Background:An engorgement and prolapse of the anal cushion lead to haemorrhoidal disease. There are different anatomical sites and presentation of this common pathology which affects the quality of life.Aims:To study the predilection sites, presentation and treatment of haemorrhoidal disease.Patients and Method:A cohort study of patients diagnosed with haemorrhoids at an Endoscopy centre in Port Harcourt, Rivers State Nigeria from February 2014- July 2017.The patients were divided into 2 groups: A - asymptomatic and B- symptomatic. Variables studied included: demographics, anatomic variations, grade of haemorrhoids, clinical presentation and treatment. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 20.0. Armonk, NY.Results:One hundred and twenty- one cases were included in study. There were 76 males and 45 males with age range from 15 -80 years (mean 51.9±13.1yrs). Bleeding per rectum was the most common presentation. The position frequency of haemorrhoids in decreasing order were: right posterior (34.1%); right anterior (28.2%); left lateral (17.1%); left posterior (7.6%). Multiple quadrants were affected in 58(72.5%) cases of external haemorrhoids. Grade I, II and III haemorrhoids were seen in 38 (31%), 31(26%) and 21(17%) cases respectively.Conclusion:The most common anatomical site of external haemorrhoids is the right posterior quadrant position; frequently, multiple sites are simultaneously affected. Goligher classification Grade 1 hemorrhoids are effectively treated by injection sclerotherapy using 50% dextrose solution; a cheap and physiologic sclerotherapy agent.

Highlights Giant pseudocysts of pancreas may not be as rare as they were thought to be. They can be effectively managed by cysto-gastrostomy. Gastroscopy is a useful tool for follow up.

Introduction:A myriad of pathologies lead to gastro-intestinal bleeding (GIB). The common clinical presentations are hematemesis, melena, and hematochezia. Endoscopy aids localization and treatment of these lesions.Aims:The aim was to study the differential diagnosis of GIB emphasizing the role of endoscopy in diagnosis and treatment of GIB.Patients and Methods:A prospective study of patients with GIB referred to the Endoscopy unit of two health facilities in Port Harcourt Nigeria from February 2012 to August 2014. The variables studied included: Demographics, clinical presentation, risk score, endoscopic findings, therapeutic procedure, and outcome. Data were collated and analyzed using SPSS version 20 software.Results:A total of 159 upper and lower gastro-intestinal (GI) endoscopies were performed during the study period with 59 cases of GI bleeding. There were 50 males and 9 females with an age range of 13–86 years (mean age 52.4 ± 20.6 years). The primary presentations were hematochezia, hematemesis, and melena in 44 (75%), 9 (15%), and 6 (10%) cases, respectively. Hemorrhoids were the leading cause of lower GIB seen in 15 cases (41%). The majority of pathologies in upper GIB were seen in the stomach (39%): Gastritis and benign gastric ulcer. Injection sclerotherapy was successfully performed in the hemorrhoids and a case of gastric varices. The mortality recorded was 0%.Conclusion:Endoscopy is vital in the diagnosis and treatment of GIB. Gastritis and Haemorrhoid are the most common causes of upper and lower GI bleeding respectively, in our environment

Colonoscopy is a screening tool for colorectal cancer. The cost of this service, ready availability and expertise are factors limiting its routine use in low-/middle-income countries. The aim was to study premalignant colonic polyps in asymptomatic middle-aged Nigerians and highlight the usefulness of screening colonoscopy in a sub-Saharan African population. We carried out an observational study on asymptomatic patients undergoing screening colonoscopy in a referral endoscopy facility in Port Harcourt, Rivers State, Nigeria from January to December 2018. The variables collated were demographics, endoscopic and histologic findings. Statistical analysis was done using IBM SPSS Statistics for Windows, version 20 Armonk, NY. A total of 144 colonoscopy procedures were performed during the study period with 70 asymptomatic cases for screening indication. Sixty-five were males and 5 females. The age range was from 48 years to 60 years; mean 54.8 ± 3.6 years. A polyp-detection rate of 53.7% was recorded with multiple polyps seen in 13 cases. Adenoma(s) detected in 19 persons were: 22 tubular adenomas with low grade dysplasia; 3 tubulo-villous adenomas with low grade dysplasia; 1 sessile serrated adenoma. The adenoma detection rate was 28.8%. No abnormality was detected in 19 cases. There is a worrisome prevalence of adenomatous polyps; villous adenoma is rare. A targeted policy of screening and surveillance by colonoscopy will curb the rising incidence of colorectal cancer.

HighlightsJejunal diverticular disease is rare in Africa.Our patient presented with small bowel obstruction due to volvulus.Other complications are discussed.

HighlightsUpper gastro-intestinal endoscopy is part of diagnostic work-up for massive bleeding per rectum.A positive ‘pillow sign’ in a mass in the region of the ampulla of Vater may be a choledochocele.Cyst excision and marsupialization is the definitive treatment for a choledochocele.Laparoscopic adhesiolysis is useful in adhesive small bowel obstruction.

IntroductionGastric cancer is a leading cause of cancer mortality worldwide. The burden of this disease is highest in developing countries of East Asia, Eastern Europe, and parts of Central and Southern America. Africa, despite having a similar high profile of Helicobacter pylori infection with East Asia, has a reported low prevalence of gastric cancer. There is a paucity of data on the natural history and endoscopic presentation of gastric cancer in West Africa. AimTo study the topography and morphology of gastric cancer from two institutions in Southern Nigeria. MethodsA cross-sectional retrospective study of 622 consecutive cases of upper gastrointestinal (GI) endoscopy performed in two referral endoscopy facilities in Port Harcourt, Rivers State, Nigeria from February 2012 to January 2021. Variables collated from centre records included age, sex, ethnicity, symptoms, site, endoscopic classification, and histology of gastric cancers. Statistical analysis was performed using IBM SPSS version 20 (IBM Corp., Armonk, NY). ResultsThere were 17 (2.7%) cases of histologically confirmed gastric cancer. The age range of patients was from 34 years to 99 years (mean 60.7 ± 14.6 years). There were nine males and eight females (M:F ratio of 1.1:1). Antrum and cardia were predominantly affected in 10 (60.0%) and seven (6.7%) cases, respectively. Borrmann type 1 advanced gastric tumor was seen in seven (53.8%) and adenocarcinoma, the predominant histology, in 14 (82.4%) cases. Helicobacter pylori was detected in a sole case of gastric cancer. ConclusionGastric cancer is uncommon in our environment and with a delayed presentation. A predominance of gastric antrum topography and exophytic growth morphology is the pattern.

Background: Epidemiological studies on peptic ulcer disease (PUD) have shown a recent decrease in hospital admissions in Western countries. Objective: This paper aimed to study the current status and risk factors of PUD in a Nigerian metropolis. Methods: A cross-sectional study of symptomatic patients at upper gastrointestinal (GI) endoscopy diagnosed with PUD from February 2014 to September 2019 at a referral endoscopy facility in Port Harcourt, Niger delta region of Nigeria. The variables studied included demographics, symptoms and duration, blood group, chronic non-steroidal anti-inflammatory (NSAID) use, smoking, endoscopic and histology findings. Statistical analysis was performed using SPSS version 20. Results: A total of 434 upper GI endoscopies were performed during the study period with thirty-one diagnosis of PUD made. The mean age of gastric ulcer (GU) and duodenal ulcer (DU) cases were 54.4 ± 20.2yrs and 48.1 ± 14.5yrs respectively (p = 0.367). GU to DU ratio was 1.4:1. H. pylori infection, chronic NSAID use and blood group O were seen in 7(22.5%), 8(25.8%) and 18(72.0%) respectively. Major indication in 21(67.7%) cases was gastrointestinal bleeding. Conclusion: There is a low diagnostic rate of PUD (6.7%) with pre-pyloric antral gastric ulcers as most common type and multifactorial aetiology. Keywords: Gastric ulcer; duodenal ulcer; endoscopy.