The presentation, management and outcome of haemorrhoids as seen in Kenyatta National Hospital General Surgery Unit 1990-1999

Abstract

This study was carried out at Kenyatta National Hospital where the records of a total of 133 patients with haemorrhoidal disease were reviewed. There was a total of 8765.4% males and 46 female 34.6% patients representing a male preponderance with a ratio of 2:1. The majority of patients were in the active age group of 20-39 years and the mean age was 37 years. Anal fissure and HIV disease were the two conditions most commonly associated with the haemorrhoids at a rate of 35.3% and 26.3% respectively .. Proctoscopic examination was done in 79.9% of all patients with haemorrhoids. As proctoscopy is a gold standard examination procedure in the diagnosis of haemorrhoids. this was an obvious shortcoming on the clinical assessment. The most common stage at presentation "vas third degree haemorrhoids at 62.7%.

The mean duration of illness on presentation was one (1) year with the main symptoms being pain. prolapse and bleeding accounting for 92.5%, 91% and 82.7% respectively. Thrombosis was the commonest encountered complication at presentation accounting for 44.2%. followed by bleeding at 36.5% and ulceration at 25%. Haemorrhoidectorny was the commonest interventional method used for treatment representing 86% of all interventional methods. Less demanding outpatient procedures such us rubber band ligation were not carried out over the period 1990 to 1999 in

Kenyatta National Hospital. Sclerotherapy, a cost effective mode of interventional therapy is rarely carried out being perforned in only 11.9% in this study, Pain was the most frequent early complication of treatment accounting for 70.4%, while recurrence was the most frequent late complication54.8%.