Pub Date : 2010-05-28DOI: 10.4314/NJSR.V8I3-4.54902
A. Oguntayo, A. Adesiyun, P. Onwuhafua
We report a case of a 27 year old Para 1+O house wife who presented with a four months history of a rapidly increasing tumor of the anterior abdominal wall. The abdomen was swollen to the size of a 16 weeks gravid uterus. At laparatomy a tumor measured 15cm by 10cm attached to the posterior aspect of the rectus sheath. The resected mass proved on histology to be Rhabdomyoma of the anterior abdominal wall. Rhabdomyoma is an exceedingly rare tumor in females and when it does occur, it is found in the genitalia (Genital Rhabdomyoma). The origin in the anterior rectus is extremely rare.
{"title":"Anterior Abdominal wall Rhabdomyoma mimicking fibroid: A Case Report","authors":"A. Oguntayo, A. Adesiyun, P. Onwuhafua","doi":"10.4314/NJSR.V8I3-4.54902","DOIUrl":"https://doi.org/10.4314/NJSR.V8I3-4.54902","url":null,"abstract":"We report a case of a 27 year old Para 1+O house wife who presented with a four months history of a rapidly increasing tumor of the anterior abdominal wall. The abdomen was swollen to the size of a 16 weeks gravid uterus. At laparatomy a tumor measured 15cm by 10cm attached to the posterior aspect of the rectus sheath. The resected mass proved on histology to be Rhabdomyoma of the anterior abdominal wall. Rhabdomyoma is an exceedingly rare tumor in females and when it does occur, it is found in the genitalia (Genital Rhabdomyoma). The origin in the anterior rectus is extremely rare.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82504985","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}
Background :Fracture of a normal tibia shaft constitutes a major trauma mostly sustained by young adults during high-energy injuries. Its superficial location and the subcutaneous characteristics of its anteromedial aspect easily causes open fracture. The objectives of this study were to determine the pattern of presentation, and determinants of management outcome in open fractures of the tibia. Methods : This is a prospective hospital based study. A total of 89 patients aged 4 to 80 years with open fractures of the tibia with or without fibula involvement were studied. All the patients received anti tetanus prophylaxis and intravenous antibiotics as well as wound irrigation, debridement and skeletal stabilisation. Results : Students and traders accounted for the majority of the cases (57.3%). Most of the open tibia fractures 69 (77.5%) had above knee Plaster of Paris cast. The majority of the cases were Gustilo and Anderson type II 32 (36.0%) cases and type I 22(24.7%) cases. There was Correlation between the presence of wound infection and (i) Gustilo and Anderson grading (F -.352, P .001); (ii) Injury to Debridement time in hours (F -.304, P .004); (iii) Osteomyelitis (F .397, P .001); (iv) Delayed union (F .253, P .017); and (v) Union time in weeks (F -.350, P .001). There was also correlation between the following: (i) Injury to Debridement time in hours and the distance from the accident scene to the hospital (F .464, P .001); (ii) The fracture pattern and the union time in weeks (F .353, P .001); and (iii) The presence of osteomyelities and delayed union (F .382, P .001). The commonest complications observed were wound infection 35(39.3%) patients and delayed union 30(33.7%) patients. Conclusion :This study shows that the higher the Gustilo and Anderson grading of the open fractures of the tibia, the more severe the wound and bone infection that occurred. The interval between injury time and wound debridement time affected the treatment outcome.
背景:正常胫骨干骨折是青年人高能损伤中常见的主要创伤。它的表面位置和前内侧面的皮下特征容易引起开放性骨折。本研究的目的是确定开放性胫骨骨折的表现模式和治疗结果的决定因素。方法:这是一项基于医院的前瞻性研究。共89例4 ~ 80岁的开放性胫骨骨折伴或不伴腓骨受累的患者进行了研究。所有患者均给予破伤风预防、静脉注射抗生素、伤口冲洗、清创和骨骼稳定。结果:以学生和商贩居多(57.3%);开放性胫骨骨折69例(77.5%)均采用膝上石膏石膏。以Gustilo和Andersonⅱ型32例(36.0%)和ⅰ型22例(24.7%)为主。(1) Gustilo和Anderson评分(F -)与伤口感染存在相关性。352, p .001);(ii)损伤至清创时间(以小时为单位)(F -。304, p .004);(iii)骨髓炎(F .397, P .001);(iv)延迟结合(F .253, P .017);(v)以周为单位的工会时间(F -。350, p .001)。伤至清创时间(h)与事故现场至医院的距离(F .464, P .001)也存在相关性;(ii)骨折类型及周愈合时间(F .353, P .001);(iii)存在骨髓瘤和延迟愈合(F .382, P .001)。最常见的并发症为伤口感染35例(39.3%)，延迟愈合30例(33.7%)。结论:胫骨开放性骨折Gustilo和Anderson评分越高，创面和骨感染越严重。损伤时间与创面清创时间的间隔影响治疗效果。
{"title":"Determinants of management outcome in open tibia fractures in ile-ife","authors":"I. Ikem, L. Oginni, J. Ogunlusi","doi":"10.4314/NJSR.V8I1.54845","DOIUrl":"https://doi.org/10.4314/NJSR.V8I1.54845","url":null,"abstract":"Background :Fracture of a normal tibia shaft constitutes a major trauma mostly sustained by young adults during high-energy injuries. Its superficial location and the subcutaneous characteristics of its anteromedial aspect easily causes open fracture. The objectives of this study were to determine the pattern of presentation, and determinants of management outcome in open fractures of the tibia. Methods : This is a prospective hospital based study. A total of 89 patients aged 4 to 80 years with open fractures of the tibia with or without fibula involvement were studied. All the patients received anti tetanus prophylaxis and intravenous antibiotics as well as wound irrigation, debridement and skeletal stabilisation. Results : Students and traders accounted for the majority of the cases (57.3%). Most of the open tibia fractures 69 (77.5%) had above knee Plaster of Paris cast. The majority of the cases were Gustilo and Anderson type II 32 (36.0%) cases and type I 22(24.7%) cases. There was Correlation between the presence of wound infection and (i) Gustilo and Anderson grading (F -.352, P .001); (ii) Injury to Debridement time in hours (F -.304, P .004); (iii) Osteomyelitis (F .397, P .001); (iv) Delayed union (F .253, P .017); and (v) Union time in weeks (F -.350, P .001). There was also correlation between the following: (i) Injury to Debridement time in hours and the distance from the accident scene to the hospital (F .464, P .001); (ii) The fracture pattern and the union time in weeks (F .353, P .001); and (iii) The presence of osteomyelities and delayed union (F .382, P .001). The commonest complications observed were wound infection 35(39.3%) patients and delayed union 30(33.7%) patients. Conclusion :This study shows that the higher the Gustilo and Anderson grading of the open fractures of the tibia, the more severe the wound and bone infection that occurred. The interval between injury time and wound debridement time affected the treatment outcome.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77157055","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}
The problems associated with emergency surgery in infants are multifaceted, especially in the presence of inanition and fluid/electrolyte disturbances. These include the high energy requirements of the infant, the delicate physiology of their total blood voume1, and the synergism between inanition and sepsis. This could easily result in a vicious cycle if management is delayed. Therefore careful attention must be paid to patients energy and fluid/electrolyte status, and derangements promptly corrected . The underlying pathology which in this case was ileocolic intussusception should be treated without delay . Cuschieri has described intussusception as the mechanism of a catastrophic vascular accident. It is more than a mere telescoping of a segment of intestine into the adjacent segment. The vascular supply of the inner layers of the intussusception is most liable to be impaired resulting in gangrenous bowel, with its ominous consequences of dehydration, electrolyte disturbances, hypoglycaemia (sirs) and even death if prompt surgical intervention is not initiated.
{"title":"Surgery in refractory metabolic derangements: Report of a case","authors":"A. Anele, F. Thomas, E. Akpo, H. Liman","doi":"10.4314/NJSR.V8I1.54852","DOIUrl":"https://doi.org/10.4314/NJSR.V8I1.54852","url":null,"abstract":"The problems associated with emergency surgery in infants are multifaceted, especially in the presence of inanition and fluid/electrolyte disturbances. These include the high energy requirements of the infant, the delicate physiology of their total blood voume1, and the synergism between inanition and sepsis. This could easily result in a vicious cycle if management is delayed. Therefore careful attention must be paid to patients energy and fluid/electrolyte status, and derangements promptly corrected . The underlying pathology which in this case was ileocolic intussusception should be treated without delay . Cuschieri has described intussusception as the mechanism of a catastrophic vascular accident. It is more than a mere telescoping of a segment of intestine into the adjacent segment. The vascular supply of the inner layers of the intussusception is most liable to be impaired resulting in gangrenous bowel, with its ominous consequences of dehydration, electrolyte disturbances, hypoglycaemia (sirs) and even death if prompt surgical intervention is not initiated.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75242558","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 : 2010-05-28DOI: 10.4314/NJSR.V8I3-4.54874
E. Garba, N. Chom
Background/Objectives : Acute appendicitis is one of the most frequent causes of acute abdomen. The clinical diagnosis is based on the case history and the physical examination. However, in some cases the typical clinical symptoms are equivocal or misleading at which time, making the diagnosis of appendicitis may be considerably difficult. Ultrasound may play a role in this class of patients. This article assesses the accuracy of this adjunctive test at our centre Methods : This is a six-year retrospective study from July 2000 to July 2005 looking at patients that had appendicectomy done at Ahmadu Bello University Teaching Hospital Kaduna Nigeria. We analyzed postoperatively those with histological diagnosis of appendicitis who at the same time had preoperative ultrasound assessment for the main purpose of establishing appendicitis. The final histopathological evaluation was used as the standard to rate the efficacy of ultrasonographic diagnosis of appendicitis. Results : One hundred and forty nine patients 149 were documented. 128 had adequate data for further analysis and only. 78patients (60%) had ultrasound before surgery. The actual diagnostic accuracy of ultrasound in our environment is 24.4%. Conclusions : Ultrasonography routine use in all our patients suspected of having classical appendicitis cannot be advocated at present.
{"title":"Ultrasound in the diagnosis of appendicitis: a plea for caution","authors":"E. Garba, N. Chom","doi":"10.4314/NJSR.V8I3-4.54874","DOIUrl":"https://doi.org/10.4314/NJSR.V8I3-4.54874","url":null,"abstract":"Background/Objectives : Acute appendicitis is one of the most frequent causes of acute abdomen. The clinical diagnosis is based on the case history and the physical examination. However, in some cases the typical clinical symptoms are equivocal or misleading at which time, making the diagnosis of appendicitis may be considerably difficult. Ultrasound may play a role in this class of patients. This article assesses the accuracy of this adjunctive test at our centre Methods : This is a six-year retrospective study from July 2000 to July 2005 looking at patients that had appendicectomy done at Ahmadu Bello University Teaching Hospital Kaduna Nigeria. We analyzed postoperatively those with histological diagnosis of appendicitis who at the same time had preoperative ultrasound assessment for the main purpose of establishing appendicitis. The final histopathological evaluation was used as the standard to rate the efficacy of ultrasonographic diagnosis of appendicitis. Results : One hundred and forty nine patients 149 were documented. 128 had adequate data for further analysis and only. 78patients (60%) had ultrasound before surgery. The actual diagnostic accuracy of ultrasound in our environment is 24.4%. Conclusions : Ultrasonography routine use in all our patients suspected of having classical appendicitis cannot be advocated at present.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74374303","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 : 2010-05-28DOI: 10.4314/NJSR.V8I3-4.54896
I. Mungadi, N. Mbibu
Objectives : This review paper presents the current trends in the evaluation and treatment of anterior urethral strictures. Stricture disease is recorded as one of the oldest afflictions of mankind and even in the millennium; it is the one disease associated with rapid turn over in treatment options and continuous evolution of new options. The stricture is still a significant burden on the urologist workload right from initiation of treatment and follows up. It may be associated with significant morbidity and deteriorating quality of life and may be frustrating to treat. Current trends are to discover a long lasting satisfactory treatment suitable in most cases ‘the gold standard’. Methods A review of current concepts in anatomy and the patho-physiologic mechanisms of the anterior stricture has been done. A structured literature search through a MEDLINE search was performed. New urethral substitutes have been compared to other techniques of urethroplasty as seen over the. last decade. Expert surgical consensus and opinion have been reviewed. Results The anterior urethral stricture is a consequence of major peri-urethral fibrosis and may be very complex if the inflammation is complicated or prolonged. It can be satisfactorily assessed by routine retrograde urethrography and endoscopic assessment for type and complexity. The urethral ultrasound appears to provide more information about the extent of fibrosis and the length of strictures. In review of recent experience, it has proven to be accurate convenient and a cheap complement to already established studies. Oral mucosa, rectal mucosa, bladder mucosa , dermal grafts, tunica vaginalis, tissue culture and synthetic polymers have all been applied over the last decade in the search for the suitable urethral substitute. The bucccal mucosa is outstanding among several options in the repair of the diseased anterior urethra as popularized by Barbagli. It appears to provide the solution for most situations in the anterior urethral stricture.. Conclusions : The Bucccal mucosal graft(BMG) may as well be the new ‘gold standard' in the management of anterior urethral stricture .
{"title":"Current concepts in the management of anterior urethral strictures","authors":"I. Mungadi, N. Mbibu","doi":"10.4314/NJSR.V8I3-4.54896","DOIUrl":"https://doi.org/10.4314/NJSR.V8I3-4.54896","url":null,"abstract":"Objectives : This review paper presents the current trends in the evaluation and treatment of anterior urethral strictures. Stricture disease is recorded as one of the oldest afflictions of mankind and even in the millennium; it is the one disease associated with rapid turn over in treatment options and continuous evolution of new options. The stricture is still a significant burden on the urologist workload right from initiation of treatment and follows up. It may be associated with significant morbidity and deteriorating quality of life and may be frustrating to treat. Current trends are to discover a long lasting satisfactory treatment suitable in most cases ‘the gold standard’. Methods A review of current concepts in anatomy and the patho-physiologic mechanisms of the anterior stricture has been done. A structured literature search through a MEDLINE search was performed. New urethral substitutes have been compared to other techniques of urethroplasty as seen over the. last decade. Expert surgical consensus and opinion have been reviewed. Results The anterior urethral stricture is a consequence of major peri-urethral fibrosis and may be very complex if the inflammation is complicated or prolonged. It can be satisfactorily assessed by routine retrograde urethrography and endoscopic assessment for type and complexity. The urethral ultrasound appears to provide more information about the extent of fibrosis and the length of strictures. In review of recent experience, it has proven to be accurate convenient and a cheap complement to already established studies. Oral mucosa, rectal mucosa, bladder mucosa , dermal grafts, tunica vaginalis, tissue culture and synthetic polymers have all been applied over the last decade in the search for the suitable urethral substitute. The bucccal mucosa is outstanding among several options in the repair of the diseased anterior urethra as popularized by Barbagli. It appears to provide the solution for most situations in the anterior urethral stricture.. Conclusions : The Bucccal mucosal graft(BMG) may as well be the new ‘gold standard' in the management of anterior urethral stricture .","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81751924","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}
Background :The free graft of the nipple-areolar complex is almost like a “composite” graft. This is because the skin of the areola and especially the nipple are usually thicker than the case is in the usual full-thickness skin grafts (FTSG). In traditional breast reductions, the nipple-areolar complex is located to its new position by means of pedicle flaps. This, of course, enhances the proper healing of the nipple-areolar complex (NAC). However, in the case of gigantic breast hypertrophies, it is often not possible to carry the NAC on the long pedicle flap. The NAC is therefore grafted as a free graft. Very often these grafts get infected or simple become necrotic and part or whole of them may be lost. Material and methods :Fifteen Free Graft NAC were done for 8 patients in 5 years 1997-2001 .. The results are analysed. Results Out of fifteen (15) free grafted NAC for eight (8) patients the following results were achieved: The factors underlying the total or partial loss of this composite graft may be numerous and are critically analyzed in this paper.
{"title":"Nipple-areolar complex (nac) composite grafts in the Management of macromastia: Review of complications","authors":"P. Agbenorku","doi":"10.4314/NJSR.V8I1.54842","DOIUrl":"https://doi.org/10.4314/NJSR.V8I1.54842","url":null,"abstract":"Background :The free graft of the nipple-areolar complex is almost like a “composite” graft. This is because the skin of the areola and especially the nipple are usually thicker than the case is in the usual full-thickness skin grafts (FTSG). In traditional breast reductions, the nipple-areolar complex is located to its new position by means of pedicle flaps. This, of course, enhances the proper healing of the nipple-areolar complex (NAC). However, in the case of gigantic breast hypertrophies, it is often not possible to carry the NAC on the long pedicle flap. The NAC is therefore grafted as a free graft. Very often these grafts get infected or simple become necrotic and part or whole of them may be lost. Material and methods :Fifteen Free Graft NAC were done for 8 patients in 5 years 1997-2001 .. The results are analysed. Results Out of fifteen (15) free grafted NAC for eight (8) patients the following results were achieved: The factors underlying the total or partial loss of this composite graft may be numerous and are critically analyzed in this paper.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88728835","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}
{"title":"Poland’s syndrome: an incidental finding on routine medical examination","authors":"A. Hamidu, A. Musa, M. Tahir","doi":"10.4314/NJSR.V8I1.54859","DOIUrl":"https://doi.org/10.4314/NJSR.V8I1.54859","url":null,"abstract":"","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80319405","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 : 2010-05-28DOI: 10.4314/NJSR.V8I3-4.54866
M. Ohene-Yeboah
Objectives : To determine the frequency of breast cancer in patients presenting with bloody nipple discharge at the Komfo Anokye Teaching Hospital Breast Care Centre (KATH –BCC) Kumasi. Setting : Komfo Anokye Teaching Hospital Breast Care Centre (KATH –BCC) Kumasi. Materials and Methods : All patients reporting to the centre for the assessment and treatment of a bloody nipple discharge. The age of the patients, the duration of the discharge, whether the discharge was spontaneous or provoked and whether it was unilateral or bilateral, a single or multiple duct discharge and the presence of a lump. The mammographic findings and the histology of the excised ducts or lump were also recorded. Results :. The most common age group affected was 35-44 years (56.7 %). A palpable mass was detected in 25 women or (20.8%). Mammographic abnormalities were found in 15 (12.5%) of the women. In 80 patients (66.7%) there were no palpable masses or abnormal mammographic findings. Of the 120 patients carcinoma (CA) was found in 31(25.8%),, duct papilloma (DP) was the cause of the bleeding in 80(66.7%), duct ectasia (DE) in 7(5.8%) and fibrocystic breast changes (FBC) in 2 (1.7%). Of the 80 patients with bleeding only and no palpable mass or abnormal mammogram, DP was the cause in 73 (91.3%), CA in 2 (2.5 %) and DE in 5 (6.1%). In bleeding with associated palpable mass, DP was the cause in 3 (12%), CA in19 (76.0 %), DE in 1(4%) and FBC in 2 (8%). Of the 31 cases of carcinoma, 19 (61.5%) had a palpable mass, 10 (29.0%) had an abnormal mammogram and 2 (6.5%) only a bloody discharge. Conclusion : This paper concludes that carcinoma of the breast is found in one out of four women attending the Komfo Anokye Teaching Hospital Breast Care Centre (KATH –BCC.) with a bloody nipple discharge. The evaluation of these patients must always include the excision of the discharging ducts for histopathologic examination.
{"title":"The incidence of cancer in women presenting with bloody nipple discharge at a specialist breast clinic","authors":"M. Ohene-Yeboah","doi":"10.4314/NJSR.V8I3-4.54866","DOIUrl":"https://doi.org/10.4314/NJSR.V8I3-4.54866","url":null,"abstract":"Objectives : To determine the frequency of breast cancer in patients presenting with bloody nipple discharge at the Komfo Anokye Teaching Hospital Breast Care Centre (KATH –BCC) Kumasi. Setting : Komfo Anokye Teaching Hospital Breast Care Centre (KATH –BCC) Kumasi. Materials and Methods : All patients reporting to the centre for the assessment and treatment of a bloody nipple discharge. The age of the patients, the duration of the discharge, whether the discharge was spontaneous or provoked and whether it was unilateral or bilateral, a single or multiple duct discharge and the presence of a lump. The mammographic findings and the histology of the excised ducts or lump were also recorded. Results :. The most common age group affected was 35-44 years (56.7 %). A palpable mass was detected in 25 women or (20.8%). Mammographic abnormalities were found in 15 (12.5%) of the women. In 80 patients (66.7%) there were no palpable masses or abnormal mammographic findings. Of the 120 patients carcinoma (CA) was found in 31(25.8%),, duct papilloma (DP) was the cause of the bleeding in 80(66.7%), duct ectasia (DE) in 7(5.8%) and fibrocystic breast changes (FBC) in 2 (1.7%). Of the 80 patients with bleeding only and no palpable mass or abnormal mammogram, DP was the cause in 73 (91.3%), CA in 2 (2.5 %) and DE in 5 (6.1%). In bleeding with associated palpable mass, DP was the cause in 3 (12%), CA in19 (76.0 %), DE in 1(4%) and FBC in 2 (8%). Of the 31 cases of carcinoma, 19 (61.5%) had a palpable mass, 10 (29.0%) had an abnormal mammogram and 2 (6.5%) only a bloody discharge. Conclusion : This paper concludes that carcinoma of the breast is found in one out of four women attending the Komfo Anokye Teaching Hospital Breast Care Centre (KATH –BCC.) with a bloody nipple discharge. The evaluation of these patients must always include the excision of the discharging ducts for histopathologic examination.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82253488","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 : 2010-05-28DOI: 10.4314/njsr.v8i3-4.54872
S. Adewuyi, N. Chom, M. Humera, M. Samaila
Objectives :: To evaluate the pattern of skeletal metastases from breast carcinoma in an Asian population. To study the radiological pattern and distribution of bone metastases from breast cancer . Background : Breast cancer is a disease that is prevalent world wide and frequently metastasis to the bones . Bone metastasis is associated with increase morbidity and poor quality of life in breast cancer patients. Prompt identification and treatment is the best way of improving the patients’ quality of life. Skeletal x-rays and bones scan of relevant bones should be part of staging investigations and metastatic survey in breast cancer. Methods : This study was prospective, non-randomized, and single institution based. A total of 30 consecutive patients having bone pains with radiological evidence of bone metastases were included. Questionnaire was designed for the collection of patients’ data for evaluation, which was then entered on database and analyzed on the Statistical Package for Social Sciences (SPSS). Patient were staged using TNM Classification. Results : The radiological pattern was Osteolytic in (28) 93.3% and mixed pattern (osteolytic & osteoblastic) in (2)6.7%. The commonest site of bone metastases was Lumbar spine (51.5%) followed by the Thoracic spine (21.6%). There was involvement of multiple, non-contiguous skeletal bones in(7)23.3% of the patients. Majority of the patients were stage III (56.6%) at first presentation. At presentation (6) 20% had painful bone metastases and 16.7% developed painful bone metastases within 12 months, 30.0% from 12 to 24 months, and 33.3% after 24 months of diagnosing breast cancer. 20.0% of patients had painful bone metastases for Conclusion : The predominant x-ray finding in bone metastases from breast cancer was osteolytic and the Lumbar spine was the commonest site of involvement . Involvement of Multiple bones in 25% of the patients suggest widespread search in a staging protocol.
{"title":"Pattern of skeletal metastases from breast cancer in an Asian population","authors":"S. Adewuyi, N. Chom, M. Humera, M. Samaila","doi":"10.4314/njsr.v8i3-4.54872","DOIUrl":"https://doi.org/10.4314/njsr.v8i3-4.54872","url":null,"abstract":"Objectives :: To evaluate the pattern of skeletal metastases from breast carcinoma in an Asian population. To study the radiological pattern and distribution of bone metastases from breast cancer . Background : Breast cancer is a disease that is prevalent world wide and frequently metastasis to the bones . Bone metastasis is associated with increase morbidity and poor quality of life in breast cancer patients. Prompt identification and treatment is the best way of improving the patients’ quality of life. Skeletal x-rays and bones scan of relevant bones should be part of staging investigations and metastatic survey in breast cancer. Methods : This study was prospective, non-randomized, and single institution based. A total of 30 consecutive patients having bone pains with radiological evidence of bone metastases were included. Questionnaire was designed for the collection of patients’ data for evaluation, which was then entered on database and analyzed on the Statistical Package for Social Sciences (SPSS). Patient were staged using TNM Classification. Results : The radiological pattern was Osteolytic in (28) 93.3% and mixed pattern (osteolytic & osteoblastic) in (2)6.7%. The commonest site of bone metastases was Lumbar spine (51.5%) followed by the Thoracic spine (21.6%). There was involvement of multiple, non-contiguous skeletal bones in(7)23.3% of the patients. Majority of the patients were stage III (56.6%) at first presentation. At presentation (6) 20% had painful bone metastases and 16.7% developed painful bone metastases within 12 months, 30.0% from 12 to 24 months, and 33.3% after 24 months of diagnosing breast cancer. 20.0% of patients had painful bone metastases for Conclusion : The predominant x-ray finding in bone metastases from breast cancer was osteolytic and the Lumbar spine was the commonest site of involvement . Involvement of Multiple bones in 25% of the patients suggest widespread search in a staging protocol.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78137934","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}
Background : While most cases of Hirschsprung’s disease are diagnosed during the neonatal period in developed countries, majority of the cases present outside the neonatal period in developing countries. We reviewed our experience with Hirschsprung’s disease presenting during the neonatal period to document the presentation and management. Patients/Methods : A retrospective analysis of the presentation and management of 31 neonates with Hirschsprung’s disease over a nine year period in a Tertiary pediatric surgical centre in Nigeria was performed. Results : From January 1996 – December 2004, 78 children were managed for Hirschsprung’s disease in our unit. Thirty-one (39.7%) were aged 30 days or below. The median age at presentation was eight days (range 2-30 days). There were 23 boys and 8 girls. The median weight at presentation was 2.8kg (range 2.3 – 4.5kg). Fifteen weighed presented with enterocolitis while in five there was delayed passage of meconium and recurrent constipation. Barium enema was done in 25 and rectal biopsy confirmed diagnosis in 29 babies. In two babies with total colonic aganglionosis (TCA), diagnosis was confirmed by colonic biopsy at laparotomy. Twenty nine had right transverse loop colostomy in the neonatal period; four were under local anesthesia, while the two children with TCA had ileostomy. Four children died before definitive surgery, two with TCA and two with enterocolitis. None had primary pull-through. Two children were lost to follow up after colostomy formation. Twenty two had definitive surgery between the ages of three months and five years. Fifteen had Boley’s endorectal pull-through with a single mortality; while seven had Swenson’s pull-through, one of whom died. Conclusion : Few cases of Hirschsprung’s disease present during the neonatal period in our environment, many presenting with intestinal obstruction. A high index of suspicion is needed for the early diagnosis of Hirschsprung’s disease in environment with limited diagnostic facilities.
{"title":"Hirschsprung’s disease presenting in the neonatal period in Jos,Nigeria","authors":"L. Chirdan, A. Uba","doi":"10.4314/NJSR.V8I1.54825","DOIUrl":"https://doi.org/10.4314/NJSR.V8I1.54825","url":null,"abstract":"Background : While most cases of Hirschsprung’s disease are diagnosed during the neonatal period in developed countries, majority of the cases present outside the neonatal period in developing countries. We reviewed our experience with Hirschsprung’s disease presenting during the neonatal period to document the presentation and management. Patients/Methods : A retrospective analysis of the presentation and management of 31 neonates with Hirschsprung’s disease over a nine year period in a Tertiary pediatric surgical centre in Nigeria was performed. Results : From January 1996 – December 2004, 78 children were managed for Hirschsprung’s disease in our unit. Thirty-one (39.7%) were aged 30 days or below. The median age at presentation was eight days (range 2-30 days). There were 23 boys and 8 girls. The median weight at presentation was 2.8kg (range 2.3 – 4.5kg). Fifteen weighed presented with enterocolitis while in five there was delayed passage of meconium and recurrent constipation. Barium enema was done in 25 and rectal biopsy confirmed diagnosis in 29 babies. In two babies with total colonic aganglionosis (TCA), diagnosis was confirmed by colonic biopsy at laparotomy. Twenty nine had right transverse loop colostomy in the neonatal period; four were under local anesthesia, while the two children with TCA had ileostomy. Four children died before definitive surgery, two with TCA and two with enterocolitis. None had primary pull-through. Two children were lost to follow up after colostomy formation. Twenty two had definitive surgery between the ages of three months and five years. Fifteen had Boley’s endorectal pull-through with a single mortality; while seven had Swenson’s pull-through, one of whom died. Conclusion : Few cases of Hirschsprung’s disease present during the neonatal period in our environment, many presenting with intestinal obstruction. A high index of suspicion is needed for the early diagnosis of Hirschsprung’s disease in environment with limited diagnostic facilities.","PeriodicalId":19188,"journal":{"name":"Nigerian Journal of Surgical Research","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89378698","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}
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