The pattern of gallstone disease as seen in Kenyatta National Hospital

Abstract

Fifty three patients were diagnosed as having gallstone disease in a five-year retrospective study (1982-1986), at Kenyatta National Hospital. This gave a yearly average of 10.6 cases. SUrgery for gallstone disease accounted for 0.6% of all general surgery and urology operations per year during ~he same period, as opposed to &10 for inguinal herniorrhaphy, 3% f0r elective duodenal ulcer surgery and 1% for gastric cancer surgery.

Considering that most Kenyan Africans wi th gallstone disease will eventually be seen at Kenyatta National Hos­ pital, one can conclude that gallstones are uncommon in the Kenyan African. In those affected, affluence does not appear to be an important risk factor except when asso­ ciated with obesity. The sex ratio was female to male 4.3:1. The average age of onset was 41 years with peaks between 30-39 years, and 50-59 years. The average parity was five. People born and brought up in Nairobi, Kiambu and Meru were those most likely to be affected. No Masais were affected.

Recurrent episodes of right upper quadrant pain and tenderness was the commonest mode of presentation.

Chronic cholecystitis with cholelithiasis was the commonest presentation of gallstone disease.

All patients except those who refused surgery were treated by operation. 10% of gallstones in this study were radio­ paque.

Ultrasound was the most commonly used mode of investigation with 8}% diagnostic accuracy.

Surgery was completely curative in 8~ of cases with no mortality.

At Kenyatta National Hospital, the typical sufferer from gallstones is a fair, fertile, female in her thirties or fifties, born and brought up in Nairobi, Kiambu or Meru.