Colonoscopy at a tertiary teaching hospital in Ethiopia: a five-year retrospective review

INTRODUCTION: Colonoscopy is the gold standard procedure for diagnosing lower gastrointestinal disorders. However, it is relatively expensive and out of reach of many patients in resource limited settings. The objective of this study was to assess the common clinical indications, findings, and diagnostic yield of colonoscopy procedures performed at Saint Paul´s Hospital Millennium Medical College in Ethiopia. METHODS: medical records of randomly selected 309 participants were reviewed to collect background characteristics, indications and findings of colonoscopy procedures. Data were collected using structured and pretested case reporting format by trained clinicians. RESULTS: the mean age of the participants was 43.5 years (SD=15.67) with range of 15-84 years; 60.5% were male participants. The vast majority (95.1%) of colonoscopy indications were judged as appropriate. Evaluation for rectal bleeding (31.7%) and suspected colorectal cancer (15.2%) were the commonest indication for colonoscopy. However, screening colonoscopy for asymptomatic subjects was almost non-existent. The commonest colonoscopic findings were hemorroidal diseases (28.5%) and gross mass lesions (14.9%). The overall diagnostic yield was 74.1% being highest among patients presenting with lower gastrointestinal bleeding and bowel habit changes. About 58.3% of bowel preparations in this study were optimum but an excellent preparation was extremely low (13.3%). CONCLUSION: our study revealed that colonoscopy procedures for symptomatic patients were performed for appropriate indications for most of the cases. However, screening colonoscopy was extremely low. The relatively high rate of abnormalities and malignant lesions in this finding calls for national strategy for early colonoscopy screening of high-risk population.