Background:
Gastric outlet obstruction (GOO) is characterized by persistent non-bilious
vomiting due to obstruction at the pylorus. GOO is associated with
Helicobacter pylori
through both malignant and benign processes. The objective of this study was to determine
the epidemiology of gastric outlet obstruction in Rwanda.
Methods:
A cross-sectional descriptive study was undertaken on patients with GOO seen
over a 12-month period. Patients’ demographics, histopathology,
H.pylori infection and
mortality, were analyzed using Chi-square (χ2) test and logistic regression. Mortality was
assessed with a minimum follow up of 3 months.
Results:
A total of 82 patients presenting with GOO were studied. The rate of
H.pylori infection was 61%. Malignant histopathology was found in 67% of patients.
Bivariate analysis showed that
pylori infection was associated with a benign
histopathology (X
2 =4.77, p=0.029). Logistic regression showed that malignant
histopathology was associated with decreased survival (Odds Ratio = 0.072, 95%
Confidence Interval = 0.018-0.289, p< 0.001). There was no statistically significant
difference in mortality between surgical and non-surgical patients with malignant
histopathology (X
2=1.41, p= 0.495).
Conclusions:
Malignancy is a common cause of GOO in Rwanda and is associated with
increased mortality whether treated surgically or non-surgically. Over 50% of patients
with GOO in Rwanda were infected with
H pylori.