Prévalence des Ulcères Gastroduodénaux et des Lésions Précancéreuses Gastriques au cours de la Gastrite Chronique à Helicobacter Pylori selon le Système de Sydney : À Propos de 52 Cas

Stanislas Doffou Adjéka, Guillaume Dimitri Kouamé, Aboubacar Demba Bangoura, Abdélatif Yaogo, Mamonman Méité, Henriette Kissi, Kouamé Alassan Mahassadi, Fulgence Mamaert Yao-Bathaix, Alain Attia Koffi

Abstract



ABSTRACT
Background and aim. Helicobacter pylori (Hp) chronic gastritis (CG) promotes gastroduodenal ulcers (GDU) and precancerous lesions (gastric intestinal atrophy and metaplasia). The aim of our study was to evaluate the prevalence of GDU and precancerous gastric lesions in patients with CG at Hp in Abidjan. Patients and Methods. This was a prospective study conducted from 9 February to 9 August 2002 at the Yopougon University Hospital Center. Ninety patients who came to perform a gastroscopy had gastric biopsies. Only those with CG were included in the study The prevalence of GDU and precancerous gastric lesions were determined. Results. HP CG was observed in 57.8% of cases (n = 52). The sex ratio and mean age of the patients were 0.79 and 37.5 ± 14.2 years, respectively. Epigastralgia was the main reason for endoscopy (82.7% of cases, n = 43). An ulcer was seen in the duodenum  in 11 patients (21.1%) and in the stomach for 3 patients (5.8%). The mucosa of the antrum was normal at endoscopy in 73.1% (n = 38) of cases, while the fundal mucosa was normal for 76.9% (n = 40) of cases. Chronic atrophic gastritis was present in 84.6% of cases (n = 44) at the antrum and  in 61.8% (n = 8) of cases for the fundus. Gastric intestinal metaplasia was present in 3.8% of cases (n = 32) and was limited to the antrum. Conclusion. GDU and gastric pre-cancerous lesions are common in black African during endoscopy. Gastric biopsies should be the rule for any gastroscopy even in the absence of endoscopic lesions.
RÉSUMÉ
Contexte et objectif. La gastrite chronique (GC) à Helicobacter pylori (Hp) favorise les ulcères gastroduodénaux (UGD) et les lésions précancéreuses (atrophie et métaplasie intestinale gastriques). L’objectif de notre étude était d’évaluer la prévalence des (UGD) et des lésions précancéreuses gastriques chez les malades porteurs de GC à Hp à Abidjan.  Patients et Méthodes. Il s’est agit d’une étude prospective réalisée du 9 février au 9 Aout 2002 au centre hospitalier universitaire de Yopougon. Quatre-vingt-dix patients venus réaliser une gastroscopie ont été tiré au sort. Tous ont eu des biopsies gastriques. Ceux ayant  une GC à Hp à l’histologie ont été inclus dans l’étude. Chez tous,  la prévalence des UGD et des lésions précancéreuses gastriques a été déterminée. Résultats. Une GC à Hp a été observé dans 57,8% des cas (n = 52). Le  sex ratio et la moyenne d’âge des patients était respectivement de 0,79 et de 37,5± 14,2 ans.  Les épigastralgies constituaient le principal motif de l’examen endoscopique (82,7% des cas ; n=43). Un ulcère a été visualisé au niveau duodénal chez 11 patients (21,1%) et gastrique chez 3 patients (5,8%). La muqueuse gastrique était endoscopiquement normale dans 73,1% (n=38) des cas au niveau de l’antre et 76,9% (n=40) des cas au niveau du fundus. La gastrite chronique atrophique était présente dans 84,6% des cas (n= 44) au niveau antral et fundique dans  61,8% (n = 8) des cas.  La métaplasie  intestinale gastrique était présente dans 3,8% des cas (n = 32) et uniquement au niveau antral. Conclusion. Les UGD et les lésions pré cancéreuses gastriques sont fréquents en milieu endoscopique africain noir. Les biopsies gastriques devraient y être la règle lors de toute gastroscopie même en l’absence de lésion endoscopique.

Keywords


chronic gastritis; Helicobacter pylori; gastroduodenal ulcer; gastroscopy; histology; Abidjan

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