Histopathological Pattern of Endoscopic Gastric Biopsy in a District Hospital in Nigeria: A Review of 118 Consecutive Cases

Abstract

Background: The use of endoscopes for visualization of gastric mucosa has improved over times and in taking biopsy for histology. The study sets out to determine the histopathological pattern of gastritis in dyspeptic patients and correlate the histological detection of H. pylori with that of urease breath test (UBT). Method: Prospective study of 118 consecutive patients with chronic dyspepsia who underwent upper gastrointestinal endoscopic examination and UBT using heliprobe. Biopsy of gastric antrum were taken at endoscopy and sent for histopathological analysis. Routine H&E and Giemsa stains were used. Results were recorded and analysed on the basis of sex, age, histology and UBT for H. pylori. Result: There were 118 patients who had endoscopy comprising 58 males and 60 females with male to female ratio of 1:1. Histology revealed varying degrees of chronic gastritis with or without H. pylori, activity, metaplasia, ulceration and dysplasia. Sixty eight (61%) of our patients were positive for H. pylori histologically. Of the first consecutive 66 patients, histology showed 38(57.6%) positive and 28(42.6%) negative; UBT, 46(69.6%) were positive for H. pylori and 20(30.4%) negative. There was a strong correlation between the true positive and true negative patients for the first 66 consecutive cases for both histology and UBT based diagnosis for detecting H. pylori. (Correlation coefficient=0.862, p=0.01). Conclusion: The study showed that histology and UBT are both useful for H. pylori detection. Large multi centre studies should be done to adopt the non-invasive UBT in resource poor economies for the eradication of H. pylori.

Gastric Pathology

“…2 Study conducted in India shown 6.2%, 84% and 2.6% proportions for disorders of oesophagus, stomach and duodenum, 5.6% patients had unremarkable histologically and one patients was inadequate for opinion. 4 The gastritis 76% reported to being the most common inflammatory lesion on histopathological evaluation. 5 Other lesions diagnosed were non-specific as Barrett oesophagus 1.5%, oesophagitis 1.54%, gastric ulcer 3.5%, GERD 1.7%, and duodenitis 3.1%.…”

“…2 The endoscopy performed for diagnosis as well as determining the extension of the disease, monitoring treatment course, treatment response and detection of early complications. [4][5][6] In this regard the indications of biopsy expands and covers wide range of pathological conditions. 7,8 Majority of the individuals had clinical suspicious for GERD or GI discomfort but endoscopic findings are unremarkable and non specific and labeled as endoscopic negative GERD.…”

Histopathological pattern of endoscopic gastric biopsies in dyspeptic patients in a Nigerian population

“…4,8,10,11,17,18,20,21 Nigeria and Africa.The reported range Dyspepsia affectation in this study did not show a sex predilection as demonstrated by a male to Discussion associated gastritis, 7(5.8%) cases of chronic non H. Pylori associated gastritis, 9 (7.5%) cases of chronic non H. Pylori associated gastritis with metaplasia, 6 (5%) cases of chronic non H. Pylori associated gastritis with atrophy and metaplasia, 2 (1.7%) cases of chronic non H. Pylori associated gastritis with ulcer, dysplasia and metaplasia. In addition, there were also 13 (10.8%) cases of chemical gastritis with erosion and ulceration, 4 (3.3%) cases of adenocarcinoma, 3 (2.5%) cases of polyps, while 17(14.2%) of the cases were essentially normal gastric tissues (table1).www.ibommedicaljournal.org 5.…”