A FIVE YEAR CLINICOPATHOLOGICAL ANALYSIS OF LOWER GASTROINTESTINAL ENDOSCOPIC BIOPSIES IN BENIN CITY; 2008-2012

Abstract

Background: Some of the patients that come to the hospital for clinical evaluation present with
lower gastrointestinal diseases. Endoscopy is a less invasive, quick and a day procedure that is
used in the diagnosis of these gastrointestinal ailments. The recorded increase in the incidence of
colorectal cancer in Africa makes it imperative that endoscopybe used to screen the population at
risk for early detection hence the possibility of decreasing the morbidity and mortality in Nigeria.
However there are challenges associated with making a diagnosis on endoscopic biopsies as only
the colonic mucosa is represented and features of some lesions overlap.
Aim: The aim of this study was to describe the common lesions diagnosed on lower
gastrointestinal endoscopy. The findings were correlated with the endoscopic diagnosis and
clinical features.
Materials and Methods: The clinical history, endoscopic findings, slides and paraffin embedded
blocks of all endoscopic biopsies of the lower gastrointestinal tract seen from 2008 to 2012 were
studied and data analyzed using the SPSS version 16 software.
Results: Two hundred and forty nine (249) specimens were studied. Fifty seven 57(22.9%) of
these biopsies were normal colonic mucosa and 192 (77.1%) of these biopsies had remarkable
pathologies. The most common clinical indication for colonoscopy in this study was
haematochezia. Seventy 70 (36.5%) of these lesions were malignant, with epithelial cancers 67
(95.7%) being the vast majority. Thirty five (18.2%) of the lesions were benign neoplastic
lesions, 52 (27.1%) were inflammatory lesions, 18(9.4%) were IBD, 10 (5.2%) were hyperplastic
polyps and 7 (3.6%) were vascular lesions.

Conclusion: A wide spectrum of lesionswas diagnosed in this study with the predominant lesion
diagnosed being malignant neoplastic lesions. There was a higher diagnostic yield in symptomatic
patients and patients who had visible lesions seen on endoscopy. The clinical features and
endoscopic findings were similar to what has been documented in the literature.