Yousef M Ajlouni.
Esophageal carcinoma in Jordanian field hospital in Afghanistan.
Pak J Med Sci Jan ;23(1):82-5.

Objectives: Mazzar-I-Shariff in Afghanistan, is a poor wartorn city with only one gastrointestinal endoscopist in the region. It was noticed by previous gastroenterologists working in Jordanian Field Hospital in Afghanistan that oesophageal carcinoma is seen more frequant than that in Jordan. The objectives of the study were to determine the spectrum of upper gastrointestinal diseases in patients who undergone upper endoscopy in the Jordanian Field Hospital in Afghanistan and to estimat the incidence,age of diagnosis, clinical presentations and the endoscopic appearanace of the oesophageal carcinoma. Methods: Between 20 Decumber 2003 and March 3, 2004, 289 gastroscopies were performed in Jordanian field Hospital/Afghanistan on patients aged 16 years or more. Biopsies were taken from any suspected lesion. Data for each patient were kept to correlate with the histopathological results. Results: Thirty three (11.4%) endoscopies gave normal results. The most common major single findings in the other 256 were oseophageal carcinoma (22.5%) duodenal ulcers (13.5%), and oesophagitis (13%). About one third of the patients had more than one endoscopic finding. Oseophageal carcinoma was found in 22.5% of patients and it was more common in men than women. The most common presenting symptom for oseophageal carcinoma were dysphagia and weight loss. It was more frequent in age group of 60-72 years. The most common endoscopic findings were mass or ulcerative lesion. Conclusion: Oesophageal carcinoma is a common finding in patients who had upper endoscopy in the Jordanian Field Hospital in the north of Afghanistan. Mazzar-I-Sharif needs well equiped gastrointestinal unit and a multi disciplinary team (Gastroenterologist, Histopathologist, Surgeon and Dietitian) to deal with patients with oesophageal carcinoma and more research is needed to establish the possible etiology.

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