Presentation and anatomical distribution of diverticular disease in four hospitals in Sudan

Abstract

Introduction: diverticular disease (DD) was thought to be more prevalent in the western countries, especially the white populations, but the recent increase in incidence among African and Asian population, was reported. Up to our knowledge, there is no previous study of DD in Sudan. Methods: this is a descriptive cross-sectional study conducted at the department of endoscopy in four Sudanese hospitals in the period from October 2017 to February 2019. We included all patients who underwent colonoscopy during the study period. The main objective is to study the presentation and the anatomical pattern of diverticular disease among the Sudanese population. Results: prevalence of DD in the included population was 7.5% (104/1393). The mean age was 66.4 ± 12.5 years with the percentage of males in our study is 77.1% and females were 22.9%. Presenting complains were: abdominal pain in all patients, constipation in 78.8% and rectal bleeding in 57.7%. Regarding anatomical distribution: 63.5% have left colonic DD, 19.2% in the right colon and 17.3% involving the entire colon. There was a significant correlation between the left side DD and following clinical presentations: mucus per-rectum (p = 0.015) and weight loss (p = 0.048). Other endoscopic findings of significance were internal pile in 21.2% and colo-rectal polyp in 15.4%. Conclusion: the prevalence of DD in the included population, is 7.5% which is consistent with recent literature from the Middle East, Africa and Asia but still less than the prevalence in the western countries and left side colon is predominantly affected.

The prevalence and management outcomes of diverticular disease in a tertiary facility in Ghana

“…[ 12 ] In Sudan, abdominal pain was the main presenting symptom amongst all patients studied—left iliac fossa pain in 58.6% patients, 21.1% in right iliac fossa and generalised abdominal pain in 20.2% and, 57.6% also complained of rectal bleeding. [ 13 ] In this study, rectal bleeding was the commonest sole presentation (60%) or indication for colonoscopy. This was similar to that recorded by Alatise et al .…”

“…Diverticular disease was observed to be common among the elderly in the study population, with an average age of 67 years similar to other African countries and in the USA which also stood at 67. [ 13 ] Though a disease of the elderly, the youngest patient reported in this study was 26 years, while that reported in Zambia was 42 and in Sudan, 17 years. [ 13 14 ] The youngest patient ever documented with colonic diverticulosis was described by Ignacio et al .…”

“…[ 13 ] Though a disease of the elderly, the youngest patient reported in this study was 26 years, while that reported in Zambia was 42 and in Sudan, 17 years. [ 13 14 ] The youngest patient ever documented with colonic diverticulosis was described by Ignacio et al . [ 15 ] as a 9-year-old patient with William Syndrome.…”

“…[ 9 16 , 17 ] Among Thai adults, diverticulosis was predominantly on the right but predominantly on the left among Sudanese. [ 12 13 ] Like in Ghana, cases of diverticulosis studied in Nigeria were predominantly pan colonic disease. [ 3 ]…”

Spontaneous Bilateral Lumbar Region Colocutaneous Fistulae. A Case Report

“…This is despite the high prevalence of tuberculosis in this region and the rising incidence of colorectal tumors (14). In Africa, unlike in high-income regions, spontaneous colocutaneous fistulae caused by diverticular disease are expected to be minimal as the incidence of diverticular disease in this population is low (15). Most reported cases of spontaneous colocutaneous fistulae are unilateral and single, with no cases of bilateral or multiple spontaneous fistulae (1,2,7).…”