Endoscopic and Clinicopathological Patterns of Upper Gastrointestinal Conditions Among Patients Undergoing Endoscopic Examination at Bungando Medical Centre, Mwanza, Tanzania.
- Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2020
- xi; 65 Pages Includes References and Appendices
Abstract:
Background:Upper Gastrointestinal endoscopy is a safe procedure, and widely available technique for investigation of upper GI conditions. The demand for the investigation continues resulting in an increase number of endoscopic procedures. this observation little information is available in BMC regarding the profile of patients attending for endoscopic examination. The study aim at to determine the endoscopic and clinicopathological patterns of upper GI tract conditions and establish agreement between biopsied endoscopic findings and histopathological findings of upper GI tract conditions among patients attending BMC.
Methodology: This was a cross-sectional study involving patients with upper gastrointestinal tract conditions receiving endoscopic examination with or without biopsy at BMC between January and May 2020. Recruitment of patient based on serial technique and endoscopic examination done under short sedation. Biopsy were taken on the same sit in eligible patient and preserved in 10% formalin for further histology evaluation.
Results: Total of 150 participants were included in the study,139 (92.7%) were attended from outpatient clinics and 11 (7.3%) from inpatients. The median age was 50[IQR 34-65] years. Dyspepsia was the leading clinical presentation 87 (58.0%). In the study population, 141 (94.0%) had abnormal endoscopic findings. Gastritis was the leading finding in both endoscopic and histopathological finding with 41(29.1%) and 36(32.1%). Among patients with abnormal histopathological findings, 23 were esophageal malignancies, 10 gastric malignancies, and 1 duodenal malignancy. The Kappa value 0.778 considered a substantial agreement between endoscopic findings and histopathological findings where K value interpreted as <0.4 as fair, 0.4 to 0.6 as moderate, 0.6 to 0.8 substantial and >0.8 near perfect.
Conclusion: Dyspepsia was the commonest clinical presentation among the study participants while gastritis was the leading finding on both endoscopic and histopathological results, followed by esophageal and gastric malignancy. There is substantial agreement between endoscopic and histopathological findings, therefore endoscopy is incomplete without biopsy and histopathology as the gold standard for the diagnosis of upper gastrointestinal conditions.
= OPERATIONAL DEFINITIONS Clinicopathological pattern In this study was defined as clinical presentation and histopathological findings of upper GI conditions Endoscopic pattern For the purpose of this study meant endoscopic findings of upper GI endoscopy Upper GI conditions Gastritis Abnormal endoscopic findings Biopsed endoscopic findings Substantial agreement In the study defines all conditions found from esophagus, stomach and duodenum. In the study was defined as all endoscopic findings reported as diffuse erythema,linear erythema,patchy erythema,atrophic erythema or hyperemic mucosa. For the purpose of the study was defined as all mucosal lesions found during endoscopic examination.eg gastritis, duodenal ulcer,gastric ulcer. In the present study was defined as abnormal endoscopic finding of which histology sample were taken. In the study means the chance of the results obtained from the endoscopy is accurate in high percentage (77.8%) with the similar finding in histopathology evaluation ,both granted each other in a reliability of the test. OPERATIONAL DEFINITIONS Endoscopic pattern For the purpose of this study meant endoscopic findings of upper GI endoscopy OPERATIONAL DEFINITIONS Clinicopathological pattern In this study was defined as clinical presentation and histopathological findings of upper GI conditions
= ABBREVIATIONS ett Esophagus BMC Bugando Medical Center CREC CUHAS BMC Research and Ethics Committee CUHAS Catholic University of Health and Allied Science ESGE European Society of Gastrointestinal Endoscopy GERD Gastro Esophageal Reflux Disease GI Gastro Intestinal GIST Gastro Intestinal Stromal Tumor GIT Gastro Intestinal Tract HIV Human Immunodeficiency Virus H.Pylori Helicobacter Pylori IQR Inter Quartile Range NSAIDs Non-Steroidal Ant inflammatory Drugs PI Principal Investigator RA Research Assistant WHO World Health Organization
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : Website: www.bugando.ac.tz