[Hematemesis in Togo: findings of a 12-month study in an intensive care unit]. / Hématémèses au Togo: expérience d'un an en réanimation.

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.

[Upper digestive tract endoscopy in rural Africa: Togo]. / Endoscopie digestive haute en milieu rural africain au Togo.

The purpose of this report was to describe the profile of esogastroduodenal disease diagnosed by upper digestive tract endoscopy (UDTE) in a rural area of Togo. This prospective study combines data collected during two two-week screening campaigns carried out in the Kara region. Patients were informed of the presence of the endoscopy team by means of a bulletin on a rural radio station. All male and female patients 15 years or older were included. A total of 220 UDTE procedure reports were recorded and analyzed including 107 men and 113 women with a mean age of 37.7 years (range: 15-84 years). Disease was detected in 72 procedures mainly in the 21 to 41 year age group (47.2 %) with a higher proportion of men than women: 38% versus 27% respectively. The most frequent indications for UDTE were epigastralgia (47.7 %) including 39% of procedures leading to the discovery of disease and diffuse abdominal pain (21.8 %). The procedure was carried out for follow-up purposes in 19.1% of cases. The most common lesions were peptic ulcer (34.2%), inflammatory disease including esophagitis, gastritis, and bulboduodenitis (32.4%), gastroduodenal bile reflux (9.3%), pylorobulbar stenosis (5.5%), tumoral disease (3.7%), and esophageal varicosities (3.7%). This study based on UDTE diagnostic procedures provided insight into the profile of esogastroduodenal disease in rural Africa. These screening campaigns required special organization using appropriate equipment and personnel.

[Aetiologics aspects of proctorrhagia at the black adult African: about 85 cases collect in 12 years in CHU-Campus of Lome]. / Aspects etiologiques des rectorragies chez l'adulte en milieu Africain: a propos de 85 cas colliges en 12 ans au CHU-Campus de Lome.

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.