Thyroid disease in Tikur Anbessa Hospital: a five-year review

Diseases of the thyroid are not uncommon particularly in the highlands of Ethiopia. To see the pattern of surgical thyroid disorders, a review of operated cases of thyroid diseases in the period 1997-2001 was conducted in Tikur Anbessa Hospital, Addis Ababa. During the period, 472 patients underwent surgery for goiter. Of these, records of 377 patients could be retrieved and form the basis for this analysis. The mean age was 35 (range, 15-73) years. The sex ratio, M : F was 1: 3.8. The mean duration of symptoms on admission was 7 years. The most frequent presenting feature was goiter. Symptoms of airway obstruction and hyperthyroidism were not rare. About 12% of patients were clinically and biochemically categorized toxic. Location of goiter was specified in 349 cases. Of these, 56.7% had bilateral disease. Nodular colloid goiter was the most common pathological type. Neoplasm of the thyroid appeared not to be rare. The mean pre- and postoperative hospital stays were 12 and 6 days, respectively. About 66% of patients had partial or subtotal thyroidectomy. Significant intraoperative hemorrhage requiring blood transfusion occurred in 12 (3%) patients. Some post operative complications including pneumonia, wound infection, recurrent nerve or parathyroid gland injury, and recurrent goiter or hyperthyroidism were noted. One case developed thyroid crisis. Less radical surgical procedures, we believe, are adequate for all benign and most malignant goiters in Ethiopia. In areas where thyroxin is in short supply and follow-up is erratic total thyroidectomy as is recommended else where should be reserved for only few selected cases.