RESUMO
Ulcerative colitis seems to be rare in sub-Saharan Africa. Because its clinical and radiological signs are non-specific, anatomopathologic studies are necessary for definitive diagnosis after exclusion of parasitic, bacterial, and viral causes. The purpose of this report is to describe a fatal case of ulcerative colitis in a 68-year-old woman in Togo.
Assuntos
Colite Ulcerativa , Idoso , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/terapia , Evolução Fatal , Feminino , Humanos , TogoRESUMO
This prospective study was conducted over a 12-month period on patients who underwent upper digestive endoscopy for hematemesis in the medical intensive care unit (ICU) of the Tokoin University Hospital Center in Lomé, Togo. A total of 44 patients with a mean age of 44 years were included. The sex-ratio was 2.61. Risk factors included use of non-steroid anti-inflammatory (NSAI) in 16 patients (36.4%) and alcohol abuse in 13 (29.6%). At the time of admission to the ICU, 21 patients (47.7%) were in hemodynamic shock and 11 (25%) presented signs of portal hypertension. The underlying etiology was peptic ulcer in 18 cases (40.9%) including 13 cases of duodenal ulcer and 5 cases of stomach ulcer, rupture of esophageal varicosities in 8 (18.2%), gastric tumor in 6 (13.6%), Mallory Weiss syndrome in 5 (11.4%), gastritis in 4 (9,1%), and esophagitis in 3 (6.8%) due to peptic inflammation in 2 and mycotic infection in 1. The mortality rate was 45.5%. The main causes of hematemesis were peptic ulcer and rupture of esophageal varicosities. The death rate was high due to inadequate care facilities.
Assuntos
Hematemese/etiologia , Hematemese/mortalidade , Unidades de Terapia Intensiva/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Candidíase/complicações , Úlcera Duodenal/complicações , Varizes Esofágicas e Gástricas/complicações , Esofagite/complicações , Esofagite/microbiologia , Feminino , Gastrite/complicações , Gastrite/microbiologia , Hematemese/diagnóstico , Hematemese/terapia , Humanos , Masculino , Síndrome de Mallory-Weiss/complicações , Pessoa de Meia-Idade , Úlcera Péptica/complicações , Estudos Prospectivos , Fatores de Risco , Neoplasias Gástricas/complicações , Úlcera Gástrica/complicações , Taxa de Sobrevida , Togo/epidemiologiaRESUMO
PURPOSE: To count the aetiology of proctorrhagia in Lomé. METHODS: It is a retrospective study, over 12 years (1st January 1995-31 December 2006), realised from the reports of the coloscopy . It included the patients of the two sexes, old of more than 15 years, having presented a proctorrhagia explored by ano-rectoscopy and coloscopy. RESULTS: The proctorrhagia represent 38.72% of the indications of the coloscopy. The patients from 24 to 45 years were reached (52.94%). A male prevalence was found (sex-ratio: 2.4). Among the aetiology found, the haemorrhoids more frequent (23.53%), were followed by the non specific colitis (16.47%), the ulcero- haemorrhage rectocolitis (15.29%), the colon diverticulosis (10.58%), the amoebic colitis (9.4%) and colorectal cancer (5.88%). The hemorroid were associated with a non specific colitis (1 case), a ulcero-hemorrhagic rectocolitis (1 case), an amoebic colitis (1 case) and diverticulose colic (1 case). In 12 cases (14.12%), no aetiology was found. CONCLUSION: The haemorrhoids represent the most frequent aetiology of the proctorrhagia in Lomé; however their discovery in ano-rectoscopy should not exempt realisation of a complete coloscopy in the search of other causes.
Assuntos
População Negra , Hemorragia Gastrointestinal/etiologia , Doenças Retais/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Togo , Adulto JovemRESUMO
But : recenser les etiologies des rectorragies au CHU-Campus de Lome. Methodologie : Il s'agit d'une etude retrospective sur 12 ans (1er janvier 1995 - 31 decembre 2006); realisee a partir des comptes-rendus de coloscopie. Elle a inclus les dossiers des malades des deux sexes; ages de plus de 15 ans; ayant presente une rectorragie exploree par une ano-rectoscopie et une coloscopie totale. Resultats : les rectorragies representent 38;72des indications de la coloscopie. Les malades ages de 24 a 45 ans ont ete les plus atteints (52;94). Une predominance masculine a ete retrouvee (sex-ratio : 2;4). Parmi les etiologies retrouvees; les hemorroides ont ete plus frequentes (23;53) suivies par les colites non specifiques (16;47); la recto-colite ulcero-hemorragique (15;29); la diverticulose colique (10;58); les colites amibiennes (9;4) et le cancer colorectal (5;88). Les hemorroides etaient associees a une colite non specifique (1 cas); a une recto-colite ulcerohemorragique (1 cas); a une colite amibienne (1 cas) et a une diverticulose colique (1 cas). Dans 12 cas (14;12); aucune etiologie n'a ete retrouvee. Conclusion : Les hemorroides representent l'etiologie la plus frequente des rectorragies a Lome; cependant leur decouverte a l'ano-rectoscopie ne doit pas dispenser de la realisation d'une coloscopie complete a la recherche de lesions associees