Histopathological pattern of endoscopic gastric biopsies in dyspeptic patients in a Nigerian population

Background and Objective: Dyspepsia is one of the most common complaints encountered in the general outpatient and gastroenterology clinics in Nigeria. Histopathological assessment of endoscopic gastric mucosa biopsy is crucial to delineate the exact cause of dyspepsia to guide patients' management. This study aimed to determine and document the histopathological basis of dyspepsia among dyspeptic patients at our facility. Material sand Methods: This was a three year descriptive retrospective study and the materials consisted of all gastric endoscopic biopsies taken from clinically diagnosed dyspeptic patients sent to the Department of Histopathology of the Federal Medical Centre, Owerri, Nigeria. Results: The biopsies were from 64 (53.2%) male patients and 56 (46.8%) female patients, giving a male to female ratio of 1.14:1. The age range of the patients was 28-82 years with a mean of 56 years at presentation. Helicobacter Pylori (H. Pylori) bacilli were identified in the samples of 42 (35%) patients but absent in samples of 78 (65%) patients. The histopathological pattern of the aetiological basis of dyspepsia in this study consisted of gastritis (96, 80%), functional (17, 14.2%), adenocarcinoma (4, 3.3%) and polyps (3, 2.5%). H. Pylori bacilli were seen only in patients with gastritis (42/96, 43.8%), and it affected 19 (45.2%) male patients and 23 (54.8%) female patients. Chronic active H. Pylori associated gastritis (24, 25%) was the most common form of gastritis seen during the study period. Conclusion: The main organic cause of dyspepsia in our setting was chronic gastric followed in the distant by gastric adenocarcinoma and polyp. Dyspepsia and H. Pylori associated gastritis did not show a significant gender predilection

Gastroenterology practice in the COVID-19 era: Ghana Association for the Study of Liver and Digestive Diseases (GASLIDD) position statement

The COVID-19 pandemic has impacted healthcare negatively across the globe. The practice of gastroenterology has been affected especially gastrointestinal (GI) endoscopy which is considered high risk for transmission of the virus. As a community of practitioners there is the need to share information and make evidence-based statements to guide GI practice in Ghana. This GASLIDD position statement based on the growing and rapidly evolving body of knowledge is to provide up to date information on the COVID-19 disease and guidance for the practice of gastroenterology in Ghana and beyond. It is to help the GI community of practice to maintain the highest level of health delivery and safety for our patients, staff, community and GI practitioners

Prise en charge des urgences en gastro-enterologie : experience du service d'hepato-gastro enterologie du CHU-campus de Lome

But : Recenser les urgences rencontrees; leur diagnostics etiologiques et evaluer l'efficacite des approches therapeutiques. Methodologie : c'est une etude retrospective sur 1 an; de janvier a decembre 2004; sur les dossiers de malades admis pour urgences dans le service. Resultats : 65 dossiers de malades (49 hommes et 16 femmes) ages de 20 a 79 ans ont ete retenus. Le type de l'urgence rencontre a ete : hemorragie digestive (44 cas) dont 25 cas d'hemorragie digestive haute (HDH) et 19 cas de rectorragie ; douleur abdominale avec vomissement : 19 cas dont 4 malades avec arret des matieres et des gaz ; l'ingestion accidentelle de caustique : 2 cas. A l'admission un tableau de choc a ete retrouve chez 15 malades (5 en coma stade I ) qui ont d'emblee ete reanimes.11 malades ont ete transferes en chirurgie. Les etiologies des HDH ont ete dominees par les ulceres :16 cas (64) et les ruptures de varices oesophagiennes (RVO) : 7cas(28) ; celles des rectorragies par la rectocolite hemorragique ( RCH) : 8 cas (42;10) . Les etiologies des douleurs abdominales etaient tres diverses dominees par les occlusions; les gastrites; les ulceres gastro-duodenaux; les cancers du pancreas avec 4 cas (22;22) chacun. L'evolution clinique a ete marquee par 7 deces dont 6 par RVO . Conclusion : les urgences en gastro-enterologie sont frequentes dans le service d'HGE du CHUCampus de Lome (65 cas en 1 an). Elles sont dominees par les hemorragies digestives .Leur etiologie est souvent retrouve (98;45) par nos moyens d'exploration limites mais elles posent surtout un probleme de prise en charge therapeutique notamment les RVO dont la mortalite est tres elevee (85;71) en raison du manque de ressources therapeutiques endoscopiques (ligature; sclerotherapie) et medicamenteuses (molecules reduisant le debit splanchnique)

Upper gastrointestinal endoscopy at the Korle Bu Teaching Hospital, Accra, Ghana

Objectives: To study the indications for endo-scopy, the endoscopic diagnosis and other lessons learnt.. Methods: A retrospective and prospective audit of all upper gastrointestinal endoscopies performed in the Endoscopy Unit of the Korle-Bu Teaching Hospital from January 1995 to December 2002 was performed. Results: A total of 6977 patients, 3777 males and 3200 females with age range 1 year 8 months to 93 years were endoscoped. The mean age of males was 43.5 + 0.5 and females 43.7 + 0.6 years. Epi-gastric pain (42.5%), dyspepsia (32.8%) and haematemesis and melaena (14.2%) were the commonest reasons for endoscopy. Chronic duo-denal ulcer (19.6%), acute gastritis (12.7%), duo-denitis (10.2%), oesophagitis (7.5%) were the commonest diagnoses. Normal endoscopy was reported in 41.1% patients, and was higher in the younger age group compared to the older (R = 0.973, P<0.001). Nine hundred and ninety (14.2%) patients were endoscoped for haematemesis and melaena of which chronic duodenal ulcer (32.1%), gastritis/gastric erosions (12.8%), oesophageal varices (9.8%), carcinoma of the stomach (6.4%), and duodenitis (4.2%), were the commonest causes. No lesion was found in 20.6% of these patients. Urease test was positive in 75% of all biopsy specimen and 85% in chronic duodenal ulcer, gastritis and duodenitis. Conclusion: The normal endoscopy rate is high and needs to be reduced in order to help prolong the lives of the endoscopes. Chronic duodenal ul-cer is usually associated with H. pylori infection and is the commonest cause of upper gastrointesti-nal bleeding