Pub Date : 2015-01-01DOI: 10.4103/1595-1103.166886
P. Hounnasso, J. Avakoudjo, A. Dankoro, Fouad Yde Soumanou, Gilles Natchagé, M. Agounkpe, Rafiou Sanni Toré
Objectives: The goal of this study is to describe the epidemiological and diagnostic aspect of male infertility in the Department of Urology and Andrology of the Hospital mentioned above. Methods: This was a retrospective descriptive study of 6 months duration at the Academic Clinic of Urology and Andrology of a Teaching Hospital in Cotonou. A total of 96 medical records of patients were retrieved for the study. Results: The average age of the patients was 37.2 ± 6.7 years old. About 59.4% of the cases were primary infertility. The average duration of the infertility was 51 months. From the patients past medical histories; 44.9% suffered from gonorrhea. On clinical examination, the findings were: Varicocele in 23% of the cases, testicular hypotrophy in 9.3% and epididymal cyst in 4.6%. The seminal fluid analysis revealed hypospermia in 30.1% of cases, azoospermia in 33.7%, asthenozoospermia in 75.5% and teratozoospermia in 61.5%. The pH was basic in 46.4% of the cases. Follicular stimulating hormone and testosterone levels were high in 48.1% and 12.5% of cases, respectively. About 31.6% of the cases had the positive chlamydial serological test. Semen culture was positive in 25% of the cases and the main organism isolated was Staphylococcus aureus in 66.6% of the cases. Conclusion: Male infertility is the cause of couple infertility in around a third of the cases. In this study, we have found various etiologies of causes of male infertility. However, idiopathic causes could be found.
{"title":"Male infertility: diagnostic and epidemiological aspect concerning 96 cases in a teaching university hospital of cotonou, benin republic","authors":"P. Hounnasso, J. Avakoudjo, A. Dankoro, Fouad Yde Soumanou, Gilles Natchagé, M. Agounkpe, Rafiou Sanni Toré","doi":"10.4103/1595-1103.166886","DOIUrl":"https://doi.org/10.4103/1595-1103.166886","url":null,"abstract":"Objectives: The goal of this study is to describe the epidemiological and diagnostic aspect of male infertility in the Department of Urology and Andrology of the Hospital mentioned above. Methods: This was a retrospective descriptive study of 6 months duration at the Academic Clinic of Urology and Andrology of a Teaching Hospital in Cotonou. A total of 96 medical records of patients were retrieved for the study. Results: The average age of the patients was 37.2 ± 6.7 years old. About 59.4% of the cases were primary infertility. The average duration of the infertility was 51 months. From the patients past medical histories; 44.9% suffered from gonorrhea. On clinical examination, the findings were: Varicocele in 23% of the cases, testicular hypotrophy in 9.3% and epididymal cyst in 4.6%. The seminal fluid analysis revealed hypospermia in 30.1% of cases, azoospermia in 33.7%, asthenozoospermia in 75.5% and teratozoospermia in 61.5%. The pH was basic in 46.4% of the cases. Follicular stimulating hormone and testosterone levels were high in 48.1% and 12.5% of cases, respectively. About 31.6% of the cases had the positive chlamydial serological test. Semen culture was positive in 25% of the cases and the main organism isolated was Staphylococcus aureus in 66.6% of the cases. Conclusion: Male infertility is the cause of couple infertility in around a third of the cases. In this study, we have found various etiologies of causes of male infertility. However, idiopathic causes could be found.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"24 Suppl 1","pages":"20 - 22"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89842763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.4103/1595-1103.166883
Minakshi Nalbale Bhosale, Dasmit Singh
Mesenteric lymphangiomas are rare in occurrence. The dumb-bell shaped ones are even rarer. We report a case of a 7-year-old girl with a huge dumb-bell shaped mesenteric tumor weighing 3 kg, located in the jejunal mesentery and causing failure to thrive. En mass excision of the tumor along with the involved bowel segment was done with a successful outcome. Histopathology diagnosed the tumor to be mesenteric lymphangioma of the jejunal mesentery. At a follow-up of 2 years, the child is symptom-free and has a good catch up growth.
{"title":"A huge mesenteric lymphangioma of the jejunal mesentery resulting in failure to thrive","authors":"Minakshi Nalbale Bhosale, Dasmit Singh","doi":"10.4103/1595-1103.166883","DOIUrl":"https://doi.org/10.4103/1595-1103.166883","url":null,"abstract":"Mesenteric lymphangiomas are rare in occurrence. The dumb-bell shaped ones are even rarer. We report a case of a 7-year-old girl with a huge dumb-bell shaped mesenteric tumor weighing 3 kg, located in the jejunal mesentery and causing failure to thrive. En mass excision of the tumor along with the involved bowel segment was done with a successful outcome. Histopathology diagnosed the tumor to be mesenteric lymphangioma of the jejunal mesentery. At a follow-up of 2 years, the child is symptom-free and has a good catch up growth.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"1 1","pages":"23 - 25"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89343376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.4103/1595-1103.166885
A. Takure, S. Adebayo, P. Sotunmbi, L. Okeke, E. Olapade-Olaopa, O. Shittu
Objective: To report our experience with the management and outcome of treatment of adults with pelvi-ureteric junction(PUJ) obstruction Subjects and Methods: This was a retrospective study of adults with PUJ obstruction from January 2009 to December 2013. The study was conducted at a Tertiary Teaching Hospital in Ibadan in Nigeria. All adults with clinical features and radiological evidence of PUJ obstruction were included. Some patients had non operative treatment while others had open surgical treatment. The main outcome of treatment was measured by the relief of symptoms. We are not aware of previous report of the management of PUJ obstruction in adults in Nigeria. Results: Eighteen adult patients were treated. The mean age was 39 ± 11.2 standard deviation years (range 20-65 years). Seventy-two percent presented with loin pain. Thirteen of these patients were treated surgically, and 5 were treated nonoperatively. The operation findings were narrow but patent PUJ that barely admit a probe due to intrinsic muscle fibrosis in six patients, aberrant crossing vessels in 3, severely hydronephrotic kidneys in 3 and one impacted PUJ calculus. Fifty percent of patients had open dismembered pyeloplasty, simple nephrectomy (16.7%) while combined pyelolithotomy and Foley Y-V plasty (5%). All surgically treated patients were pain-free as at last time of review. Conclusion: Intrinsic muscle fibrosis and aberrant crossing vessels are the most common causes of PUJ obstruction in adults. Open pyeloplasty is still the main stay of treatment in our environment with satisfactory symptomatic relief.
{"title":"Pelvi-ureteric junction obstruction in adults in a resource limited environment: Causes, features and outcome of treatment","authors":"A. Takure, S. Adebayo, P. Sotunmbi, L. Okeke, E. Olapade-Olaopa, O. Shittu","doi":"10.4103/1595-1103.166885","DOIUrl":"https://doi.org/10.4103/1595-1103.166885","url":null,"abstract":"Objective: To report our experience with the management and outcome of treatment of adults with pelvi-ureteric junction(PUJ) obstruction Subjects and Methods: This was a retrospective study of adults with PUJ obstruction from January 2009 to December 2013. The study was conducted at a Tertiary Teaching Hospital in Ibadan in Nigeria. All adults with clinical features and radiological evidence of PUJ obstruction were included. Some patients had non operative treatment while others had open surgical treatment. The main outcome of treatment was measured by the relief of symptoms. We are not aware of previous report of the management of PUJ obstruction in adults in Nigeria. Results: Eighteen adult patients were treated. The mean age was 39 ± 11.2 standard deviation years (range 20-65 years). Seventy-two percent presented with loin pain. Thirteen of these patients were treated surgically, and 5 were treated nonoperatively. The operation findings were narrow but patent PUJ that barely admit a probe due to intrinsic muscle fibrosis in six patients, aberrant crossing vessels in 3, severely hydronephrotic kidneys in 3 and one impacted PUJ calculus. Fifty percent of patients had open dismembered pyeloplasty, simple nephrectomy (16.7%) while combined pyelolithotomy and Foley Y-V plasty (5%). All surgically treated patients were pain-free as at last time of review. Conclusion: Intrinsic muscle fibrosis and aberrant crossing vessels are the most common causes of PUJ obstruction in adults. Open pyeloplasty is still the main stay of treatment in our environment with satisfactory symptomatic relief.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"41 1","pages":"15 - 19"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75875443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-01-01DOI: 10.4103/1595-1103.166881
J. Makama
Multidisciplinary collaborations and active participation of multiple authors in scientific studies and publications are being increasingly encouraged. This may be so because multi-author publications, presumably, have been considered to lend greater credibility, reliability, greater support, and enhance the integrity of the work as it will often reflect a pool of experiences and contributions from all the authors. When the article is finally published in a scientific journal, many other stakeholders’ interests will become obvious such as is found in the work often done by the appointment and promotion committee in real academic circles, where credits are now awarded to each author for the purpose of promotion, grant allocation, and assigning supervision by grant awarding firms are just but a few examples.[1] In these instances, surely, the stakeholders will pick interest in the order or sequence in which the list of authors names appear in the work. At this point, the question will then arise whether the list of authors’ names in scholarly publications has any particular sequence or value? If it does, what is the interpretation of the sequence? What value does it has and how do you quantify the value? These could be some of the questions that will follow particularly during assessment of the roles or contributions made by various authors in multi-authored publications. This editorial is intended to highlight the interpretation of the order or sequence of list of authors names in scholarly publications and attempt to give a summary of the guidelines that have been in use for the evaluation of the roles or contributions made by various authors. In scientific and scholarly publications, the roles of the first author has been wrongly misconstrue and thought that the person that has the greatest contribution to the work should be first author. With this misconception, that has been fairly straightforward in identifying such a role in any multi-author publication. The major problem is often with the remaining names, which factors guide the order in which the remaining names are arranged? As at the moment, no universally accepted order is practiced among scholars. However, the following options and guidelines have been noted to be in place or use for various reasons.
{"title":"List of authors in scholarly publications: Sequence and what value?","authors":"J. Makama","doi":"10.4103/1595-1103.166881","DOIUrl":"https://doi.org/10.4103/1595-1103.166881","url":null,"abstract":"Multidisciplinary collaborations and active participation of multiple authors in scientific studies and publications are being increasingly encouraged. This may be so because multi-author publications, presumably, have been considered to lend greater credibility, reliability, greater support, and enhance the integrity of the work as it will often reflect a pool of experiences and contributions from all the authors. When the article is finally published in a scientific journal, many other stakeholders’ interests will become obvious such as is found in the work often done by the appointment and promotion committee in real academic circles, where credits are now awarded to each author for the purpose of promotion, grant allocation, and assigning supervision by grant awarding firms are just but a few examples.[1] In these instances, surely, the stakeholders will pick interest in the order or sequence in which the list of authors names appear in the work. At this point, the question will then arise whether the list of authors’ names in scholarly publications has any particular sequence or value? If it does, what is the interpretation of the sequence? What value does it has and how do you quantify the value? These could be some of the questions that will follow particularly during assessment of the roles or contributions made by various authors in multi-authored publications. This editorial is intended to highlight the interpretation of the order or sequence of list of authors names in scholarly publications and attempt to give a summary of the guidelines that have been in use for the evaluation of the roles or contributions made by various authors. In scientific and scholarly publications, the roles of the first author has been wrongly misconstrue and thought that the person that has the greatest contribution to the work should be first author. With this misconception, that has been fairly straightforward in identifying such a role in any multi-author publication. The major problem is often with the remaining names, which factors guide the order in which the remaining names are arranged? As at the moment, no universally accepted order is practiced among scholars. However, the following options and guidelines have been noted to be in place or use for various reasons.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"103 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75891058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4103/1595-1103.141387
Er Abah, K. Oladigbolu, Abdul-Sadik Ahmed
Aims and Objectives: To identify the causes of visual impairment and blindness in students of Kaduna State Special Education School (KASSES) and make recommendations for the planning of eye care, including prevention and management of the avoidable causes of childhood blindness in our environment. Background: Childhood blindness is one of the priorities of vision 2020: The Right to sight. The "blind years" attributable to childhood is comparable to that of age related cataract (the commonest cause of blindness worldwide). Significant proportions of the causes of childhood blindness are avoidable and can be identified after a screening exercise and treated. Periodic screening will also provide current data for planning and implementation of childhood blindness prevention programmes. Materials and Methods: All the students of the blind section of KASSES who were present during the study were examined and the Georgia Project′s screening protocol for visual impairment in children was completed for each of them. The data was analyzed using Analyze-it V2.22 (2010) statistical software. Results: A total of 71 students were examined. M:F ratio was 1.7:1. The age range was between 6-29 years but 76% were within the bracket of 10-19 years. Seventy percent were blind, 21% had severe visual impairment, and 9% had moderate visual impairment. Cataract was the commonest cause of blindness (25.3%), followed by trauma (16.9%), optic atrophy, buphthalmos, and retinitis pigmentosa (12.7% each). Others were corneal scarring/staphyloma (9.9%), Rubella (7.0%), and a case each of bilateral ankyloblepharon and uveitis (1.4%). Conclusion: The causes of visual impairment in KASSES are largely avoidable. Incorporation of Primary Eye Care (PEC) into Primary Health Care (PHC) will drastically reduce needless blindness, especially in childhood and the morbidity and mortality associated with the blind years. Early identification of students with treatable causes such as cataract should also be encouraged through regular school screening and health education.
{"title":"Causes of visual impairment and blindness in Kaduna State Special Education School","authors":"Er Abah, K. Oladigbolu, Abdul-Sadik Ahmed","doi":"10.4103/1595-1103.141387","DOIUrl":"https://doi.org/10.4103/1595-1103.141387","url":null,"abstract":"Aims and Objectives: To identify the causes of visual impairment and blindness in students of Kaduna State Special Education School (KASSES) and make recommendations for the planning of eye care, including prevention and management of the avoidable causes of childhood blindness in our environment. Background: Childhood blindness is one of the priorities of vision 2020: The Right to sight. The \"blind years\" attributable to childhood is comparable to that of age related cataract (the commonest cause of blindness worldwide). Significant proportions of the causes of childhood blindness are avoidable and can be identified after a screening exercise and treated. Periodic screening will also provide current data for planning and implementation of childhood blindness prevention programmes. Materials and Methods: All the students of the blind section of KASSES who were present during the study were examined and the Georgia Project′s screening protocol for visual impairment in children was completed for each of them. The data was analyzed using Analyze-it V2.22 (2010) statistical software. Results: A total of 71 students were examined. M:F ratio was 1.7:1. The age range was between 6-29 years but 76% were within the bracket of 10-19 years. Seventy percent were blind, 21% had severe visual impairment, and 9% had moderate visual impairment. Cataract was the commonest cause of blindness (25.3%), followed by trauma (16.9%), optic atrophy, buphthalmos, and retinitis pigmentosa (12.7% each). Others were corneal scarring/staphyloma (9.9%), Rubella (7.0%), and a case each of bilateral ankyloblepharon and uveitis (1.4%). Conclusion: The causes of visual impairment in KASSES are largely avoidable. Incorporation of Primary Eye Care (PEC) into Primary Health Care (PHC) will drastically reduce needless blindness, especially in childhood and the morbidity and mortality associated with the blind years. Early identification of students with treatable causes such as cataract should also be encouraged through regular school screening and health education.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"5 1","pages":"17 - 21"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90585128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4103/1595-1103.141394
J. Makama, P. Enesi, J. Jibrin
Persistent descending mesocolon is a congenital anomaly that has been shown, in most cases, to be asymptomatic because of its short length. To the best of our literature review and knowledge, no case of internal herniation of the mobile descending colon into either gastrocolic or splenocolic recesses have been reported. We therefore wish to report a case of herniated mobile descending colon in a middle-aged woman. HA was a 54-year-old female with a 2-year history of recurrent episodes of left upper quadrant pain of the abdomen. The pain, which was initially dull aching, suddenly became sharp in nature and so severe that it precluded her from doing her domestic activities. She had undergone clinical evaluation and work up previously but no etiology for her pain was found. After resuscitation, she consented to exploratory laparatomy for an acute on-chronic abdominal pain of unknown etiology. The intraoperative findings were a portion of the wall of the left colon seen to have herniated into a small band of tissue on the left posterior wall. The whole descending colon was unattached to the posterior peritoneum. The trapped portion (4 cm in length) of the wall of the colon was released and a warm pack was applied to the segment of large bowel so released. Following this maneuver, the portion was found to be viable and so a left colopexy was performed and the adhesion band that was placed obliquely from the spleen toward the midline was excised. Postoperative period was uneventful and since then the patient′s abdominal pain has been abated over the past 1 year. The morbidity of a mobile descending colon includes internal herniation. Therefore, early detection and colopexy is necessary.
{"title":"Herniated mobile descending colon","authors":"J. Makama, P. Enesi, J. Jibrin","doi":"10.4103/1595-1103.141394","DOIUrl":"https://doi.org/10.4103/1595-1103.141394","url":null,"abstract":"Persistent descending mesocolon is a congenital anomaly that has been shown, in most cases, to be asymptomatic because of its short length. To the best of our literature review and knowledge, no case of internal herniation of the mobile descending colon into either gastrocolic or splenocolic recesses have been reported. We therefore wish to report a case of herniated mobile descending colon in a middle-aged woman. HA was a 54-year-old female with a 2-year history of recurrent episodes of left upper quadrant pain of the abdomen. The pain, which was initially dull aching, suddenly became sharp in nature and so severe that it precluded her from doing her domestic activities. She had undergone clinical evaluation and work up previously but no etiology for her pain was found. After resuscitation, she consented to exploratory laparatomy for an acute on-chronic abdominal pain of unknown etiology. The intraoperative findings were a portion of the wall of the left colon seen to have herniated into a small band of tissue on the left posterior wall. The whole descending colon was unattached to the posterior peritoneum. The trapped portion (4 cm in length) of the wall of the colon was released and a warm pack was applied to the segment of large bowel so released. Following this maneuver, the portion was found to be viable and so a left colopexy was performed and the adhesion band that was placed obliquely from the spleen toward the midline was excised. Postoperative period was uneventful and since then the patient′s abdominal pain has been abated over the past 1 year. The morbidity of a mobile descending colon includes internal herniation. Therefore, early detection and colopexy is necessary.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"4 1","pages":"33 - 36"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79654120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4103/1595-1103.141395
A. Randawa, A. Muhammed, L. Khalid
Sir, We made an unusual observation of the occurrence of uretero-vaginal f istula following emergency cesarean section in four consecutive patients, in whom Pfannenstiel incision was employed to gain access to the uterus. All the cesarean sections were done in rural hospitals and apparently by inexperienced surgeons. In all the patients [Figures 1a-d], the incision scar was ragged and ugly, indicating healing by secondary intention, thus defeating the major goal of the incision, which is cosmesis. None of these patients had concurrent vesico-vaginal fi stula (VVF). Pfannenstiel incision (described by Hermann Johannes Pfannenstiel in 1900) is a low transverse abdominal skin crease surgical incision about 2-3 cm above the pubic symphysis. The rectus abdominis muscles are separated along the linea alba and retracted laterally without cutting.[1,2] It produces an aesthetically more pleasing “bikini-line” scar, thus it is often also called a “bikini-line incision. It is employed to access the pelvic organs including the uterus. Its main advantage is the cosmetic scar it produces which is desirable generally by women. It offers large view of central pelvis but limits exposure to the lateral extent of the pelvis and upper abdomen, a factor that limits its usefulness in gynecologic oncology surgery.[3] The limited access Pfannenstiel incision offers makes it difficult to perform certain pelvic surgeries including emergency cesarean section, especially if the situation is complicated by obstructed labor. In obstructed labor, the fetal head is deep in the pelvis, thus there may be the need to employ a wider incision in the lower segment of the uterus to deliver the fetal head. This may, in the hands of the inexperienced surgeons, poor operative fi eld lighting and inadequate instruments, lead to inadvertent injury to the uterine vessels. In the surgeon’s desperate attempt to secure hemostasis, deep stitches are applied blindly with resultant injury or ligation of the pelvic ureter and subsequent development of uretero-vaginal fi stula.[4-6] This was probably the case in these patients. This observation questions the validity of using Pfannenstiel incision for emergency cesarean Section especially in the hands of the less experienced surgeon, as it may increase the risk of ureteric injury and subsequent development of uretero-vaginal fistula. There was no obvious obstetric cause because none of the patients had VVF. We call for caution in using Pfannenstiel incision as a routine in emergency cesarean section; surgeons should consider safety over aesthetics in choosing the appropriate incision. This is particularly so if the surgeon has limited experience and is working with an inexperienced assistant in a suboptimal operating theatre setting. Training and retraining of medical offi cers and surgeons must be emphasized to avert this preventable complication.
先生，我们对连续4例采用Pfannenstiel切口进入子宫的紧急剖宫产术后输尿管阴道瘘的发生进行了不同寻常的观察。所有的剖宫产手术都是在农村医院进行的，而且显然是由没有经验的外科医生进行的。在所有患者中[图1a-d]，切口疤痕粗糙丑陋，表明愈合是次要的，这就违背了切口的主要目的，即美容。这些患者均无并发膀胱阴道瘘(VVF)。Pfannenstiel切口(由Hermann Johannes Pfannenstiel于1900年描述)是耻骨联合上方约2-3 cm的低横向腹部皮肤切口。腹直肌沿白线分离，不切割地向外侧缩回。[1,2]它会产生更美观的“比基尼线”疤痕，因此它通常也被称为“比基尼线切口”。它被用来进入盆腔器官，包括子宫。它的主要优点是它产生的美容疤痕，这是女性普遍希望的。它提供了骨盆中央的大视野，但限制了骨盆和上腹部外侧的暴露，这限制了它在妇科肿瘤手术中的实用性。[3]Pfannenstiel切口提供的有限通道使得进行某些骨盆手术(包括紧急剖宫产)变得困难，特别是当情况因难产而复杂化时。在难产中，胎儿的头在骨盆深处，因此可能需要在子宫的下段使用一个更宽的切口来娩出胎儿的头。这可能在缺乏经验的外科医生的手中，手术现场照明不良和器械不充分，导致无意中损伤子宫血管。在外科医生不顾一切地试图止血时，盲目地使用深缝线，导致骨盆输尿管损伤或结扎，随后发展为输尿管阴道瘘。[4-6]这些患者可能就是这种情况。这一观察结果对急诊剖宫产使用Pfannenstiel切口的有效性提出了质疑，特别是在经验不足的外科医生的情况下，因为它可能增加输尿管损伤和随后发生输尿管阴道瘘的风险。没有明显的产科原因，因为没有患者患有VVF。我们建议在紧急剖宫产术中谨慎使用Pfannenstiel切口;外科医生在选择合适的切口时应考虑安全性而非美观性。如果外科医生经验有限，并且在不理想的手术室环境中与经验不足的助手一起工作，则尤其如此。必须强调对医务人员和外科医生的培训和再培训，以避免这种可预防的并发症。
{"title":"Could pfannenstiel incision for emergency caesarean section be associated with the development of uretero-vaginal fistula?","authors":"A. Randawa, A. Muhammed, L. Khalid","doi":"10.4103/1595-1103.141395","DOIUrl":"https://doi.org/10.4103/1595-1103.141395","url":null,"abstract":"Sir, We made an unusual observation of the occurrence of uretero-vaginal f istula following emergency cesarean section in four consecutive patients, in whom Pfannenstiel incision was employed to gain access to the uterus. All the cesarean sections were done in rural hospitals and apparently by inexperienced surgeons. In all the patients [Figures 1a-d], the incision scar was ragged and ugly, indicating healing by secondary intention, thus defeating the major goal of the incision, which is cosmesis. None of these patients had concurrent vesico-vaginal fi stula (VVF). Pfannenstiel incision (described by Hermann Johannes Pfannenstiel in 1900) is a low transverse abdominal skin crease surgical incision about 2-3 cm above the pubic symphysis. The rectus abdominis muscles are separated along the linea alba and retracted laterally without cutting.[1,2] It produces an aesthetically more pleasing “bikini-line” scar, thus it is often also called a “bikini-line incision. It is employed to access the pelvic organs including the uterus. Its main advantage is the cosmetic scar it produces which is desirable generally by women. It offers large view of central pelvis but limits exposure to the lateral extent of the pelvis and upper abdomen, a factor that limits its usefulness in gynecologic oncology surgery.[3] The limited access Pfannenstiel incision offers makes it difficult to perform certain pelvic surgeries including emergency cesarean section, especially if the situation is complicated by obstructed labor. In obstructed labor, the fetal head is deep in the pelvis, thus there may be the need to employ a wider incision in the lower segment of the uterus to deliver the fetal head. This may, in the hands of the inexperienced surgeons, poor operative fi eld lighting and inadequate instruments, lead to inadvertent injury to the uterine vessels. In the surgeon’s desperate attempt to secure hemostasis, deep stitches are applied blindly with resultant injury or ligation of the pelvic ureter and subsequent development of uretero-vaginal fi stula.[4-6] This was probably the case in these patients. This observation questions the validity of using Pfannenstiel incision for emergency cesarean Section especially in the hands of the less experienced surgeon, as it may increase the risk of ureteric injury and subsequent development of uretero-vaginal fistula. There was no obvious obstetric cause because none of the patients had VVF. We call for caution in using Pfannenstiel incision as a routine in emergency cesarean section; surgeons should consider safety over aesthetics in choosing the appropriate incision. This is particularly so if the surgeon has limited experience and is working with an inexperienced assistant in a suboptimal operating theatre setting. Training and retraining of medical offi cers and surgeons must be emphasized to avert this preventable complication.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"19 1","pages":"37 - 38"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74729195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4103/1595-1103.141384
A. Ibrahim, P. Mshelbwala, A. Obiadazie, C. Ononiwu, M. Asuku, S. Ajike, E. Ameh
Background: Cleft lip and palate is the commonest congenital malformation of the head and neck region. This article discusses the experiences of the authors′ in the management of clefts of the primary and secondary palate in a tertiary institution in Nigeria. Patients and Methods: This is a retrospective review of the clinical database for all children with cleft lip and palate. Data were analyzed for age at presentation, sex distribution, surgical technique, associated congenital anomalies, and complications. The results obtained were converted to relative values in frequency tables for analysis. Results: The average age at presentation for all patients with cleft was 2.47 years. Males were slightly more affected than females among all clefts with a frequency of 40 (53%) and 35 (47%). The distribution of clefts by location showed a preponderance of the left side 33 (44%), followed by right side 18 (24%) and bilateral cases 11 (15%). Three patients (4%) had a relative with a cleft of the primary or secondary palate. At least one congenital malformation coexisted with a cleft of the primary or secondary palate in 13 (17%) of the 75 babies. The commonest post-operative complication of cleft of the primary palate was wound dehiscence 3 (4%). Conclusion: This study has shown that there was a wide range of age at presentation. It is characterized by delays in the repair of clefts of the primary and secondary palate. We strongly support early repair of clefts of the primary and secondary palate to facilitate normal feeding, better speech and ensure social acceptance.
{"title":"A Descriptive Study of Clefts of the Primary and Secondary Palate Seen in a Tertiary Institution in Nigeria","authors":"A. Ibrahim, P. Mshelbwala, A. Obiadazie, C. Ononiwu, M. Asuku, S. Ajike, E. Ameh","doi":"10.4103/1595-1103.141384","DOIUrl":"https://doi.org/10.4103/1595-1103.141384","url":null,"abstract":"Background: Cleft lip and palate is the commonest congenital malformation of the head and neck region. This article discusses the experiences of the authors′ in the management of clefts of the primary and secondary palate in a tertiary institution in Nigeria. Patients and Methods: This is a retrospective review of the clinical database for all children with cleft lip and palate. Data were analyzed for age at presentation, sex distribution, surgical technique, associated congenital anomalies, and complications. The results obtained were converted to relative values in frequency tables for analysis. Results: The average age at presentation for all patients with cleft was 2.47 years. Males were slightly more affected than females among all clefts with a frequency of 40 (53%) and 35 (47%). The distribution of clefts by location showed a preponderance of the left side 33 (44%), followed by right side 18 (24%) and bilateral cases 11 (15%). Three patients (4%) had a relative with a cleft of the primary or secondary palate. At least one congenital malformation coexisted with a cleft of the primary or secondary palate in 13 (17%) of the 75 babies. The commonest post-operative complication of cleft of the primary palate was wound dehiscence 3 (4%). Conclusion: This study has shown that there was a wide range of age at presentation. It is characterized by delays in the repair of clefts of the primary and secondary palate. We strongly support early repair of clefts of the primary and secondary palate to facilitate normal feeding, better speech and ensure social acceptance.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"16 1","pages":"7 - 12"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73058073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4103/1595-1103.141389
A. Abdulkadir, A. Abubakar
Congenital anterior urethral diverticulum (CAUD) is a rare congenital blind ended out pouching of the urethral through the corpus spongiosium. We report its coexistence with phimosis in a 7-year-old boy who presented with difficulty in passing urine. His prepuce was not retractable and balloons at voiding. Suspected associated CAUD was confirmed at circumcision. His voiding became normal with resolution of lower urinary tract symptoms after treatment. The related literatures were reviewed. The symptoms of the two conditions mimic one another and the diagnosis of phimosis which is clinical may overshadows CAUD with its needed confirmatory imaging studies. CAUD can coexist with phimosis and high index of suspicion helps in the management. Diverticulectomy and urethroplasty with circumcision at the same sitting is curative.
{"title":"Congenital anterior urethral diverticulum co-existing with phimosis: A case report and review of literature","authors":"A. Abdulkadir, A. Abubakar","doi":"10.4103/1595-1103.141389","DOIUrl":"https://doi.org/10.4103/1595-1103.141389","url":null,"abstract":"Congenital anterior urethral diverticulum (CAUD) is a rare congenital blind ended out pouching of the urethral through the corpus spongiosium. We report its coexistence with phimosis in a 7-year-old boy who presented with difficulty in passing urine. His prepuce was not retractable and balloons at voiding. Suspected associated CAUD was confirmed at circumcision. His voiding became normal with resolution of lower urinary tract symptoms after treatment. The related literatures were reviewed. The symptoms of the two conditions mimic one another and the diagnosis of phimosis which is clinical may overshadows CAUD with its needed confirmatory imaging studies. CAUD can coexist with phimosis and high index of suspicion helps in the management. Diverticulectomy and urethroplasty with circumcision at the same sitting is curative.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"10 1","pages":"22 - 24"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77521345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.4103/1595-1103.141380
J. Makama
The Nigerian Journal of Surgical Research seeks to advance the surgical research of Nigerians and the world at large. It will serve as a source of information on the state of the art of surgical sciences. The journal will publish articles in the fi eld of Surgery and other fields which have relevance in the care of a surgical patient. We encourage researchers from all over the world especially Nigeria and Africa to submit their valuable and cutting edge research fi ndings in the fi eld of surgical sciences for consideration/publication.
{"title":"Nigerian Journal of Surgical Research in its newest outlook as shipper of surgical scientists of the generation: Welcome!","authors":"J. Makama","doi":"10.4103/1595-1103.141380","DOIUrl":"https://doi.org/10.4103/1595-1103.141380","url":null,"abstract":"The Nigerian Journal of Surgical Research seeks to advance the surgical research of Nigerians and the world at large. It will serve as a source of information on the state of the art of surgical sciences. The journal will publish articles in the fi eld of Surgery and other fields which have relevance in the care of a surgical patient. We encourage researchers from all over the world especially Nigeria and Africa to submit their valuable and cutting edge research fi ndings in the fi eld of surgical sciences for consideration/publication.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"36 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78839685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：