Inflammatory Bowel Disease in Adults - Experience and Challenges in Gastroenterology Practices in Calabar, South-South Nigeria.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract that is reported to be rare in Africans. The objective of this study is to share the experience of our Gastroenterology practice in Calabar, Cross River State on IBD. METHODS: This is a ten-year review of the records of patients visiting the Gastroenterology clinic of the University of Calabar Teaching Hospital and two private gastroenterology clinics in Calabar Municipality. The diagnosis of IBD was made based on clinical, laboratory, endoscopic, and histological data obtained. RESULTS: Eight patients presented with features consistent with IBD. Six had ulcerative colitis while 2 had Crohn's disease. Seven patients had moderate disease with the main clinical features being recurrent mucoid bloody diarrhoea. All the patients had treatments with either sulphasalazine or mesalazine as well as azathioprine, steroids and antibiotics with variable response. One patient had strictures requiring a colostomy, while another developed colorectal cancer as complications of IBD. CONCLUSION: Although IBD is uncommon in Nigeria, a high index of suspicion is important, especially in patients presenting with the recurrent passage of mucoid bloody stools. Hence, the role of colonoscopy and histology are invaluable in establishing the diagnosis.

FONDEMENT: La maladie inflammatoire de l'intestin (MII) est un trouble inflammatoire chronique du tractus gastro-intestinal qui est rapporté comme étant rare chez les Africains. L'objectif de cette étude est de partager l'expérience de notre pratique en gastroentérologie à Calabar, dans l'État de Cross River, sur la MII. MÉTHODES: Il s'agit d'une revue de dix ans des dossiers des patients fréquentant la clinique de gastro-entérologie de l'Hôpital universitaire de Calabar et de deux cliniques privées de gastroentérologie dans la municipalité de Calabar. Le diagnostic de MII a été posé sur la base de données cliniques, biologiques, endoscopiques et histologiques obtenues. RÉSULTATS: Huit patients présentaient des caractéristiques compatibles avec la MII. Six présentaient une colite ulcéreuse tandis que 2 présentaient une maladie de Crohn. Sept patients avaient une maladie modérée avec comme principale caractéristique clinique des diarrhées muqueuses sanglantes récurrentes. Tous les patients ont été traités soit avec de la sulfasalazine soit avec de la mésalazine ainsi que de l'azathioprine, des stéroïdes et des antibiotiques avec une réponse variable. Un patient avait des sténoses nécessitant une colostomie, tandis qu'un autre développait un cancer colorectal comme complications de la MII. CONCLUSION: Bien que la MII soit rare au Nigeria, un indice de suspicion élevé est important, surtout chez les patients présentant un passage récurrent de selles muqueuses sanglantes. Ainsi, le rôle de la coloscopie et de l'histologie est inestimable pour établir le diagnostic. MOTS-CLÉS: Adultes, Maladie de Crohn, Maladie inflammatoire de l'intestin, Colite ulcéreuse.

The role of computerized tomographic scan in the management of children with cerebral palsy.

AIMS AND OBJECTIVES: The aim of this study was to describe the role of computed tomography (CT) scan in the management and evaluation of children with cerebral palsy (CP) and to categorize the CT findings and then relate them to their respective aetiologies, as well as the types of CP. MATERIALS AND METHODS: The CT findings in 32 children consisted of 16 boys and 16 girls with age range of 2-61 months who were diagnosed of CP and with detailed clinical information were analysed. The 84.4% positive CT findings were analyzed to evaluate their relationship with the clinical types, as well as the aetiological basis for the CP. RESULTS: The spastic type found in 78.1% of the total number of children, had the highest positive findings. The yield was increased in children with birth asphyxia (46.9%) and neonatal jaundice (37.5%). The findings were those of cerebral atrophy in 46.9%, infarcts in 12.5%, hydrocephalus in 9.4% and porencephaly 6.3% of cases. Treatable lesions, such as Dandy Walker syndrome, tumour, hydrocephalus and porencephaly were identified in 25% of cases. CONCLUSION: CT scan is no doubt efficacious in the management and evaluation of children with CP.

Mediastinal bronchogenic cyst with back pain.

We report a case of a mediastinal bronchogenic cyst with back pain. The rarity of this lesion and even the more uncommon association of this lesion with symptoms of back pain prompted the report of this case.