Gastric outlet obstruction among adult patients at two Rwandan referral hospitals: Etiology, H. pylori infection and outcomes

Abstract

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.pyloriinfection was 61%. Malignant histopathology was found in 67% of patients. Bivariate analysis showed that pylori infection was associated with a benign histopathology (X2 =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 (X2=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.

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