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 to a tertiary care hospital in Quetta.

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

Results: The mean age of patients was 31.53 ± 13.81 years, with a male predominance (70.4%). Anemia (39.5%) and chronic diarrhea (19.1%) were the most common presenting symptoms. Inflammatory and benign conditions accounted for 95.4% of cases, while malignant lesions comprised 4.6%. Chronic non-specific inflammation was the most frequent histopathological finding (61.2%). Celiac disease was diagnosed 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 identified in 1.3% of cases. Among malignant lesions, adenocarcinoma was the most common (2%), followed by intestinal lymphomas and gastrointestinal stromal tumors.

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