Background: Upper gastrointestinal (UGI) symptoms are common in East Africa but there is limited diagnostic endoscopy availability. Surgical camps are a recognised method of providing intensive service provision and training. We describe a novel application of the camp model for diagnostic UGI endoscopy in eastern Uganda. Methods: A 7-day camp took place in an existing endoscopy department of Mbale Regional Referral Hospital. Patients with symptoms warranting investigation were invited for free diagnostic UGI endoscopy, biopsy and H.pylori testing. Results: 148 patients underwent endoscopy. 47 were deemed to have significant pathology, 7 with malignancy. 61% had H.Pylori. A resident surgeon was trained and performed 55 supervised unassisted procedures. Conclusion: Our pilot has illustrated that camps are a safe and efficient way of providing intense endoscopy service and training in an established department. Camps can be utilised for scaling up much needed endoscopy services and training in low- and middle-income countries. Keywords: Gastrointestinal endoscopy; Helicobacter pylori; esophageal neoplasms.

Background: Endoscopy is required for formal diagnosis of many upper gastrointestinal (UGI) conditions including oe- sophageal cancer (OC). There is a paucity of data on endoscopy findings in East Africa as access to testing is challeng- ing for patients. We describe the findings of 10 years of UGI endoscopy in Mbale Regional Referral Hospital (MRRH). Method: Records of patients that underwent UGI endoscopy in MRRH, November 2009 – March 2019 were retrospective- ly analysed. Indication, macroscopic findings, histology and patient demographics were retrieved. Sub-group analyses were performed on those with a histological diagnosis of oesophageal cancer. Results: 833 eligible patients received single UGI procedures during the study period. Mean age was 54.8 years, range 16-93 years and 56.9% of patients were male. The main indication was dysphagia (42%) and the most common findings OC (34%) and gastritis (28%). 151 patients had histologically proven OC with a median age of 60 years and a 2:1 male to female ratio. 145/151 (96%) of samples tested revealed squamous cell carcinoma (SCC). Conclusion: Those undergoing endoscopy in MRRH are most commonly male patients presenting in their 5th decade with dysphagia. There is a high proportion of significant findings including gastritis, peptic ulcer disease, and oesophageal cancer. Keywords: Gastrointestinal; OGD; LMIC; oesophageal cancer.

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Leeches are an unusual cause of epistaxis and haemoptysis that should be considered in places with poor access to water. In this case report, we present a 7-year-old girl previously mismanaged as bacterial pharyngitis but later discovered to be a leech in the pharynx. She had ingested a leech from a spring that caused a foreign body sensation in the throat, frequent throat clearing, epistaxis, haemoptysis, and mild anaemia. The 3cm long leech was successfully removed by using Tilley forceps without any anaesthesia and with complete resolution of symptoms.