Objective: To compare the findings of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatographyin patients presenting with bile duct disorders. Methodology: The retrospective secondary-data study was conducted at the Gastroenterology Department of Lady Reading Hospital, Peshawar, Pakistan,and comprised data of patients who presented with bile duct disordersfrom June2019 to May2020. Data was analysed using SPSS 25. Results: Of the 92 patients, 41(44.6%) were males and 51(55.4%) were females. The overall mean age was 50.12 years with a standard deviation of 16.70 years (ranged: 13-80 years). Out of 28 bile duct calculi cases detected by endoscopic retrograde cholangiopancreatography, 25(89.3%) were detected by magnetic resonance cholangiopancreatography, and, of the 64 without calculi, it detected 50(78.1%). Out of 8 bile duct strictures detected by endoscopic retrograde cholangiopancreatography, 3(37.5%) were correctly diagnosed by magnetic resonance cholangiopancreatography, and, of the 84 unaffected patients, it excluded 79(94%). Out of 64 bile duct dilatation cases, magnetic resonance cholangiopancreatography correctly diagnosed 59(92.2%), and, of the 28 unaffected patients, it excluded 27(96.4%). Conclusion: For bile duct stone and dilation, magnetic resonance cholangiopancreatography was found to have high diagnostic accuracy. Key Words: Choledocholithiasis, Cholangiopancreatography, MRCP, ERCP. Continuous...

Aim: To establish the frequency of gastric varices in patients presenting with upper GI bleed. Study design: Descriptive cross sectional study. Place and duration of study: Department of Gastroenterology, Hayatabad Medical Complex, Peshawar from 11th May 2018 to 11th November 2018. Methodology: Ninety three patients with upper GI bleed were enrolled. After brief history and clinical evaluation, prompt resuscitation was done. Patient underwent a careful upper GI endoscopic evaluation after initial resuscitation. All endoscopic procedures were carried out by a single gastroenterologist of at least assistant professor level to detect gastric varices. All the information’s collected were recorded Results: The mean age was 37±12.2 years. Fifty four percent patients were male while 46% patients were female. Twenty two percent patients had gastric varices while 78% patients didn’t had gastric varices. Conclusion: The frequency of gastric varices was 22% in patients presenting with upper gastrointestinal bleed. Key words: Gastric varices, Upper, Gastrointestinal bleed

Introduction: Fatty liver (FL) is often recognized in patients with acute pancreatitis (AP) and is frequently found in clinical practice because of substantial variables that put one at risk of complications. Aim: To evaluate the severity of acute pancreatitis in patients with and without fatty liver using CT severity index. Methodology: In this prospective study was carried out from June 2020 till December 2022. Liver and spleen mean attenuation values were examined using plain CT scans abdomen of patients with AP. Fatty liver was defined as a mean Hounsfield Unit (HU) liver/spleen) ratio < 1. Contrast-enhanced computed tomography (CECT) scan and CT Severity Index (CTSI) to grade the severity of AP. Analyzed information in SPSS. Degree of significance was determined using the chi-square test. Results: This study comprised of 100 Patients with AP (88 (88.0%) males and 32 (32.0%) female, mean age 34.68 12.762 years), 46 (46.0%) had FL and 54 (54.0%), without FL. Patients with FL experienced much worse pancreatitis than patients without FL. Acute edematous pancreatitis (39.4% vs. 60.6%) and acute necrotic collections (58.8% vs. 41.2%) were observed in patients with FL and without FL respectively. Conclusion: The severity of acute pancreatitis is significantly influe

Objective: According to recent guidelines Histoacryl® (N-butyl-2 -Cyanoacrylate) injection is the first line therapy for the endoscopic obliteration of gastric varices. Lipiodol is commonly used to facilitate injection Histoacryl® but it is expensive. In this study we compare Lipiodol with Vitamin D3 injection as priming agents for Histoacryl injection in terms of efficacy and safety in the management of isolated fundal varices. Methods: This is a retrospective comparative study conducted at Gastroenterology Unit, Lady Reading hospital Peshawar. Patients’ information was collected from March, 2012 to January, 2020 from medical records and statistically analyzed in terms of fundal varices obliteration, re-bleeding, mortality, and adverse events related to treatment. Results: From March, 2012 to January, 2020, 171 patients met the criteria. 7 cases lost follow up, and all the cases in both groups were treated successfully. There were no adverse events related to procedure in either group. Twenty six patients developed upper GI re-bleeding, which did not differ significantly betweenthe twogroups. There was also no difference between the groups in terms of treatment failure, complications, varices obliteration, and mortality. Conclusion: Vitamin D3 is as safe and effective as Lipoidol when used as priming agent for Histoacryl injection for obliteration of isolated fundal varices and can be used as a cheaper alternative to Lipoidol.

Objective: To establish the diagnostic accuracy of BISAP in detecting the severe acute pancreatitis keeping computed tomography severity index as gold standard. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Hayatabad Medical Complex, Peshawar from April 16th 2018 to 16th October 2018. Methodology: One hundred and twenty nine patients of age range of 18-60, of either gender having severe acute pancreatitis were included. While patients already diagnosed as severe acute pancreatitis and having known history of chronic pancreatitis were excluded. Patients were subjected to CT scan to confirm whether the severe acute pancreatitis is present or not. All CT scans were reported by single experiences radiologist. Results: There were 30.3% were males and 69.7% were females with mean age 42±11.03 years. BISAP had sensitivity 92.74%, specificity 80%, positive predictive value 99.13%, negative predictive value 20.76% and the overall diagnostic accuracy was 92.24%. Conclusion: BISAP had sensitivity 93.61%, specificity 100%, positive predictive value 100%, negative predictive value 40% and the overall diagnostic accuracy was 93.87% in severe acute pancreatitis keeping CT severity index as gold standard. Keywords: Accuracy, Severe acute pancreatitis, Computed tomography