M. Atinga, N. Baraza, Sarah Wambui, Wachira Joseph Thiong’o, A. Atinga
Background: Failure of fusion to any of the acromion physes at maturity may lead to an os acromiale. A radiological review into the prevalence of os acromiale in an indigenous East African population was performed using computer tomography (CT) imaging. The study aimed to demonstrate a lower prevalence of os acromiale in an urban population compared with cadaveric studies. Methods: This was a cross-sectional study with consecutive sampling. CT scans of both shoulders obtained for non-shoulder pathology were used for the analysis. CT scanning was performed at a tertiary referral hospital from January 2019 to July 2020. Results: Nine hundred eighty-two CT studies were eligible for the review. There were148 os acromiale identified that were either pre-acromiale or meso-acromiale. The study found a 15% prevalence of os acromiale among an ethnic East African population, of which almost 40% were meso-acromiale and 60% were pre-acromiale, with no meta-acromiale. Conclusion: The prevalence of os acromiale found in this study is similar to that observed in earlier cadaveric studies.
{"title":"Prevalence of os acromiale in an indigenous East African population: a computerized tomography scan-based study","authors":"M. Atinga, N. Baraza, Sarah Wambui, Wachira Joseph Thiong’o, A. Atinga","doi":"10.4314/aas.v19i1.2","DOIUrl":"https://doi.org/10.4314/aas.v19i1.2","url":null,"abstract":"Background: Failure of fusion to any of the acromion physes at maturity may lead to an os acromiale. A radiological review into the prevalence of os acromiale in an indigenous East African population was performed using computer tomography (CT) imaging. The study aimed to demonstrate a lower prevalence of os acromiale in an urban population compared with cadaveric studies. \u0000Methods: This was a cross-sectional study with consecutive sampling. CT scans of both shoulders obtained for non-shoulder pathology were used for the analysis. CT scanning was performed at a tertiary referral hospital from January 2019 to July 2020. \u0000Results: Nine hundred eighty-two CT studies were eligible for the review. There were148 os acromiale identified that were either pre-acromiale or meso-acromiale. The study found a 15% prevalence of os acromiale among an ethnic East African population, of which almost 40% were meso-acromiale and 60% were pre-acromiale, with no meta-acromiale. \u0000Conclusion: The prevalence of os acromiale found in this study is similar to that observed in earlier cadaveric studies. \u0000 \u0000 ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72730800","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: Early and accurate diagnosis has a major impact on outcome of diseases. Prompt delivery by the laboratory on requests sent by clinicians is fundamental to this. For useful laboratory outcomes, clinicians should provide comprehensive information, as required in laboratory request forms. The aim of this study was to analyze how well clinicians complete laboratory request forms. Methods: This is a retrospective descriptive study from January 1 to December 31, 2017. Laboratory request forms submitted with laboratory requests were retrieved and reviewed for completeness of required information. Results: An error prevalence of 12.2% was observed from the analyzed requests, and the average number of errors per request was 1.7. Surgical specialties contributed by far the most errors (t=-7.571; p=0.0000), and biodata information was the group that was mostly omitted from laboratory forms. Conclusion: This study revealed that clinicians submit requests with various irregularities, including suboptimal information, to the histopathology laboratory of our hospital. Regular interaction between clinicians and pathologists is needed in order to enlighten clinicians on the importance of providing necessary information regarding their requests to the laboratory.
{"title":"Clinicians’ compliance with requirements on surgical pathology laboratory request forms","authors":"S. Ohayi, M. Ezeme, N. Okoloagu","doi":"10.4314/aas.v19i1.3","DOIUrl":"https://doi.org/10.4314/aas.v19i1.3","url":null,"abstract":"Background: Early and accurate diagnosis has a major impact on outcome of diseases. Prompt delivery by the laboratory on requests sent by clinicians is fundamental to this. For useful laboratory outcomes, clinicians should provide comprehensive information, as required in laboratory request forms. The aim of this study was to analyze how well clinicians complete laboratory request forms. Methods: This is a retrospective descriptive study from January 1 to December 31, 2017. Laboratory request forms submitted with laboratory requests were retrieved and reviewed for completeness of required information. Results: An error prevalence of 12.2% was observed from the analyzed requests, and the average number of errors per request was 1.7. Surgical specialties contributed by far the most errors (t=-7.571; p=0.0000), and biodata information was the group that was mostly omitted from laboratory forms. Conclusion: This study revealed that clinicians submit requests with various irregularities, including suboptimal information, to the histopathology laboratory of our hospital. Regular interaction between clinicians and pathologists is needed in order to enlighten clinicians on the importance of providing necessary information regarding their requests to the laboratory.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85541481","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":"Reflections on clinical mentorship in surgical practice, training, and research","authors":"Michael M. Mwachiro, Andrea Parker","doi":"10.4314/aas.v19i1.1","DOIUrl":"https://doi.org/10.4314/aas.v19i1.1","url":null,"abstract":"No Abstract","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77844267","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}
Postoperative ventral hernia represents one of the causes of anterior abdominal wall hernias. Repair of this hernia can be very challenging for surgeons, as they are associated with cardiovascular and respiratory complications, development of compartment syndrome, and high recurrence rates. Our case is a 48-year-old woman was operated on twice. The first time was in 2015 due to perforation of colonic diverticulitis for which abdominal exploration and Hartmann’s procedure was performed. In 2016, the reverse of Hartmann’s procedure was done. Forty days after the second operation, she noticed a small hernia in the scar area that increased rapidly. After 1 year, it became irreducible with dimensions (30X17 cm) reached the para-umbilical region without any sign of intestinal obstruction. We decided to do hernioplasty using self-gripping mesh. Six weeks before surgery, botulinum toxin type A was injected intramuscularly to induce muscle weakness and restore the normal biomechanics of the anterior abdominal wall, facilitating closure and repair. Postoperative results and follow-up after 6 months were satisfactory.
{"title":"Use of botulinum toxin type A in giant ventral postoperative hernia","authors":"Protasov Andrey Vitalievich, Podolskiy Mikhail Yurievich, Mekhaeel Shehata Fakhry, Kulakova Anna Leonidovna, Kulchenko Irina Gennadievna, Sherreen Elhariri","doi":"10.4314/AAS.V18I4.10","DOIUrl":"https://doi.org/10.4314/AAS.V18I4.10","url":null,"abstract":"Postoperative ventral hernia represents one of the causes of anterior abdominal wall hernias. Repair of this hernia can be very challenging for surgeons, as they are associated with cardiovascular and respiratory complications, development of compartment syndrome, and high recurrence rates. Our case is a 48-year-old woman was operated on twice. The first time was in 2015 due to perforation of colonic diverticulitis for which abdominal exploration and Hartmann’s procedure was performed. In 2016, the reverse of Hartmann’s procedure was done. Forty days after the second operation, she noticed a small hernia in the scar area that increased rapidly. After 1 year, it became irreducible with dimensions (30X17 cm) reached the para-umbilical region without any sign of intestinal obstruction. We decided to do hernioplasty using self-gripping mesh. Six weeks before surgery, botulinum toxin type A was injected intramuscularly to induce muscle weakness and restore the normal biomechanics of the anterior abdominal wall, facilitating closure and repair. Postoperative results and follow-up after 6 months were satisfactory.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87893474","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: Prostate cancer (PC) is curable with early detection, yet it remains a major public health problem globally and a leading cause of mortality among men. The objective of the study was to explore the barriers and facilitators to the uptake of prostate cancer screening among men aged 40–69 years in a rural community in Kenya. Methods: We utilized an explorative qualitative design and purposive sampling to select participants. Six focus group discussions (FGDs) and seven in-depth interviews were conducted among 59 men aged 40–69 years and key informants in Kiambu County, Kenya. Data was collected using a semi-structured guide and content analysis was done. Results: The facilitators of screening included experience of symptoms, proximity and prominence of cancer, accessibility, and advocacy. The barriers to screening included lack of knowledge, fatalistic beliefs, low risk perception, stigma, and male dominance factors. Conclusion: This study provides vital information for the development of interventions to enhance shared decision-making in regard to PC screening. Capacity building of clinicians, task shifting and provision of well-coordinated affordable culturally sensitive screening services should be explored. The concerted effort among policy makers and all health care workers to overcome the stated barriers to screening is highly recommended.
{"title":"Barriers and Facilitators to Uptake of Prostate Cancer Screening in a Kenyan Rural Community","authors":"R. Mbugua, Simon Karanja, S. Oluchina","doi":"10.4314/AAS.V18I3.2","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.2","url":null,"abstract":"Background: Prostate cancer (PC) is curable with early detection, yet it remains a major public health problem globally and a leading cause of mortality among men. The objective of the study was to explore the barriers and facilitators to the uptake of prostate cancer screening among men aged 40–69 years in a rural community in Kenya. \u0000Methods: We utilized an explorative qualitative design and purposive sampling to select participants. Six focus group discussions (FGDs) and seven in-depth interviews were conducted among 59 men aged 40–69 years and key informants in Kiambu County, Kenya. Data was collected using a semi-structured guide and content analysis was done. \u0000Results: The facilitators of screening included experience of symptoms, proximity and prominence of cancer, accessibility, and advocacy. The barriers to screening included lack of knowledge, fatalistic beliefs, low risk perception, stigma, and male dominance factors. \u0000Conclusion: This study provides vital information for the development of interventions to enhance shared decision-making in regard to PC screening. Capacity building of clinicians, task shifting and provision of well-coordinated affordable culturally sensitive screening services should be explored. The concerted effort among policy makers and all health care workers to overcome the stated barriers to screening is highly recommended. \u0000 ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78139203","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}
Prashanth Annayyanapalya Thimmegowda, K. Lakshman, R. Reddy, Sachin Nale, Ravishanka Ravishanka
Background: We are currently in the era of laparoscopic surgery. It has gained popularity in the last few decades because of its well- known advantages. Laparoscopy requires different skills from those of open surgery. In a paradigm shift, learning basic surgical skills is now performed more in the skills laboratory than in the operation theater. However, there is a lack of reliable training and assessment tools for laparoscopic surgical skills. This study aimed to objectively assess the effect of bench laparoscopic training in novices. Methods: This prospective study was conducted at the Clinical Skills Centre of Bangalore Medical College and Research Institute (BMCRI) in Bangalore, India. Sixty interns with no previous experience in laparoscopy were included. They underwent supervised training on the box trainer for 3 days, 2 hours a day, in basic surgical tasks, including pointing dots, joining straight lines, joining curved lines, picking objects, peg transfer, and circle cut. All participants were assessed objectively in a virtual reality (VR) simulator before and after training. The objective outcomes measured were time taken, distance traveled, and error scores given by the VR simulator metrics. Results: The novices showed statistically significant improvement in all the tasks after the training compared with their skill levels before the training. Conclusion: Structured short-term training significantly improves basic laparoscopic surgery skills.
{"title":"Objective Measurement of Impact of Bench Laparoscopic Training in Novices","authors":"Prashanth Annayyanapalya Thimmegowda, K. Lakshman, R. Reddy, Sachin Nale, Ravishanka Ravishanka","doi":"10.4314/AAS.V18I3.8","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.8","url":null,"abstract":"Background: We are currently in the era of laparoscopic surgery. It has gained popularity in the last few decades because of its well- known advantages. Laparoscopy requires different skills from those of open surgery. In a paradigm shift, learning basic surgical skills is now performed more in the skills laboratory than in the operation theater. However, there is a lack of reliable training and assessment tools for laparoscopic surgical skills. This study aimed to objectively assess the effect of bench laparoscopic training in novices. \u0000Methods: This prospective study was conducted at the Clinical Skills Centre of Bangalore Medical College and Research Institute (BMCRI) in Bangalore, India. Sixty interns with no previous experience in laparoscopy were included. They underwent supervised training on the box trainer for 3 days, 2 hours a day, in basic surgical tasks, including pointing dots, joining straight lines, joining curved lines, picking objects, peg transfer, and circle cut. All participants were assessed objectively in a virtual reality (VR) simulator before and after training. The objective outcomes measured were time taken, distance traveled, and error scores given by the VR simulator metrics. \u0000Results: The novices showed statistically significant improvement in all the tasks after the training compared with their skill levels before the training. \u0000Conclusion: Structured short-term training significantly improves basic laparoscopic surgery skills.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72817954","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":"Eye Surgery in Africa","authors":"Abba Hydara","doi":"10.4314/AAS.V18I3.1","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.1","url":null,"abstract":"No Abstract.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79301663","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}
Cholecystectomy is the most commonly performed operation worldwide nowadays. Laparoscopic cholecystectomy (LC) is the gold standard treatment of gallstones. We present a case of an 81-year-old male with a 3-months’ history of loss of appetite and weight with no associated symptoms. The patient had undergone an LC for symptomatic cholelithiasis 1 year previously, with an uneventful recovery. The clinical examination was essentially normal. A computed tomography (CT) of the abdomen and pelvis showed thickening of the right perihepatic peritoneum measuring 15 × 15 × 3.5 cm, suggestive of chronic granulomatous lesion or atypical mesothelioma. We performed a diagnostic laparoscopy and found the lesion to be an abdominal wall abscess. The abscess cavity was deroofed, the pus was drained and a thorough wash out given. Surprisingly no stones or any foreign body were found in the cavity. Histology of the abscess wall showed non-specific inflammation. We report this case as a post-LC abdominal wall abscess with two peculiar features – (a) no systemic or local symptoms, and (b) no association with spilt gallstones or other foreign bodies like sutures.
{"title":"Unusual Abdominal Wall Abscess Post-Laparoscopic Cholecystectomy","authors":"Prashanth Annayyanapalya Thimmegowda, K. Lakshman","doi":"10.4314/AAS.V18I3.11","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.11","url":null,"abstract":"Cholecystectomy is the most commonly performed operation worldwide nowadays. Laparoscopic cholecystectomy (LC) is the gold standard treatment of gallstones. We present a case of an 81-year-old male with a 3-months’ history of loss of appetite and weight with no associated symptoms. The patient had undergone an LC for symptomatic cholelithiasis 1 year previously, with an uneventful recovery. The clinical examination was essentially normal. A computed tomography (CT) of the abdomen and pelvis showed thickening of the right perihepatic peritoneum measuring 15 × 15 × 3.5 cm, suggestive of chronic granulomatous lesion or atypical mesothelioma. We performed a diagnostic laparoscopy and found the lesion to be an abdominal wall abscess. The abscess cavity was deroofed, the pus was drained and a thorough wash out given. Surprisingly no stones or any foreign body were found in the cavity. Histology of the abscess wall showed non-specific inflammation. We report this case as a post-LC abdominal wall abscess with two peculiar features – (a) no systemic or local symptoms, and (b) no association with spilt gallstones or other foreign bodies like sutures. \u0000 ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"27 25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88153990","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}
Christian Vyamungu, P. Fru, T. Sefeane, Cynthia Sathekga, E. Ndobe
Background: Patients with hand masses present for consultation either for pain, loss of function, or cosmetic embarrassment caused by the mass. The majority of hand masses are benign soft tissue tumors. The aim was to review the histology results of hand masses operated on at the Chris Hani Baragwanath Academic Hospital Hand Unit in Johannesburg, South Africa, to explore the relationship of the types of masses according to age, sex, side, and compare the findings with what is in the current literature. Methods: Patients operated on in the hand unit, for hand masses between April 2016 and April 2019 with histology results were included in the study for statistical analysis. Results: There were 64 males and 105 females with a mean age of 41.03 ± 18.81 years. The most frequent masses were ganglion cysts. Females appeared to be more affected than males by the different hand masses, but there were no statistically significant differences. Of the 21 giant cell tumors, 15 occurred on the right hand (p-value = 0.021). Conclusion: The profile of hand masses at a high-volume hand unit in Johannesburg, were comparable to the reported literature. There were no significant differences between sex and diagnosis, however, there was a relationship between diagnosis and side for giant cell tumors of tendon sheaths, requiring further exploration.
{"title":"Review of Histology Results of Hand Masses: A South African Audit","authors":"Christian Vyamungu, P. Fru, T. Sefeane, Cynthia Sathekga, E. Ndobe","doi":"10.4314/AAS.V18I3.7","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.7","url":null,"abstract":"Background: Patients with hand masses present for consultation either for pain, loss of function, or cosmetic embarrassment caused by the mass. The majority of hand masses are benign soft tissue tumors. The aim was to review the histology results of hand masses operated on at the Chris Hani Baragwanath Academic Hospital Hand Unit in Johannesburg, South Africa, to explore the relationship of the types of masses according to age, sex, side, and compare the findings with what is in the current literature. \u0000Methods: Patients operated on in the hand unit, for hand masses between April 2016 and April 2019 with histology results were included in the study for statistical analysis. \u0000Results: There were 64 males and 105 females with a mean age of 41.03 ± 18.81 years. The most frequent masses were ganglion cysts. Females appeared to be more affected than males by the different hand masses, but there were no statistically significant differences. Of the 21 giant cell tumors, 15 occurred on the right hand (p-value = 0.021). \u0000Conclusion: The profile of hand masses at a high-volume hand unit in Johannesburg, were comparable to the reported literature. There were no significant differences between sex and diagnosis, however, there was a relationship between diagnosis and side for giant cell tumors of tendon sheaths, requiring further exploration.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89298496","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}
Metastatic small bowel tumors are rare. They often present with small bowel occlusion, bleeding, perforation, or intestinal intussusception. Pulmonary adenocarcinoma with metastasis to the small intestine causing intussusception is exceedingly rare. A 72-yearold male patient with a past medical history of left lung adenocarcinoma, presented to the emergency department with abdominal pain and vomiting. On admission, an X-ray of the abdomen without preparation showed some hydroaeric levels on the small intestine. The abdominopelvic computed tomography (CT) scan revealed an ileo-ileal invagination, with an image of the invagination rod. The patient underwent a surgical resection of the small bowel with the removal of the ischemic areas and immediate anastomosis. Macroscopic examination of the surgical specimen revealed five tumor masses varying in size between 1 and 4 cm. The histological examination of the samples taken from these tumors, coupled with an immunohistochemical study confirmed the diagnosis of intestinal metastases of pulmonary origin expressing cytokeratin 7 (CK7) and thyroid transcription factor 1 (TTF1) but negative for CK20, chromogranin, and synaptophysin. The postoperative course was uneventful, and the symptoms transiently recovered. However, the patient died 3 months later. We should consider multiple metastatic lesions in adult intussusception, especially in patients with a past medical history of lung cancer.
{"title":"Small Bowel Intussusception due to Multiple Intestinal Metastases from Lung Adenocarcinoma","authors":"F. Limaiem, S. Bouraoui","doi":"10.4314/AAS.V18I3.12","DOIUrl":"https://doi.org/10.4314/AAS.V18I3.12","url":null,"abstract":"Metastatic small bowel tumors are rare. They often present with small bowel occlusion, bleeding, perforation, or intestinal intussusception. Pulmonary adenocarcinoma with metastasis to the small intestine causing intussusception is exceedingly rare. A 72-yearold male patient with a past medical history of left lung adenocarcinoma, presented to the emergency department with abdominal pain and vomiting. On admission, an X-ray of the abdomen without preparation showed some hydroaeric levels on the small intestine. The abdominopelvic computed tomography (CT) scan revealed an ileo-ileal invagination, with an image of the invagination rod. The patient underwent a surgical resection of the small bowel with the removal of the ischemic areas and immediate anastomosis. Macroscopic examination of the surgical specimen revealed five tumor masses varying in size between 1 and 4 cm. The histological examination of the samples taken from these tumors, coupled with an immunohistochemical study confirmed the diagnosis of intestinal metastases of pulmonary origin expressing cytokeratin 7 (CK7) and thyroid transcription factor 1 (TTF1) but negative for CK20, chromogranin, and synaptophysin. The postoperative course was uneventful, and the symptoms transiently recovered. However, the patient died 3 months later. We should consider multiple metastatic lesions in adult intussusception, especially in patients with a past medical history of lung cancer. \u0000 ","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86898363","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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