NIGERIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY

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Materials for this review were obtained mainly through online search of relevant websites, survey of gastroenterologists in Nigeria, and personal communication with some leaders in various locations. Endoscopy became a reality because of the desire of medical practitioners over the centuries to look inside hollow organs to make accurate diagnosis and to treat such illnesses. From rudimental equipment in antiquity, endoscopy developed rapidly in the nineteenth century. Initial practitioners in Nigeria were foreign trained and were located in the first-generation teaching hospitals. The advance was slowed down with the downward trend of the economy in the 1990s and the early 2000s. Progress has picked up now due mainly to the establishment of more tertiary hospitals, training of specialists at the postgraduate colleges, and the influence of the professional body, Society for Gastroenterology and Hepatology in Nigeria. Endoscopy has contributed to help us define more precisely the epidemiology of diseases of the gastrointestinal (GI) tract in Nigeria, including peptic ulcer disease, Helicobacter pylori, reflux disease, GI bleeding, and disease of the lower gastrointestinal tract. It has provided means for treating many diseases locally, without the need for surgery. For endoscopy to grow rapidly, we must use our training center regularly, persuade our administrators to see the need for providing equipment and facilities, bring along our support staff by providing relevant training, maintain collaboration with foreign partners, and influence equipment suppliers to provide better services to us though replacement agreements and establishment of competent repair facilities in Nigeria.

Background: There are few publications on the histopathological spectrum of cancer arising from the colon and rectum in this country. Knowledge of the spectrum of findings from colorectal cancer (CRC) biopsies will help reveal the type of cancers, the most common grade and the most prevalent anatomical distribution, the demographical distribution as well as the association of clinical symptoms with various conditions. This will inform interventions to be made. Methodology: The study employed a retrospective design with data and archived slides extracted from the Department of Pathology, Komfo Anokye Teaching Hospital, January 2009–September 2018. The slides were reviewed to establish diagnoses on colorectal biopsies. Results: A total of 237 CRC cases were reviewed, and the mean age was 54.61 ± 17.62 years, with the modal age being 75 years. The age ranges from 5 to 91 years, with the age group of 50–59 years recording the most with 22.36%. The male-to-female ratio is 1:1.09. Rectal cancers were relatively more common constituting 48.10% of the cases compared to colonic cancers, which contributed 45.57% of the cases, and rectoanal cancers recorded 6.33% of the cases. Adenocarcinoma was the most common cancer type constituting 209 (88.19%) cases and squamous cell carcinoma accounting for 21 (8.86%) cases. There were 4 neuroendocrine cancers representing 1.62% of the cases and 2 non-Hodgkin's lymphomas contributing to 0.84% of the cases, with sarcoma contributing a single case (0.42%) of the total number of cancers. Conclusion: CRC incidence is on the ascendency and continues to pose major health risk in this sub-Sahara African population. Females were at slightly increased risk and frequently located in the rectum, with most being high-grade CRCs.

Introduction: Dyspepsia is a common symptom worldwide and has been reported to account for a considerable proportion of general practice and gastroenterology consultation. It could be subclassified as structural, functional, or uninvestigated dyspepsia. Uninvestigated dyspepsia refers to dyspeptic symptoms in persons whom no diagnostic investigations have been performed. The aim of this study is to determine the prevalence and sociodemographic characteristics of patients with Rome III features of dyspepsia. Materials and Methods: It was a cross-sectional descriptive study where all patients who presented with any of the Rome III features of dyspepsia and had no diagnostic investigations done to ascertain the cause of the dyspepsia during the study period were recruited as test subjects. The controls were age- and sex-matched asymptomatic hospital staff. Results: A total of 130 test subjects and 65 controls were recruited and used for the data analysis. More females were recruited among the test subjects than males with a ratio of 1.4:1, respectively. The most common age group was the fifth decade of life, and the proportion of patients with symptoms of dyspepsia thereafter reduced with increasing age. Epigastric pain (95.4%) was the most prevalent feature of dyspepsia. Early satiety accounted for 15.4%, while the least prevalent was postprandial distress. Heartburn was the most common symptom associated with Rome III features of dyspepsia. Conclusion: Epigastric pain was found to be the most prevalent Rome III feature of dyspepsia, while heartburn is the most associated symptom.

Background and Objective: Hepatocellular carcinoma (HCC) is a common rapidly growing tumor with poor outcomes and hence requires precise, accurate, and timely diagnosis for early intervention. Although it may be suspected clinically and by imaging investigation such as ultrasound scan (USS) of the liver, there are insufficient data correlating these two modalities with histological diagnosis. This study aims at determining the relevance of liver biopsy in the diagnostic confirmation of HCC in clinically suspected Nigerian patients. Materials and Methods: This is a retrospective cross-sectional study of 105 clinically diagnosed Nigerian patients with HCC who had liver biopsy between January 1, 2001 and December 31, 2017 at the GIT/liver Unit of UCH, Ibadan. After securing the appropriate ethical clearance from the UI/UCH Ibadan ERC, relevant data were collected from patients' Pathology Departmental records and analyzed using appropriate statistical instruments. Results: There were 105 cases of clinically diagnosed HCC patients, 45 of which had imaging (USS/or computerized tomography scan) diagnosis. The mean age of the patients was 44 ± 14.8 years, ranging from 0.25 to 85 years. They consisted of 69 males and 36 females with M:F ratio of 1.9:1. Histological diagnosis was not ascertained in 8 cases (7.6%), while 97 cases (92.4%) had varied diagnoses. Malignant neoplasms, benign neoplasms, liver dysplasia, and nonneoplastic liver diseases were established in 74.1%, 2%, 9.6%, and 14.5% of cases, respectively. Primary liver cancers accounted for 62.8% of cases and included HCC (59.8%), cholangiocarcinoma (1%), hepatoblastoma (1%), and NHL (1%). The sensitivities of clinical and USS diagnoses were 100% and 93%, respectively. The positive and negative predictive values for USS were 65.1% and 0%, respectively. The overall clinical and USS diagnostic accuracies for HCC were 59.8% and 62.2%, respectively. Conclusion: The clinical accuracy for the diagnosis of HCC among clinically suspected and USS diagnosed HCC is limited in comparison to histological diagnosis by liver biopsy. Hence there should be the utilization of liver biopsies for confirmation of HCC in such suspected Nigerian patients.

Online since 20^th November 2019