Nigerian Journal of Gastroenterology and Hepatology

Coexistence of G6PD Deficiency in a Crohn’s Disease Patient: Case Report

2025-02-28T06:37:28+00:00

Mutations in the X-chromosome G6PD gene cause glucose-6-phosphate dehydrogenase (G6PD) deficiency. Crohn’s disease (CD) is an inflammatory bowel disease that can cause inflammation and damage to the lining of the digestive tract. We report a 50-year-old male with CD who was found to have an unrecognized variant of G6PD deficiency. Further investigation confirmed the presence of G6PD enzymatic activity impairment, indicating the clinical relevance of this genetic alteration. This case report presents the G6PD variants rs137852339, rs1050757, and rs2230037 in an individual from South India, highlighting the significance of early genetic screening in individuals experiencing persistent symptoms lasting for years. The present case underscores the importance of genetic screening in patients with prolonged symptoms, aiming to prevent delayed diagnosis and enhance overall patient well-being through timely interventions and personalized treatment approaches.

Multidisciplinary collaboration in treatment of obstructive jaundice secondary to large biliary staghorn stone in a Nigerian: A case report

2025-02-28T06:58:22+00:00

The increasing local deployment of minimally interventional radiology procedures as therapy for benign and malignant causes of obstructive jaundice in Nigeria is noteworthy. The procedures, however, have limitations. This report details an innovative multi-specialist approach to one such drawback. In our report, following a successful cholangiogram, sphincteroplasty was not possible for the removal of a large common hepatic duct staghorn calculus and multiple stones proximal to it. As standard cholangioscopic lithotripsy equipment was not available, recourse was made to the expertise of a urologist who deployed a flexible digital ureteroscope to fragment the large stone with thulium laser under direct cholangioscopic vision. This facilitated the removal of the said stone the other smaller proximal stones with no complications and prompt reversal of the clinical presentation of the patient. We highlight this case to show the significance and role of creative and collaborative thinking in the care of high-end minimally invasive procedures in our resource-limited locality.

Budd–Chiari syndrome at the cirrhosis stage: A case report from Campus Teaching Hospital of Lome-Togo

2025-02-28T07:02:31+00:00

Budd–Chiari syndrome is a rare disease and is a significant cause of cirrhosis. We report a clinical case of a 23-yearold patient, highlighting the diagnostic and therapeutic difficulties of Budd–Chiari syndrome at the cirrhosis stage in a country with limited resources such as Togo. A 23-year-old, nonalcoholic, patient who tested negative for hepatitis B and C virus presented with progressive abdominal distension. Examination revealed grade 2 ascites and soft, painless, cold, bucketing edema of the lower limbs rising to the knees. The calculated serum-ascites albumin gradient was 12g/L. Abdominal ultrasound and abdominal computed tomography indicated the presence of thrombosis of the inferior vena cava, which ascended to the hepatic veins. Biological signs of hepatocellular insufficiency such as a low prothrombin time (56%) and low serum albumin levels (22g/L) with a beta-gamma block were also found. Upper gastrointestinal endoscopy revealed grade 3 esophageal varices with red signs. The diagnosis of Budd–Chiari syndrome at the stage of cirrhosis classified as Child–Pugh score 9 decompensated in the ascitic mode, complicated by grade 3 esophageal varices with red signs, was retained. Due to the inadequacy of the technical facilities in Togo, and also because of financial difficulties, aetiological work-up was not carried out. Anticoagulant treatment with rivaroxaban 10mg/day has been instituted. The clinical outcomes were poor with gastrointestinal bleeding, stage 3 hepatic encephalopathy, and death on the 46th day. The prognosis of Budd–Chiari syndrome is poor in resource-limited countries such as Togo. It depends on the quality of care, not only of the etiology but also of the complications of cirrhosis.

Radiation proctitis in Lagos, Nigeria: A Review of clinical, endoscopic, and pathological findings

2025-02-27T14:38:45+00:00

Background and Objectives: Radiation proctitis (RP) is only sparsely documented as a gastrointestinal side effect of the administration of radiotherapeutic interventions in oncology practice in Nigerian patients. This review sought to profile important clinical aspects in five such cases of RP along with a review of the endoscopic and pathological findings.
Materials and Methods: We conducted a retrospective review of all patients who were diagnosed with RP at two Lagos-based privately run colonoscopy centers. The record examined covered a duration of 36 months (April 1, 2016–May 31, 2019). Over this period, 1035 colonoscopies were carried out, and all RP cases (n = 5) were identified. The clinical presentations and endoscopic findings were documented as well as the findings of the pathologists’ report for the chronic proctitis (CP) cases.
Results: All patients were in their sixth or seventh decade of life (age range, 63–78 years). There were two males and three females. All subjects had haematochezia as their presenting complaint. In the case of the two patients with acute RP, bleeding commenced after initiation of radiotherapy. As for the three patients with CP, the above symptoms started at 7, 11, and 36 months, respectively, after the last dose of radiotherapy. The time from the onset of the symptom to seeking colonoscopy evaluation varied between 2 and 12 weeks. The histological findings of biopsies of CP were consistent with the diagnosis in the three cases. The endoscopic findings were classified using the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer criteria.
Conclusion: This study documents the changes related to RP in a cohort of Nigerian patients, with a focus on clinical, endoscopic, and histopathological findings.

Electrocardiographic abnormalities in patients with chronic liver disease: suggestions for cirrhotic cardiomyopathy

2025-02-27T14:43:05+00:00

Background: Cardiac dysrhythmia is a silent complication of chronic liver disease (CLD), notably liver cirrhosis, which is rarely sought for. However, its presence could indicate the development of cirrhotic cardiomyopathy, and in conditions of stress such as infections, it could contribute to mortality.

Objective: We aimed to evaluate the electrocardiographic abnormalities in patients with CLD.

Materials and Methods: This was a cross-sectional study carried out at the University of Calabar Teaching Hospital, Calabar, over a 12- month period, which recruited 80 patients who had CLD and 80 age-/gender-matched apparently normal controls. All patients were interviewed, examined, and underwent resting electrocardiography. The data were analyzed using IBM SPSS version 20.0.

Results: A total of 160 patients were recruited, out of which 73.8% were males, while 26.2% were females. The mean age of patients with CLD was 42.0 ± 12.6 years. Prolongation of the QTc interval was the most prevalent ECG abnormality, with a prevalence of 36%. The prevalence of disturbances in heart rate and conduction abnormalities was not significantly different between the CLD and control groups.

Conclusion: Prolonged QT interval is prevalent in patients with CLD compared to apparently healthy controls.

A Single Center Experience of Adolescents and Young Adults with Gastrointestinal Tract Cancers

2025-02-28T06:27:26+00:00

Background: Gastrointestinal tract (GIT) tumors are predominantly seen among middle-aged and elderly persons. However, there are reports of an increasing incidence among adolescents and young adults.

Objective: We sought to describe the morphological characteristics of malignancies involving the GIT among adolescents and young adults in our center.

Materials and Methods: This is a retrospective review of all histologically diagnosed cases of gastrointestinal malignancies in persons between the ages of 10 and 35, over a 10-year period (2010–2019).

Results: There were 79 cases of GIT tumors in adolescents and young adults during the study period amounting to 14.2% of total GIT malignancies. The male: female ratio was 1:1.1. Colonic malignancies predominated, accounting for 75% of cases; these were mostly adenocarcinomas. Gastric cancers showed a female predilection; small intestinal tumors were observed more in males.

Conclusion: Gastrointestinal tract tumors affecting adolescents and young adults are not uncommon. Most of these tumors are adenocarcinomas and affect the colon. Gastric cancers showed a female predilection.

Abstracts presented at the Society for Gastroenterology and Hepatology (SOGHIN) conference held in Jos, Nigeria, July 18–19, 2024

2025-02-28T07:21:30+00:00

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