Pattern of Surgical Diseases Based on Histopathological Findings: A 13-years Personal Experience in a Rural Hospital in Kenya

Abstract

Background: Church/mission hospitals and other non-government health institutions inKenya provide 30% of the healthcare needs, providing affordable care to the rural poor. This review presents the surgical pathology to which a general surgeon working in a rural Kenyan hospital is exposed through training and beyond. Additionally, some of the rarer surgical pathology, ‘rare birds’, encountered during this period is reported.

Methods: In this retrospective study, all the surgical specimens submitted by the author for histopathological examination over a period of thirteen years were reviewed and analyzed. The findings are reported.

Results: The results of 1826 surgical specimens were divided into the major surgical specialties that a surgeon working in this environment is exposed to. General surgical specimens constituted 48.4% of the total specimens, while urology, gynecology, maxillofacial/otolaryngology and ‘other’ specialties made up 34.6%, 7.8%, 6.7%, and 2.5% respectively. There were a total of 389 malignancies, of which 55% were in general surgery and 31.1% in urology. Rare surgical pathologies encountered over this period included acne conglobata, an intramuscular lipoma of the forearm, intraosseous lipoma of the fibula, primary tuberculosis of the prostate gland and of the thyroid gland, amongst others.

Conclusion: Church/mission hospitals currently present excellent opportunities both for training and career development in general surgery and related disciplines.