Abstract
The etiology of colonic strictures in 263 South African black and Indian patients is presented. Nonmalignant lesions accounted for strictures in two-thirds of the patients and included amebiasis (27), tuberculosis (24), nonspecific colitis (30), ulcerative colitis/Crohn's colitis (11) and other lesions (36). Malignant lesions caused strictures in approximately a third of the black and Indian patients, which is higher than in other reported series in blacks. Accurate clinical diagnosis is difficult and early histologic confirmation is mandatory in order to institute rational management. Strictures of the right colon in the black population are more likely to be benign, except in younger patients. Leftsided colonic strictures have an equal chance of being benign or malignant, and early histologic confirmation is essential. The coexistence of an underlying malignant lesion in association with an inflammatory lesion in an endemic area should always be considered, particularly if it fails to respond to empirical therapy within a short period of time.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kark AE, Epstein AE, Chapman DS. Nonmalignant anorectal strictures. Surg Gynecol Obstet 1959;109:333–43.
Bremner CG, Ackerman LV. Polyps and carcinoma of the large bowel in the South African Bantu. Cancer 1970; 26:991–9.
Bank S, Burns DG, Marks IN, Stein D. The clinical spectrum of amoebic colitis. S Afr Med J 1971;45:219–25.
Wilmot AJ. Clinical amoebiasis, Oxford: Blackwell Scientific Publications, 1962.
Gelfand M. The clinical features of E. histolytica infection in Europeans and Africans in Rhodesia. Cent Afr J Med 1970;16:180–4.
Tchang S. Amebiasis in Northern Saskatchewan: radiological aspects. Can Med Assoc J 1968;99:688–95.
Reeder MM, Hamilton LC. Tropical diseases of the colon. Semin Roentgenol 1968;3:62–80.
Bassler A. Intestinal obstruction due to amebiasis. JAMA 1936;106:1965–8.
Cain GD, Wolma FJ Jr, Patterson M. Extensive stenosis of the colon and fistula formation following amoebic dysentery. Gastroenterology 1971;61:898–900.
Stein D, Bank S. Surgery in amoebic colitis. Gut 1970; 11:941–6.
Das P, Kumar P, Gupta CK, Indrayan A. Clinical patterns of abdominal tuberculosis. Am J Proctol 1975;26:75–86.
Hoon JR, Dockerty MB, Pemberton JdeJ. Collective review: ileocecal tuberculosis including a comparison of this disease with nonspecific regional enterocolitis and noncaseous tuberculated enterocolitis. Int Abst Surg 1950;91:417–40.
Dutta Gupta AK. Intestinal tuberculosis. Indian J Surg 1958;20:396–408.
Giraud RM, Luke I, Schmaman A. Crohn's disease in the Transvaal Bantu: a report of 5 cases. S Afr Med J 1969; 43:610–3.
Trowell HC. Non-infective disease in Africa; the peculiarities of medical non-infective diseases in the indigenous inhabitants of Africa south of the sahara. Baltimore: Williams & Wilkins, 1960.
Ssali JC. Carcinoma of the large bowel in Uganda. Ann R Coll Surg Engl 1977;59:420–2.
Pillay VK. Ulcerative colitis in the African (correspondence). Br Med J 1964;2:689.
Billinghurst JR, Welchman JM. Idiopathic ulcerative colitis in the African: a report of four cases. Br Med J 1966;1:211–3.
Samuels AD, Weese JL, Berman PM, Kirsner JB. An epidemiologic and demographic study of inflammatory bowel disease in black patients. Am J Dig Dis 1974;19:156–60.
Ngala-Kenda JF. Carcinoma of the large bowel in the African: a 15-year survey at Kinshasa University Hospital, Zaïre. Br J Surg 1976;63:966–8.
Pillay SP, Angorn IB, Baker LW. Colorectal carcinoma in young black patients: A report of eight cases. J Surg Oncol 1978;10:125–32.
Burkitt DP. Epidemiology of cancer of the colon and rectum. Cancer 1971;28:3–13.
Author information
Authors and Affiliations
About this article
Cite this article
Pillay, S.P., Moshal, M.G., Spitaels, J.M. et al. Etiology of colonic strictures in South African black and Indian patients. Dis Colon Rectum 24, 107–113 (1981). https://doi.org/10.1007/BF02604298
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02604298