BACKGROUND AND OBJECTIVESThe 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.DESIGN AND SETTINGRetrospective study conducted in a tertiary care hospital in Riyadh from January 1970 to December 2008.PATIENTS AND METHODSWe reviewed all the cases of IBD diagnosed and collected all data pertaining to patients with IBD.RESULTSA 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.CONCLUSIONSThe 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.

PTC rarely metastasizes to the pancreas. In this patient, an FDG PET scan and EUS-guided biopsy played important roles in the diagnosis. PTC metastases to the pancreas usually occur in otherwise advanced disease. In the patient presented here, sorafenib may have slowed disease progression but the overall utility of tyrosine kinase inhibitors in pancreatic metastases from PTC is not clear.

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