Search

Fifteen children and 23 adults with complications of chronic pancreatitis were managed in Zaria, Nigeria from 1971 to 1987. They comprised 26 patients with chronic pseudocysts, 9 with chronic abdominal pain, and 3 with obstructive jaundice. Internal drainage was performed for 22 (85%) of the pseudocysts, with resection and external drainage, respectively, in 2 each. A longitudinal pancreaticojejunostomy was performed in a child with juvenile tropical pancreatitis syndrome and biliary bypass was performed in the jaundiced patients. The cause of chronic pancreatitis was known only in 8 (31%) of the patients.

✓ Two cases are reported of extradural abscess from guinea-worm infection, one that resulted in paraplegia, and the other in motor weakness of the legs.

The presentation of intussusception in children in Zaria, Nigeria has been studied with the aim of identifying any features that may differentiate it from that which obtains in temperate countries. Our data reveal no difference in age of peak incidence, sex ratio, absence of preceding upper respiratory infection or lack of significant seasonal variation. However, there is an unusually high incidence (41%) of caecocolic intussusception. It is believed that this may account for other observed features, such as the low occurrence of constipation and other evidence of intestinal obstruction, and the relatively high incidence of "painless" intussusception and sub-acute or chronic intussusception. Twenty-nine per cent of the patients had only one or two of the usual diagnostic features of the disease and this contributed to delayed diagnosis. In all but two patients the condition was idiopathic and there was no evidence to implicate bacterial enteritis or parasitic infestation in the aetiology of the disease.

Thus, we conclude that true adenomatous polyps are uncommon in northern Nigeria, and appear in patients more than 20 years old (fig. 7). The commonest type of rectal polyp is the juvenile polyp. Next in importance is the schistosomal polyp, which is seen at an earlier age here than in Egypt. These two histologic types together account for three quarters of all the rectal polyps, and appear mostly before the age of 20 years. While the schistosomal polyp in Zaria looks a little different histologically from that seen in Egypt, neither seems to have a malignant potential. There appears to be no relationship between these polyps and colorectal carcinoma, which is relatively uncommon in this region.

• We recently examined a Nigerian with regional enteritis in whom the main lesion was located in the ascending colon. The diagnosis of Crohn's disease was established only on histological grounds. In countries like Nigeria where conditions such as tuberculosis, parasitic infestations, intestinal lymphomas, and ischemic strictures of the intestine are relatively common, the clinical and/or radiological diagnosis of nonspecific inflammatory lesions of the intestine may be extremely difficult, particularly when the clinical features of these conditions are not unlike those of Crohn's disease. ( Arch Surg 1982;117:957-959)