5 research outputs found
Helicobacter pylori and precancerous conditions of the stomach: The frequency of infection in a cross-sectional study of 79 consecutive patients with chronic antral gastritis in Yaoundé, Cameroon
Introduction: The study aimed at determining the different types of precancerous conditions of the stomach and searches the frequency ofHelicobacter pylori in these lesions in patients with chronic antral gastritis in Yaounde, Cameroon.Methods: Five gastric biopsies were performed during upper gastrointestinal endoscopy for pathology and fixed in formol 10% before being coated in paraffin. Both the modified Giemsa and Periodic acid of Shift – Alkaline blue stains were used for the histological diagnosis of Helicobacter pylori infection. Hematoxylyn and eosin stain was used to determine the activity of gastritis, atrophic gastritis and intestinal metaplasia in accordance to the Sydney’s classification of gastritis.Data were analysed using both the Epi info 6.04 and Excel 2007 softwares. Means and their standard deviations, medians and their interquartiles(IQR) were calculated. Proportions were established for qualitative variables and chi square analysis done in this study with a p value set at 0.05.Results: Seventy-nine patients with chronic antral gastritis were enrolled, of which 43 (54.4%) were male, median age: 43 years (range from 21 to 70 years). The rate of atrophic gastritis was 74.7% (59/79). The activity of atrophic gastritis was mild in 47.5% (28/59) of cases, moderate in 47.5% (28/59) and severe in 5% (5/59). Intestinal metaplasia and follicular gastritis were present in 6.3% (5/79), and 10.1% (8/79), respectively.Concerning Helicobacter pylori infection, 71.2% (42/59) of patients with atrophic gastritis tested positive against 28.8% (17/59) who tested negative (p = 0.00003). Helicobacter pylori infection was related to the severity of gastric atrophy (p = 0.0001). Among patients with intestinalmetaplasia and follicular gastritis, the proportion of those who tested positive for Helicobacter pylori infection was 80% (4/5), and 75% (6/8),respectively. There were no significant differences in the occurrence of atrophic gastritis according to age groups (p = 0.908).Conclusion: This study concludes that atrophic gastritis, which is most often caused by Helicobacter pylori, is the most frequent precancerous condition of stomach in Cameroon. Routine gastric sampling for pathologic analysis is mandatory for effective diagnosis and surveillance of Helicobacter pylori infection and precancerous conditions of the stomach
Emergency total gastrectomy for massive haemorrhage in a low income country
Background: Gastric cancer is the second most common cancer of the gastrointestinal tract behind colorectal cancer in Cameroon. Total gastrectomy which is recommended for proximal gastric cancer is rarely performed and has not been reported in this country.Aim: To report emergency gastrectomy for life threatening haemorrhage of proximal gastric tumours.Methods: The case notes of all the patients who had total gastrectomy in two major hospitals in Cameroon from August 2002 to September 2009 were reviewed.Results: During the period, 15 patients had total gastrectomy for cancer. Five (5) patients out of these had emergency total gastrectomy for uncontrollable bleeding proximal ulcer cancer. All the cases were males with the mean age of 64.6years. A total gastrectomy with a D2 lymph node dissection and a Roux-en-Y oesophago-jejunostomy was carried out. A splenectomy was done in cases when the spleen was involved. Histo-pathological report revealed an adenocarcinoma in 4 cases (80%) and a lymphoma in one case (20%). There was no perioperative mortality but there was a minor complication of superficial wound infection in one case. One patient was lost to follow-up. Two (2) patients died at 18 months and 2 years respectively after the surgery while 2 patients are still alive.Conclusion: Proximal gastric cancer is more common in men in Cameroon. From our results, it is implied that total gastrectomy can be performed in Cameroon with few complications and an acceptable survival rate. Keywords: Emergency total gastrectomy; Cancer; Bleeding; Oesophago-jejunostom