Evaluation of the endoscopic findings in patients with dyspepsia

Introduction: Dyspepsia involves at least one of the cases of belly dysfunction after meals, early onset satiety when a person eats a normal meal, and epigastric pain or burning sensation. The aim of this study was to investigate endoscopic and pathological findings in patients referred to Imam Khomeini Hospital in Urmia, Iran. Methods: One hundred patients who complained of two different types of dyspepsia enrolled and findings were recorded during the endoscopy. Also specimens were taken from all patients during endoscopy and sent to the lab for pathological examination. Pathologic findings of all patients were recorded from Helicobacter pylori (H. pylori) colonies. Results: 60 patients were women (60%) and 40 were men (40%). 67% of patients had pain type dyspepsia and 33% of them had postprandial distress type. There was no significant relationship between gender and type of dyspepsia. Endoscopy findings consisted of 54% antral gastritis, 20% peptic ulcer, 43% esophagitis (mostly includes grade A), 5% hiatal hernia, 5% gastric metaplasia, 15% prepyloric ulcer, 18% duodenal ulcer, 38% positive for H. pylori, and 1% Barrett's esophagus disease which had no significant relationship with dyspepsia. Pathologic study findings showed 38% of patients had H. pylori infection with a significant higher incidence in patients with pain type dyspepsia. Conclusion: According to this study, the incidence of any endoscopic findings in patients with two different types of dyspepsia was not significantly different, but the rate of H. pylori infection in patients with pain type dyspepsia was much more than the postprandial type.

Insulinoma-Induced Hypoglycemia in a Patient with Insulinoma after Gastrojejunostomy for Prepyloric Ulcer

Hyperinsulinism due to dumping syndrome following gastric surgery is an uncommon condition. It is specified with hypoglycemic attacks. However, linking symptoms to dumping syndrome in each patient to whom gastric surgery was performed leads to inappropriate diagnosis and therapy. Insulinoma and other causes that give rise to hyperinsulinemia should not be ignored and these diagnoses should be excluded. In this paper, 71-year-old male patient who was followed up for 2 years with a false conclusion of dumping syndrome and operated on due to insulinoma diagnosed at endoscopic ultrasonography is presented in the light of the literature.

Giant Prepyloric Ulcer Haemorrhage: Patient Characteristics, Treatment, and Outcome in 2003–2012

The aim of the study was to characterize patients with giant prepyloric ulcer haemorrhage, their treatment, and outcome. The data for 929 peptic ulcer haemorrhage (PUH) patients were divided into three groups according to ulcer location: group I: 165 prepyloric ulcer patients, group II: 353 gastric ulcer patients, and group III: 411 duodenal ulcer patients. Among these groups giant ulcer (ulcer diameter ≥ 2 cm) haemorrhage cases were selected for the study and the data for group I were compared with the data for groups II and III. The study shows that the proportion of giant ulcers in all prepyloric ulcers was significantly 2.2 times lower compared with the proportion of giant ulcers in all gastric ulcers and 1.5 times lower than the proportion of giant ulcers in all duodenal ulcers. The share of surgical therapy for haemorrhages from giant prepyloric ulcers did not differ from the share of surgical therapy in the case of giant gastric ulcers but was 3.5 times lower than in the case of giant duodenal ulcers. Generally, treatment for PUH from giant prepyloric ulcers was successful not involving inhospital mortality.