Spectrum of Duodenal & Small Intestinal Diseases in Quetta: A Hospital-Based Study

Abstract

Objective: To determine the spectrum of inflammatory and neoplastic diseases affecting the duodenum and small intestine in patients presenting at a tertiary care hospital in Quetta, Balochistan.

Methodology: This is a retrospective observational study. It was conducted in a tertiary care hospital from April 2021 to January 2025 in Quetta. A total of 152 patients of all ages and both genders who underwent duodenal or small intestinal biopsy were included in the study. Those cases with complete clinical, endoscopic, and histopathological data were analyzed. Histological findings of endoscopic biopsies, incisional biopsies, and excision specimens were assessed. Celiac disease was classified using the Marsh classification. Data was analysed using SPSS version 20. Associations between variables were calculated using Chi-square and Fisher’s exact tests. Statistical significance was set at p<0.05.

Results: The mean age of patients was 31.53 ± 13.81 years, with a male predominance (70.4%). The most common presenting symptoms were anemia (39.5%) and chronic diarrhea (19.1%). Inflammatory and benign conditions accounted for 95.4% of cases, while malignant lesions comprised 4.6%. The most common histopathological finding was chronic non-specific inflammation (61.2%). Celiac disease was reported in 19.7% of cases, predominantly in males, with Marsh stage 1 and stage 3b being the most common subtypes. Giardiasis and Meckel’s diverticulum were each diagnosed in 1.3% of cases. Adenocarcinoma was most common malignant lesion (2%), followed by intestinal lymphomas and gastrointestinal stromal tumors (GISTs).

Conclusion: Inflammatory conditions, especially chronic non-specific inflammation and celiac disease, represent the majority of duodenal and small intestinal pathologies in this area. Although uncommon, malignant lesions remain clinically significant. Histopathological examination of biopsies plays a crucial role in accurate diagnosis and appropriate management.