODS This observational study was conducted on 199 patients with CD from 2010 to 2019.The patients were divided into typical and atypical groups according to the presenting symptoms including 120 and 79 patients respectively.Serology,upper gastrointestinal endoscopy with duodenal biopsy were performed for patients who had symptoms suggestive of CD.The severity of the intestinal damage was graded according to the histo-pathologic Marsh-Oberhuber classification.RESULTS Chronic diarrhea was the main intestinal presentation in the typical group.Anemia was the most common extraintestinal symptom in both the typical and atypical group.Marsh-Oberhuber type 3b and 3c was significantly higher in the seropositive patients with a P value of 0.007.A significant correlation was observed between the histological grade of the biopsied duodenal mucosa and the clinical presentation(P<0.001).Age was significantly higher in the atypical group(P value<0.001).CONCLUSION Although typical CD was observed in 120 patients in this study,the clinical variability of the condition was frequently observed.Age only was a significant predictor for the appearance of atypical CD.Therefore,CD presentations in LMIC are not different from industrialized countries.
