Rectal bleeding in adults over 20 years: Endoscopic investigations and results in current hospital practices in Yaoundé, Cameroon

Firmin Ankouane Andoulo, Dominique Noah Noah, Roger Djapa, Michele Tagni Sartre, Elie Claude Ndjitoyap Ndam, Kathleen Ngu Blacket

CHU Yaounde, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
La Cathédrale Medical Centre, Yaounde, Cameroon.
Yaounde Central Hospital, Department of Internal Medicine, Faculty of Medicine and Pharmaceuticals Sciences, University of Douala, Douala, Cameroon.
Yaounde General Hospital, Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, Uni- versity of Yaounde I, Yaounde, Cameroon.

DOI: 10.4236/ojgas.2013.36051                

Abstract

Introduction: In order to identify the modes of investigation and the results of the assessment of rectal bleeding in the Cameroonian adult, we retrospectively analysed the records of 287 patients aged above 20 years diagnosed with rectal bleeding with the aim to know the prescription patterns according to age, the diagnostic performance of tests and the results. Methodology: Between the 1^st of January 2009 and the 30^th of June 2010, we examined patients at the University Teaching Hospital and the “La Cathédrale” Medical Centre in Yaounde. Age, sex, endoscopic tests and results were evaluated. Results: 287 protocols met our selection criteria, sex ratio (M/F) 2.4/1, median age 46 years interquartile range [36, 55]. Normal tests were 57 (19.2%). Main lesions: haemorrhoids (42.4% CI95 36.7 -48.3), colorectal cancer (10.8% CI95 7.5 -14.9), anal fissure (8.8% CI95 5.8 -12.6) and colorectal polyps (8.4% CI95 5.5 -12.2). The prevalence of significant lesions (polyps and cancer) recorded 7% for those under age 40. 20.5% in those were between 40 -50 years, and 28.9% for those over 50 years. For anoscopies, 44.4% were under 40 years, 39.3% of cases of sigmoidoscopy affected those between 40 -50 years and colonoscopy affected 54% of those over 50 years. For the diagnostic yield, 26.2% had a significant lesion for flexible sigmoidoscopy and only 16.7% and 1.6% for colonoscopy and anoscopy respectively. Conclusion: The study shows that anoscopy and sigmoidoscopy are the main initial tests conducted in Cameroon in the assessment of rectal bleeding in adults of less than 50 years and they are quite sufficient. Haemorrhoids and colorectal cancer are the main pathologies.

Keywords

Rectal Bleeding; Colon Polyps; Colorectal Cancer; Sigmoidoscopy; Colonoscopy; Cameroon

Conflicts of Interest

The authors declare no conflicts of interest.

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