ABSTRACT
The epidemiology, clinical characteristics, and natural course of inflammatory bowel disease [IBD] in Saudi Arabia are still largely unknown. Hence, we decided to conduct a large retrospective, cohort study to determine these features of the disease. Retrospective study conducted in a tertiary care hospital in Riyadh from January 1970 to December 2008. We reviewed all the cases of IBD diagnosed and collected all data pertaining to patients with IBD. A total of 312 patients with IBD were included for this analysis, including 197 [63%] patients with Crohn disease [CD] and 115 [37%] patients with ulcerative colitis [UC]. The mean age [standard deviation] of patients with IBD was 25.5 [10.6] years; 152 [48.7%] were males and 160 females. The referral rate in the past 10 years was 72.1% compared with preceding 20 years, and 56% [n=178] of patients with IBD were from the central region of Saudi Arabia. The patients were followed up for a mean duration of 9.5 years; during their follow-up, 206 patients [66%] required hospital admission and 9 patients [2.9%] with UC developed colon cancer. A total of 6 patients died during the follow-up. Fifty-three percent [n=104] of the patients with CD underwent surgeries as part of their treatment, whereas only 20% [n=23] of the patients with UC underwent colectomy. The incidence of IBD has been gradually increasing in Saudi Arabia over the years. Clinical features and morbidity in patients are not different from patients with IBD seen in the West
Subject(s)
Humans , Male , Female , Retrospective Studies , Crohn Disease , Colitis, UlcerativeABSTRACT
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 at ten-year period. 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 11 were female [37.9%]; mean age was 35.4 [range 17-69 years]. Nine patients had Behect's disease seven patients had malignancy [five HCC, one melanoma and one hypernephroma]. Eight patients had antiphospholipid syndrome, two patients 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. Budd Chiari syndrome in a 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