Transarterial chemoembolization and microwave ablation for early hepatocellular carcinoma in a Nigerian

The West African subregion has a high number of cases of hepatocellular carcinoma (HCC), and this is partly because of a lack of expertise and health infrastructure for the delivery of effective locoregional therapies for patients who present with early disease. This report documents the successful treatment of a case of early HCC in a Nigerian patient using a combination of transarterial chemoembolization and microwave ablation techniques. We showed that, despite difficulties, such techniques are possible. It is our hope that this publication will help stimulate discussion, policy changes, and other alterations necessary to establish beneficial high-end techniques for the alleviation of the health burden of HCC patients in Nigeria

Rectal inflammatory fibroid polyp in a Nigerian: case report & brief review of literature.

Background: Inflammatory fibroid polyps are very unusual gastrointestinal tumours. Furthermore, their occurrence in the rectum is a rarity indeed. Objective: To document this very rare pathologic entity in a patient from our region of Africa and highlight some pertinent clinical and pathologic aspects of the disease. Case report: We present a 59 year old Nigerian who had neither significant previous medical history nor current complaint and had a routine colonoscopy done. The finding in the rectum was of a small polypoidal mass which was excised whole and whose histopathologic findings were consistent with a diagnosis of inflammatory fibroid polyp. Conclusion: A unique case of rectal inflammatory fibroid polyp in a Nigerian is hereby presented. This, to the best of our knowledge, is the first such documented case from our region of the world. Hence, the entity should be considered in the differential diagnosis of colonic polyps from the continent

Lymphocytic Colitis in Nigeria: A Case Series

The term “microscopic colitis” (MC) is used to describe a chronic inflammatory bowel disease that includes two main subtypes based on  histopathologic features: collagenous and lymphocytic. Scientific literature is replete with documentation of the disease from various regions of the world. However, the condition is rarely described in black African patients. We herein present the details of the clinical  aspects and endoscopic findings of 3 Nigerian patients with the lymphocytic variant of MC. A short literature review of the clinical, endoscopic, and pathologic features of this rare condition as well as other relevant aspects of MC is also presented

Gastrointestinal stromal tumor of the anal wall in a Nigerian

Documented reports of gastrointestinal stromal tumors (GIST) are relatively few in the sub-Saharan continent. The body of evidence points towards anal wall involvement being a rarity indeed. In this article we document a 61 year old Nigerian man who presented with bleeding per rectum and in whom the histological features (including immunohistochemistry) of the biopsied anal lesion was GIST.Key words: Gastrointestinal stromal tumors (GIST), anal wall, immunohistochemistry, Nigeri

Upper gastrointestinal bleeding in a Nigerian diagnostic center: a retrospective study of endoscopic records

Background: Upper gastrointestinal bleeding (UGIB) is a common indication for endoscopy. We aimed to describe the endoscopic findings in patients referred to our center with UGIB. Methods: This was a singlecenter retrospective study of the endoscopic findings in patients with UGIB between August 1, 2017, and April 30, 2019, in Lagos, Nigeria. Data were analyzed using Statistical Package for Social Sciences version 23.0.Results: Eight hundred thirty-two patients underwent endoscopy, of which 129 (16%) were for UGIB, which occurred twice as frequently in males. Melena was the most frequent presentation. Endoscopic abnormalities including gastric/duodenal peptic ulcers (39%),gastroduodenal erosions (36%), and varices (12%), were identified in 83% of the participants. Most ulcers were ow risk. Conclusion: Patients presenting to our center with UGIB commonly have gastric/duodenal peptic ulcers or gastroduodenal erosions

Portal Hypertensive Duodenopathy Manifesting as “Kissing” Duodenal Ulcers in a Nigerian with Alcoholic Cirrhosis: A Case Report and Brief Review of the Literature

Multiple duodenal ulcers are an uncommon finding in portal hypertensive duodenopathy (PHD). They represent a potential source of clinically significant bleeding from the upper gastrointestinal system in patients with cirrhosis. As this particular ulcer entity in relation to PHD has no distinguishing symptoms aside from those relating to the consequent bleeding, most of them are found either on routine endoscopic screening for cirrhotics or on endoscopic examination for cause(s) of bleeding in this patient population. The case documented below highlights many of the aspects of pathogenesis, associations, and consequences of this unique endoscopic finding in cirrhotic patients

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Introduction: colorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria. Methods: this is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 –July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria. Results: a total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%).The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis. Conclusion: the study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.The Pan African Medical Journal 2016;2

Prevalence of a marker of active <it>helicobacter pylori</it> infection among patients with type 2 diabetes mellitus in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>There appears to exist a potentially important interplay between diabetes mellitus (DM) and <it>Helicobacter pylori (H. pylori)</it> infection. Findings from previous studies have been conflicting. Only a few studies have examined the topic in a sub-Saharan African population. This study sought to determine the prevalence of <it>H. pylori</it> infection among Type 2 diabetes mellitus (T2DM) patients in Lagos, Nigeria.</p> <p>Findings</p> <p><it>H. pylori</it> infection was detected in 18% of T2DM patients and 13% of controls but there was no statistical significance in this difference (p = 0.52). The prevalence of <it>H. pylori</it> was neither associated with the known duration of T2DM nor was it associated with age, gender, body mass index (BMI), smoking status. T2DM was not shown to be a risk factor independently associated with risk for <it>H. pylori</it> infection (OR = 0.87, 95% CI = 0.58-1.31, p = 0.57).</p> <p>Conclusions</p> <p>The lack of a statistical significant difference between the <it>H. pylori</it> infection rates in T2DM patients and controls suggests that the infection is not increased in T2DM. Larger studies need to be conducted to confirm the study findings.</p