Pediatric gastrointestinal diseases in Nigeria: A histopathological analysis of 74 cases.

Abstract

Abudu Emmanuel Kunle,Oyebadeyo Tope Yinka, Inyang-Etoh Emmanuel Columba

Background: Children are vulnerable to a vast number of diseases including gastrointestinal disorders, which may be associated with life threatening complications that sometimes result in mortality especially if left untreated. Objective: To establish the age and sex distribution of children in the study population as well as the histopathological characteristics of gastrointestinal diseases that occurred in those children who were aged 14years and below in Sagamu, Southwestern Nigeria. Materials and Methods: Demographic data such as age, sex, and clinical summary of children in the study population were extracted from the medical records of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State from January 2003 to December 2009. Based on this information, a review of paraffin embedded blocks and slides as well as histopathological reports of gastrointestinal diseases that occurred in those children aged 14years and below was undertaken at the Morbid Anatomy Department of the hospital. Results: Seventy-four cases of gastrointestinal diseases were seen in children aged 14 years and below. The majority (39.2%) of gastrointestinal diseases were accounted for by appendiceal lesions. Hirschsprung’s disease, intussusceptions, enterocolitis and jejunal atresia accounted for 29.7%, 10.8%, 6.8% and 4.1% of cases respectively. Adenocarcinoma of the intestine was the predominant gastrointestinal tumor, occurring in 5 out of 7 children. Two cases of non-Hodgkin’s lymphoma were also seen. The ages of the children ranged from 2 to 14 years, with a mean age of 8.6years and a peak age incidence of gastrointestinal disease in the 10-14year age group. Male children were more commonly affected with the exception of appendiceal lesions, which occurred more in females (M:F ratio= 1.6:1.0). Acute suppurative appendicitis was the most prevalent lesion of the appendix, occurring in 13 out of 29 appendiceal lesions. Moderately differentiated to poorly differentiated histological types were seen in the tumors, which were three adenocarcinomas and two mucinous carcinomas. Burkitt’s and Mucosal-associated types of non-Hodgkin’s lymphomas were the two histological types of lymphoma seen primarily in the stomach and small intestine respectively. Conclusion: Appendiceal lesion was the predominant pediatric gastrointestinal disease found in the study population with preponderance for female children. Adenocarcinoma was the most common gastrointestinal tumor found, while, Hirschsprung’s disease, intussusception, enterocolitis, jejunal atresia and non-Hodgkin’s lymphoma contributed to only a minority of the gastrointestinal diseases found in the study population.