Postoperative perineal hernia (PerH) following abdominoperineal resection is a rare complication of radical pelvic oncologic surgery performed with curative intent for rectal cancer, with a reported prevalence of 0.6–7%. PerH is clinically diagnosed as an occurrence of a swelling in the perineum caused by the herniation of abdominal or pelvic viscera through a defect in the pelvic floor. The definitive repair method of pelvic floor defect of PerH is not established but includes exclusion of tumor recurrence and repair of pelvic floor defect. We herein report the treatment of a PerH using a combination of biological mesh and a V-Y gluteal fascio-cutaneous advancement flap, performed at Tata Memorial Hospital, in Parel, Mumbai, India.
{"title":"Perineal Repair of a Postoperative Perineal Hernia – Case Report","authors":"S. Kazuma, Kazi Mufaddal, V. Sukumar, A. Saklani","doi":"10.4314/aas.v19i2.9","DOIUrl":"https://doi.org/10.4314/aas.v19i2.9","url":null,"abstract":"Postoperative perineal hernia (PerH) following abdominoperineal resection is a rare complication of radical pelvic oncologic surgery performed with curative intent for rectal cancer, with a reported prevalence of 0.6–7%. PerH is clinically diagnosed as an occurrence of a swelling in the perineum caused by the herniation of abdominal or pelvic viscera through a defect in the pelvic floor. The definitive repair method of pelvic floor defect of PerH is not established but includes exclusion of tumor recurrence and repair of pelvic floor defect. We herein report the treatment of a PerH using a combination of biological mesh and a V-Y gluteal fascio-cutaneous advancement flap, performed at Tata Memorial Hospital, in Parel, Mumbai, India.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82207973","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}
A. Kenneth, K. Stanley, N. Ferdinand, Ikol James, Were Andrew, Gathariki Mukami, Ajujo Martin, Alungo Nang’andu
Penile replantation is uncommon, with most data being case reports or case series. In our setting, replantation is fairly new despite penile amputations being common as a result of marital disputes and assault. Replantation remains the most ideal option for managing these cases. We present a case of penile replantation in a 17-year-old male after traumatic amputation following an assault. Some of the challenges we encountered included loss of skin and the glans with formation of a hypospadias. Nevertheless, the outcome was satisfactory with return of sensation and erection.
{"title":"Microsurgical Penile Replantation: Case Report","authors":"A. Kenneth, K. Stanley, N. Ferdinand, Ikol James, Were Andrew, Gathariki Mukami, Ajujo Martin, Alungo Nang’andu","doi":"10.4314/aas.v19i2.12","DOIUrl":"https://doi.org/10.4314/aas.v19i2.12","url":null,"abstract":"Penile replantation is uncommon, with most data being case reports or case series. In our setting, replantation is fairly new despite penile amputations being common as a result of marital disputes and assault. Replantation remains the most ideal option for managing these cases. We present a case of penile replantation in a 17-year-old male after traumatic amputation following an assault. Some of the challenges we encountered included loss of skin and the glans with formation of a hypospadias. Nevertheless, the outcome was satisfactory with return of sensation and erection.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80153674","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}
I. Ongidi, T. Amuti, Joseph Mageto, Nick Dennis, I. Ouko, Rebecca Murerwa, B. Olabu, J. Ogeng’o
Background: The fifth lumbar arteries have a more variable presence and origin as compared to the first four arteries. Its anatomical variations may influence lower spine surgical and vascular interventions. Aim: Our objective was to determine the variations of the fifth lumbar artery in a cadaveric and contrast computed tomography (CT) study. Materials and methods: This descriptive cross-sectional study combined data from 90 cadaveric and 120 post-contrast abdomino-pelvic computed tomography (CT) from Human Anatomy Department, University–of-Nairobi and Radiology Department, Kenyatta-National-Hospital. Cadavers were dissected to expose the arteries. Their prevalence, patterns and position of origin on the 5th vertebral bodies were determined. Data were analyzed using SPSS. Results: The artery was present in 26.7% of the cadaveric group, and 16.7% of the CT group. It was only noted in males in both the cadaveric and CT groups. It originated bilaterally as a common stem in 50% and as paired single branches in 50%. It originated at a mean distance of 9.03mm ± 7.23mm from the top of the L5 vertebra, maintaining a consistent relation to the upper third (90%) and the middle third (10%) of the body. Conclusions: The arteries were only noted in males and portrayed population specific variations.
{"title":"Anatomical Variations of The Fifth Lumbar Artery in A Sample Kenyan Population","authors":"I. Ongidi, T. Amuti, Joseph Mageto, Nick Dennis, I. Ouko, Rebecca Murerwa, B. Olabu, J. Ogeng’o","doi":"10.4314/aas.v19i2.7","DOIUrl":"https://doi.org/10.4314/aas.v19i2.7","url":null,"abstract":"Background: The fifth lumbar arteries have a more variable presence and origin as compared to the first four arteries. Its anatomical variations may influence lower spine surgical and vascular interventions. \u0000Aim: Our objective was to determine the variations of the fifth lumbar artery in a cadaveric and contrast computed tomography (CT) study. \u0000Materials and methods: This descriptive cross-sectional study combined data from 90 cadaveric and 120 post-contrast abdomino-pelvic computed tomography (CT) from Human Anatomy Department, University–of-Nairobi and Radiology Department, Kenyatta-National-Hospital. Cadavers were dissected to expose the arteries. Their prevalence, patterns and position of origin on the 5th vertebral bodies were determined. Data were analyzed using SPSS. \u0000Results: The artery was present in 26.7% of the cadaveric group, and 16.7% of the CT group. It was only noted in males in both the cadaveric and CT groups. It originated bilaterally as a common stem in 50% and as paired single branches in 50%. It originated at a mean distance of 9.03mm ± 7.23mm from the top of the L5 vertebra, maintaining a consistent relation to the upper third (90%) and the middle third (10%) of the body. \u0000Conclusions: The arteries were only noted in males and portrayed population specific variations.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82439475","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}
Mariah Obino, Edward Ng’ang’a Chege, S. Vinayak, Samuel Gitau Nguk
Background: Traditionally, the diagnosis of prostate cancer was based on increased prostate-specific antigen level or an abnormal digital rectal examination and confirmed histologically following biopsy. Consequently, a proportion of men without cancer or with clinically insignificant disease undergo unwarranted prostate biopsies and experience resultant complications. Pre-biopsy multiparametric magnetic resonance imaging (MP-MRI) is vital in determining those with clinically significant cancer who need biopsy and those with a negative MRI who can safely avoid unnecessary biopsy. Methods: The diagnostic accuracy of MP-MRI using transrectal ultrasound-guided biopsy as the reference test was established for 133 men who had undergone MRI and biopsy. The MRI images were reviewed and reported by two independent consultant radiologists. Clinically significant cancer was defined as Prostate Imaging Reporting and Data System score ≥3 on multiparametric MRI and Gleason score ≥3 + 4 (grade group ≥2) on histology. Results: MP-MRI of the prostate was found to have 92% sensitivity, 47.8% specificity, 86.8% negative predictive value (NPV) and 62% positive predictive value for the diagnosis of prostate cancer. Conclusion: MP-MRI has a high sensitivity and a high NPV, validating its use in pre-biopsy evaluation of men at risk of prostate cancer to safely avoid unnecessary prostate biopsy and to guide biopsy of suspicious lesions.
{"title":"Utility of Multiparametric Magnetic Resonance Imaging as a Predictor of Clinically Significant Prostate Cancer in a Sub-Saharan African Population","authors":"Mariah Obino, Edward Ng’ang’a Chege, S. Vinayak, Samuel Gitau Nguk","doi":"10.4314/aas.v19i2.8","DOIUrl":"https://doi.org/10.4314/aas.v19i2.8","url":null,"abstract":"Background: Traditionally, the diagnosis of prostate cancer was based on increased prostate-specific antigen level or an abnormal digital rectal examination and confirmed histologically following biopsy. Consequently, a proportion of men without cancer or with clinically insignificant disease undergo unwarranted prostate biopsies and experience resultant complications. Pre-biopsy multiparametric magnetic resonance imaging (MP-MRI) is vital in determining those with clinically significant cancer who need biopsy and those with a negative MRI who can safely avoid unnecessary biopsy. \u0000Methods: The diagnostic accuracy of MP-MRI using transrectal ultrasound-guided biopsy as the reference test was established for 133 men who had undergone MRI and biopsy. The MRI images were reviewed and reported by two independent consultant radiologists. Clinically significant cancer was defined as Prostate Imaging Reporting and Data System score ≥3 on multiparametric MRI and Gleason score ≥3 + 4 (grade group ≥2) on histology. \u0000Results: MP-MRI of the prostate was found to have 92% sensitivity, 47.8% specificity, 86.8% negative predictive value (NPV) and 62% positive predictive value for the diagnosis of prostate cancer. \u0000Conclusion: MP-MRI has a high sensitivity and a high NPV, validating its use in pre-biopsy evaluation of men at risk of prostate cancer to safely avoid unnecessary prostate biopsy and to guide biopsy of suspicious lesions.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80577772","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}
N. Kavitha, Noor Azura Noor Mohamad, N. Kampan, M. Shafiee
Bone metastasis from endometrial cancer is rare. Most of the early stage endometrial cancers with endometrioid histology are confined to the uterus at the time of diagnosis and confer a good prognosis. Endometrial metastases to the bone are generally restricted to the axial skeleton, including the pelvis and thoracolumbar vertebrae. Skeletal metastases in the appendicular skeleton such as scapula, clavicle and extremities to tibia, and tarsus are rarely reported. We present the case of a 50-year-old woman with diagnosis of endometrioid adenocarcinoma of the endometrium, FIGO stage IB, grade 2, with lympho-vascular space invasion who developed recurrence within 10 months with bone metastasis to left scapula and extraosseous soft tissue mass over left shoulder. There are very few cases reported in literature of scapular metastases in an early-stage endometrial carcinoma. We discuss evaluation, treatment options, overall survival rates and provide a literature review of prior published reports.
{"title":"A Rare Presentation of Endometrial Cancer recurrence with Scapular metastasis: A Case Report and Review of the Literature","authors":"N. Kavitha, Noor Azura Noor Mohamad, N. Kampan, M. Shafiee","doi":"10.4314/aas.v19i2.11","DOIUrl":"https://doi.org/10.4314/aas.v19i2.11","url":null,"abstract":"Bone metastasis from endometrial cancer is rare. Most of the early stage endometrial cancers with endometrioid histology are confined to the uterus at the time of diagnosis and confer a good prognosis. Endometrial metastases to the bone are generally restricted to the axial skeleton, including the pelvis and thoracolumbar vertebrae. Skeletal metastases in the appendicular skeleton such as scapula, clavicle and extremities to tibia, and tarsus are rarely reported. We present the case of a 50-year-old woman with diagnosis of endometrioid adenocarcinoma of the endometrium, FIGO stage IB, grade 2, with lympho-vascular space invasion who developed recurrence within 10 months with bone metastasis to left scapula and extraosseous soft tissue mass over left shoulder. There are very few cases reported in literature of scapular metastases in an early-stage endometrial carcinoma. We discuss evaluation, treatment options, overall survival rates and provide a literature review of prior published reports.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80990336","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}
Cranial-entry high-voltage electrical burn injury rarely occurs. Hence, early presentation is rare. We herein present a case of a teenage male with mainly fullthickness electrical burn injury covering 9% of the total body surface area, with gangrenous mid-fronto-parietal scalp and calvarium, moderate head injury with bihemispheric deficits, and left frontoparietotemporal intracerebral hematoma and exit wounds (right thumb, thigh, and toes). He underwent initial outer-strip and, later, inner-strip corticectomy, covered with splitthickness skin graft (STSG) and bilateral posteriorauricular artery-based flap, respectively, as well as tangential burn wound excisions with STSG and louvre flap cover for the digits. He also underwent right upper eyelid contracture release and tarsorrhaphy. He developed late post-traumatic seizures, which were managed with anti-epileptic drugs. Definitive calvarial reconstruction is underway. Cranial-entry electrical injury had high morbidity and mortality risks. The spectrum of nervous damage causation mimics nervous syndromes and their presentations. Although elaborate surgical and medical care offers the possibility of survival, the neurological and neuropsychological syndromes in the post-acute and rehabilitative phases of care should be taken care of.
{"title":"Cranial-entry electrical burns with neurological sequelae: A case report","authors":"Promise Jaja, A. Michael","doi":"10.4314/aas.v18i4.11","DOIUrl":"https://doi.org/10.4314/aas.v18i4.11","url":null,"abstract":"Cranial-entry high-voltage electrical burn injury rarely occurs. Hence, early presentation is rare. We herein present a case of a teenage male with mainly fullthickness electrical burn injury covering 9% of the total body surface area, with gangrenous mid-fronto-parietal scalp and calvarium, moderate head injury with bihemispheric deficits, and left frontoparietotemporal intracerebral hematoma and exit wounds (right thumb, thigh, and toes). He underwent initial outer-strip and, later, inner-strip corticectomy, covered with splitthickness skin graft (STSG) and bilateral posteriorauricular artery-based flap, respectively, as well as tangential burn wound excisions with STSG and louvre flap cover for the digits. He also underwent right upper eyelid contracture release and tarsorrhaphy. He developed late post-traumatic seizures, which were managed with anti-epileptic drugs. Definitive calvarial reconstruction is underway. Cranial-entry electrical injury had high morbidity and mortality risks. The spectrum of nervous damage causation mimics nervous syndromes and their presentations. Although elaborate surgical and medical care offers the possibility of survival, the neurological and neuropsychological syndromes in the post-acute and rehabilitative phases of care should be taken care of.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78748114","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}
Nilesh B. Patil, P. Das, Kalyan Panday, K. Goutam, B. Satpathy
Background: Early breast cancer with clinical or radiological node-negative axilla is treated with breast conservation surgery where lumpectomy with axillary dissection is done. Sentinel lymph node biopsy (SLNB) is an acceptable alternative to axillary clearance and has relatively lesser morbidity. SLNB methods include radioisotope (RI)-guided, blue dye-guided, or a combination of both. However, access to RI can be limited in certain geographic locations. Objective: This study aimed to determine the effectivity of methylene blue (MB) dye-guided SLNB as an alternative to RI. Methods: In this investigation, 43 clinically nodenegative early breast cancer patients were prospectively enrolled. SLNB was performed using MB dye (1%) administered to the peritumoral or periareolar region. The histopathology reports of the harvested nodes were studied, and the results were computed using SPSS and 2×2 contingency table. Results: The sensitivity, specificity, false-negative rate (FNR), and accuracy of MB-guided SLNB in our study were 92.8%, 100%, 7.14%, and 97.7%, respectively. Conclusion: The use of MB dye along with intraoperative palpation after meticulous lymph node dissection in each level is more effective and has lower FNR than RI.
{"title":"Sentinel lymph node biopsy using methylene blue dye and intraoperative palpation method in node-negative early breast cancer","authors":"Nilesh B. Patil, P. Das, Kalyan Panday, K. Goutam, B. Satpathy","doi":"10.4314/aas.v18i4.4","DOIUrl":"https://doi.org/10.4314/aas.v18i4.4","url":null,"abstract":"Background: Early breast cancer with clinical or radiological node-negative axilla is treated with breast conservation surgery where lumpectomy with axillary dissection is done. Sentinel lymph node biopsy (SLNB) is an acceptable alternative to axillary clearance and has relatively lesser morbidity. SLNB methods include radioisotope (RI)-guided, blue dye-guided, or a combination of both. However, access to RI can be limited in certain geographic locations. Objective: This study aimed to determine the effectivity of methylene blue (MB) dye-guided SLNB as an alternative to RI. Methods: In this investigation, 43 clinically nodenegative early breast cancer patients were prospectively enrolled. SLNB was performed using MB dye (1%) administered to the peritumoral or periareolar region. The histopathology reports of the harvested nodes were studied, and the results were computed using SPSS and 2×2 contingency table. Results: The sensitivity, specificity, false-negative rate (FNR), and accuracy of MB-guided SLNB in our study were 92.8%, 100%, 7.14%, and 97.7%, respectively. Conclusion: The use of MB dye along with intraoperative palpation after meticulous lymph node dissection in each level is more effective and has lower FNR than RI.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73937505","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}
M. Abass, Yassir Altahir Abdullah, Elssayed Osman Elssayed., Abdelrahman Babekir Mhammed, Mohamed Saeed Alfaki
Background: Acute appendicitis is the most common cause of the acute abdomen; thus, appendectomy is part of most daily emergency surgical duties. It is conducted through either open or laparoscopic approach. Methods: A prospective hospital-based study compared the clinical outcomes of open versus laparoscopic appendectomy for patients with acute appendicitis in El-Mek Nimir University Hospital, Sudan. Results: A total of 550 cases of acute appendicitis were studied, of which 328 (59.6%) underwent open appendectomy surgery and 222 (39.4%) underwent laparoscopic appendectomy. The majority of the study’s population was female.Laparoscopic appendectomy generally involved a longer operation time than open appendectomy (mean duration, 42.4±12.5 vs. 29±16 minutes), lesser incidence of severe pain postoperatively (3% vs. 11%; p=0.000), shorter hospital stay (i.e., <24 hours; 96% vs.77%; p=0.000), and a higher rate of patient return to normal activities within 1 week (92% vs.15%; p=0.000). Differences in the occurrence of bleeding, wound infection, or intra-abdominal septic collection were not statistically significant. Conclusion: Both open and laparoscopic appendectomy procedures are safe for the management of acute appendicitis; however, laparoscopic appendectomy is associated with fewer complications and a faster recovery.
{"title":"Clinical outcomes of laparoscopic versus open appendectomy for acute appendicitis in a resource-limited setting","authors":"M. Abass, Yassir Altahir Abdullah, Elssayed Osman Elssayed., Abdelrahman Babekir Mhammed, Mohamed Saeed Alfaki","doi":"10.4314/aas.v18i4.7","DOIUrl":"https://doi.org/10.4314/aas.v18i4.7","url":null,"abstract":"Background: Acute appendicitis is the most common cause of the acute abdomen; thus, appendectomy is part of most daily emergency surgical duties. It is conducted through either open or laparoscopic approach. Methods: A prospective hospital-based study compared the clinical outcomes of open versus laparoscopic appendectomy for patients with acute appendicitis in El-Mek Nimir University Hospital, Sudan. Results: A total of 550 cases of acute appendicitis were studied, of which 328 (59.6%) underwent open appendectomy surgery and 222 (39.4%) underwent laparoscopic appendectomy. The majority of the study’s population was female.Laparoscopic appendectomy generally involved a longer operation time than open appendectomy (mean duration, 42.4±12.5 vs. 29±16 minutes), lesser incidence of severe pain postoperatively (3% vs. 11%; p=0.000), shorter hospital stay (i.e., <24 hours; 96% vs.77%; p=0.000), and a higher rate of patient return to normal activities within 1 week (92% vs.15%; p=0.000). Differences in the occurrence of bleeding, wound infection, or intra-abdominal septic collection were not statistically significant. Conclusion: Both open and laparoscopic appendectomy procedures are safe for the management of acute appendicitis; however, laparoscopic appendectomy is associated with fewer complications and a faster recovery.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81043996","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}
H. Tesfamariam, P. Ekanem, Birhane Alem, Anne C K Nyaga
Background: The aortic arch (AA) is a key anatomical vascular structure through which blood is distributed to the body’s organs. Knowledge of its branching patterns is important for surgical procedures. This study aimed to describe anatomical variations in the branching patterns of human AAs in patients who underwent chest contrastenhanced computed tomography. Methods: A retrospective study involving 630 chest contrastenhanced computed tomography scans from July 2018 to July 2019 was carried out at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. These images were reviewed for AA branching patterns and classified accordingly. Data were analyzed using SPSS version 21. Results: Of the 630 patients (364 males and 266 females), AA branching pattern variations were found in 35.2%: type II, 26%; type III, 6.5%; type V, 2.7%; the rest, 64.8%, had a normal (type I) AA branching pattern. The left vertebral artery and the aberrant right subclavian artery were also observed to originate directly from the AA. Conclusions: AA branching pattern variation types II, III, and V were found in our study. These findings could be vital during aortic instrumentation and surgical procedures of the head and neck in Ethiopia and globally.
背景:主动脉弓(AA)是一个重要的解剖血管结构，血液通过它被分配到身体的器官。了解其分支模式对外科手术很重要。本研究旨在描述在接受胸部增强计算机断层扫描的患者中人类AAs分支模式的解剖学变化。方法:回顾性研究包括2018年7月至2019年7月在埃塞俄比亚Mekelle的Ayder综合专科医院进行的630例胸部对比增强计算机断层扫描。对这些图像的AA分支模式进行审查并进行分类。数据采用SPSS version 21进行分析。结果:630例患者(男364例，女266例)中，AA分支型变异占35.2%，II型占26%;III型，6.5%;V型，2.7%;其余64.8%为正常(I型)AA分支型。左椎动脉和异常的右锁骨下动脉也被观察到直接起源于AA。结论:在我们的研究中发现了AA分支模式变异类型II、III和V。这些发现在埃塞俄比亚和全球的头颈部主动脉置入和外科手术过程中可能是至关重要的。
{"title":"Anatomical branching patterns of the aortic arch in Ethiopia: An imaging-based study","authors":"H. Tesfamariam, P. Ekanem, Birhane Alem, Anne C K Nyaga","doi":"10.4314/aas.v18i4.9","DOIUrl":"https://doi.org/10.4314/aas.v18i4.9","url":null,"abstract":"Background: The aortic arch (AA) is a key anatomical vascular structure through which blood is distributed to the body’s organs. Knowledge of its branching patterns is important for surgical procedures. This study aimed to describe anatomical variations in the branching patterns of human AAs in patients who underwent chest contrastenhanced computed tomography. Methods: A retrospective study involving 630 chest contrastenhanced computed tomography scans from July 2018 to July 2019 was carried out at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. These images were reviewed for AA branching patterns and classified accordingly. Data were analyzed using SPSS version 21. Results: Of the 630 patients (364 males and 266 females), AA branching pattern variations were found in 35.2%: type II, 26%; type III, 6.5%; type V, 2.7%; the rest, 64.8%, had a normal (type I) AA branching pattern. The left vertebral artery and the aberrant right subclavian artery were also observed to originate directly from the AA. Conclusions: AA branching pattern variation types II, III, and V were found in our study. These findings could be vital during aortic instrumentation and surgical procedures of the head and neck in Ethiopia and globally.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90080139","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}
Mukami Gathariki, S. Khainga, K. Aluora, Nang’andu Malungo, Laura Ocholla, T. Amuti
Lymphedema has a high incidence and various causes including filariasis in developing countries and as complications following oncological surgery in developed countries. It reduces patients’ quality of life, productivity and currently lacks a cure. Current management involves debulking or physiological methods, with debridement being the preferred debulking method and lymph node transfer, the preferred physiological option. Most reports on the management of lymphedema or its associated outcomes have reported the use of either of these modalities with favourable outcomes, albeit some complications. There is however paucity of documented cases where a patient underwent both debulking and physiological treatment in management of chronic lymphedema and our case study reports on the same, with favourable outcome and minimal complications. Our patient, a 30 year old female presented with an 8 year history of slowly progressive right lower limb oedema. Physical examination revealed marked right lower limb swelling that was non- pitting, non-tender, erythematous, with marked thickening of skin, yellowing of the nails and a positive stemmer sign. Lymphoscintigraphy revealed hypoplastic lymphatic channels and faulty valves. Debulking using modified Charles procedure and vascularised lymph node transfer were done within a one month interval. Ten months later, she is doing well with no relapse.
{"title":"Surgical management of unilateral lower limb lymphedema in combination of debulking and physiologic procedures: a case report","authors":"Mukami Gathariki, S. Khainga, K. Aluora, Nang’andu Malungo, Laura Ocholla, T. Amuti","doi":"10.4314/aas.v19i4.11","DOIUrl":"https://doi.org/10.4314/aas.v19i4.11","url":null,"abstract":"Lymphedema has a high incidence and various causes including filariasis in developing countries and as complications following oncological surgery in developed countries. It reduces patients’ quality of life, productivity and currently lacks a cure. Current management involves debulking or physiological methods, with debridement being the preferred debulking method and lymph node transfer, the preferred physiological option. Most reports on the management of lymphedema or its associated outcomes have reported the use of either of these modalities with favourable outcomes, albeit some complications. There is however paucity of documented cases where a patient underwent both debulking and physiological treatment in management of chronic lymphedema and our case study reports on the same, with favourable outcome and minimal complications. Our patient, a 30 year old female presented with an 8 year history of slowly progressive right lower limb oedema. Physical examination revealed marked right lower limb swelling that was non- pitting, non-tender, erythematous, with marked thickening of skin, yellowing of the nails and a positive stemmer sign. Lymphoscintigraphy revealed hypoplastic lymphatic channels and faulty valves. Debulking using modified Charles procedure and vascularised lymph node transfer were done within a one month interval. Ten months later, she is doing well with no relapse.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"46 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72479323","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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