East and Central African Journal of Surgery最新文献_第10页

Clinico-pathological pattern and early post-operative complications of gastro-duodenal perforations at Mulago Hospital Kampala- a prospective cohort study 坎帕拉穆拉戈医院胃-十二指肠穿孔的临床病理模式和术后早期并发症——一项前瞻性队列研究

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.1

M. Nansubuga, S. Kirunda, A. Wesonga, J. Yiga, P. Makobore, H. Wabinga, E. Elobu

{"title":"Clinico-pathological pattern and early post-operative complications of gastro-duodenal perforations at Mulago Hospital Kampala- a prospective cohort study","authors":"M. Nansubuga, S. Kirunda, A. Wesonga, J. Yiga, P. Makobore, H. Wabinga, E. Elobu","doi":"10.4314/ecajs.v21i2.1","DOIUrl":"https://doi.org/10.4314/ecajs.v21i2.1","url":null,"abstract":"Background: Gastro-Duodenal Perforations are one of the commonest causes of mortality and morbidity in conditions that require emergency surgery. The main objective of this study was to determine the clinico-pathological pattern and evaluate factors for early post operative complications of Gastro-duodenal perforations in Mulago. Methods: This was a prospective cohort study of patients with gastro-duodenal perforations managed by simple repair between September 2014 and April 2015 in Mulago was studied. Primary/ secondary outcomes were mortality and complications respectively. Data was managed using stata-12 and multivariate analysis using log-binomial regression model. Results: A total of 65 patients were operated for Gastro-duodenal perforations in the study period. 86.2% were male (M: F 6.2:1). Median age was 35 years (range 16- 80 years). 93.9% had gastric perforations. Clinical diagnosis was predicted in 89.3%. H. pylori was present in 7.9%. Mortality was 18.5% and complications developed in 58.5%. Age above 35 and presence of co morbidity predicted mortality (CI 1.22- 21.12, p= 0.009) (CI 1.26- 8.82, p= 0.024) and early post-operative complications (CI 1.03- 2.44, p= 0.031) (CI 1.23- 2.44, p= 0.011) respectively. Conclusion: Gastroduodenal perforations remain a common surgical emergency in Mulago hospital affecting mainly young men below 35 years. Majority are gastric perforations. Mortality and early post-operative complications are high, and increase with age and presence of co morbidity. Keywords: gastro-duodenal perforations, perforated peptic ulcer disease, gastric perforations","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117223622","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}

引用次数: 2

Bleeding gastrointestinal stromal tumour of the stomach complicated by massive deep vein thrombosis – a management ilemma – a case report 胃出血的胃肠道间质瘤合并大量深静脉血栓形成-一个管理回肠一例报告

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.14

S. Mungazi, David Muchuweti, Edwin G. Muguti

{"title":"Bleeding gastrointestinal stromal tumour of the stomach complicated by massive deep vein thrombosis – a management ilemma – a case report","authors":"S. Mungazi, David Muchuweti, Edwin G. Muguti","doi":"10.4314/ecajs.v21i2.14","DOIUrl":"https://doi.org/10.4314/ecajs.v21i2.14","url":null,"abstract":"Cancer is a major risk factor for venous thromboembolism (VTE). Its treatment is an added risk factor for VTE. Malignancy results in a hypercoagulable state and hence DVT requiring anticoagulation. Cancer patients are at high risk of anticoagulant associated bleeding. Bleeding complications occur more with unfractionated heparin as compared to low molecular weight heparin. Standard medical treatment based on vitamin K antagonists is less effective and is associated with increased risk of bleeding in cancer patients. Low molecular weight heparin treatment has added advantages such as less sensitivity to drug interactions, lack of need for regular monitoring and has no problem of narrow therapeutic window as opposed to warfarin. Gastrointestinal stromal tumours (GIST) are the most common mesenchymal tumours of the gastrointestinal tract. The most common presentation is of gastrointestinal bleeding, pain and/or dyspepsia. We report the case of a 67 year old hypertensive female patient who presented with a history of massive haematemesis and malaena. Upper gastrointestinal endoscopy confirmed a gastric tumour. She developed massive sudden swelling of the left lower limb whilst awaiting surgery. Doppler ultrasound scan confirmed an iliofemoral deep vein thrombosis (DVT). Inferior vena cava filter insertion was not possible due to non-availability. Coexistence of DVT needing anticoagulation and bleeding gastric GIST requiring urgent resection presented a management dilemna. Despite the risk, the patient was taken for an emergency tumor resection primarily to stop the bleeding and facilitate full anticoagulation therapy more safely. After 24 months follow up the patient had no evidence of recurrence of both the GIST and DVT. Keywords : deep vein thrombosis, venous thromboembolism upper gastrointestinal bleeding, gastric tumour","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128057626","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}

引用次数: 0

Pattern of limb amputations in male patients in a sub-urban teaching hospital 郊区某教学医院男性患者截肢模式分析

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.11

E. Edomwonyi, J. Onuminya

{"title":"Pattern of limb amputations in male patients in a sub-urban teaching hospital","authors":"E. Edomwonyi, J. Onuminya","doi":"10.4314/ecajs.v21i2.11","DOIUrl":"https://doi.org/10.4314/ecajs.v21i2.11","url":null,"abstract":"Background: Extremity amputations represent a major disability and it is compounded by the difficulty in obtaining prosthesis in developing nations. The consequences of loss of earning abilities, particularly when the patient is the only wage earner in a large extended family is high. The aim of this study was to evaluate the pattern of limb amputations in male patients in Irrua specialist teaching hospital, lrrua, Edo state of Nigeria. Methods: This is a retrospective review of the pattern of limb amputation surgeries in male patients in Irrua over a five year period. Data was obtained from the medical records department. Extracted data were analyzed using simple statistical method of proportions and percentages. Results: Fifty-nine male patients had sixty-four limb amputation surgeries during the study period. Median age of patients was forty-nine years. The most frequent level of amputation was below knee level in 53.1% of cases, followed by above knee in 31.2% of cases. The lower limb was involved in 92.1% of cases, the rest 7.9% involved the upper limb. Diabetic foot disease was the commonest indication for amputation, 26 patients (40.6% of cases) followed by trauma in 23 patients (35.9% of cases). Wound infection was the most frequent post-operative complication occurring 34.4% of wounds in this study. Conclusion: Diabetic foot disease and trauma were the commonest indications. The middle aged was the most involved. Preventive measures such as education of diabetic patients on foot care, regulation of the activities of traditional bone setters, and public enlightenment on road safety rules would assist in no small measure in addressing this problem. Keywords: Pattern, male, limb amputation, Teaching Hospital","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":" 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132124030","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}

引用次数: 1

An audit of the quality of surgical operation notes in a Nigerian teaching hospital 尼日利亚某教学医院外科手术记录质量审核

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.12

R. Babalola, O. Olasehinde, O. A. Sowande

{"title":"An audit of the quality of surgical operation notes in a Nigerian teaching hospital","authors":"R. Babalola, O. Olasehinde, O. A. Sowande","doi":"10.4314/ecajs.v21i2.12","DOIUrl":"https://doi.org/10.4314/ecajs.v21i2.12","url":null,"abstract":"Background: Operation note records are important tools for ensuring patients’ continuity of care, for research purposes and medico-legal reasons. They can effectively serve these purposes only if well documented. The main objective of this study was to assess the practice of recording the operation notes among surgical trainees in a Nigerian Teaching Hospital. Methods: Operation notes completed by doctors in the Surgery Department over a 2-month period were audited for completeness, legibility and conformity to the standards of the Royal College of Surgeons of England. Results: There were 100 operation notes reviewed, two-thirds of these were written by Senior Registrars, majority of which were for elective operations (63%). Only 37 of the operation notes were appropriately completed with about two-thirds either incomplete or wrongly filled. The cadre of the surgical trainee did not significantly influence the completeness of the operation notes. Legibility of the operation notes was associated significantly with completeness (p<0.04). Conclusion: Standards of operation note writing in our practice needs to be improved upon. The challenges of legibility and completeness of documentation can be overcome by the use of an aide-memoire as well as computerized operation notes.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115405161","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}

引用次数: 2

Chondromyxoid fibroma of distal 1/3 rd of fibula a rare tumour at rare site 腓骨远端1/3的软骨粘液样纤维瘤是一种罕见部位的罕见肿瘤

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.18

K. Mane, Sohael M. Khan, Shraddha Singhania, Mahendra Gudhe, G. Mundada, P. Singh, M. Arora

引用次数: 0

Presentation and management outcome of children with intussusception at Tenwek Hospital, Kenya 肯尼亚tenweek医院儿童肠套叠的表现和治疗结果

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ECAJS.V21I2.8

P. B. Ooko, M. Oloo, V. Mwaka, W. Russell

{"title":"Presentation and management outcome of children with intussusception at Tenwek Hospital, Kenya","authors":"P. B. Ooko, M. Oloo, V. Mwaka, W. Russell","doi":"10.4314/ECAJS.V21I2.8","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I2.8","url":null,"abstract":"Background: Intussusception, a common cause of Intestinal obstruction in infants and young children, occurs when one segment of the bowel invaginates into a distal segment. While non-operative reduction has been well described, surgery remains the predominant mode of therapy in many developing countries due to delayed presentation. This study aimed to describe the presentation, management and outcome of children with intussusception at a single institution. Method: A retrospective review of patients aged 16 years and below with intussusception managed at Tenwek hospital from January 2009 through December 2014 was undertaken. Diagnosis was based on the presenting signs, symptoms, physical findings and plain upright or supine abdominal X-rays, and confirmed via ultrasonography, barium enema or at surgery. Results: A total of 45 cases (24 boys, 21 girls) of intussusception were noted, with a mean age of 2.6 years (range 1 month-15 years). The mean duration between symptom onset and presentation was 4.4 days (range 1-14), and the classic triad (vomiting, bloody mucoid stools and abdominal pain/distension) was noted in 27 (60%) cases. Abdominal ultrasound was diagnostic in 7 of the 11 cases ordered, with the rest diagnosed clinically. Non-operative reduction was undertaken in 4 cases and successful in 3. Surgery was performed in 42 cases with bowel gangrene and perforation noted in 20 (47.6%) and 15 (35.7%) cases respectively. The main types of intussusception were ileocolic (23, 51.1%), colocolonic (10, 22.2%) and ileoceacal (7, 15.6%). Five (11.1%) mortalities and 4 (8.8%) morbidities were noted at discharge, most commonly being surgical site infection in three cases. Conclusion: Intussusception, in this series, was primarily diagnosed clinically and managed surgically, with a majority of the patients having gangrenous or perforated bowel at laparotomy. Keywords: Intussusception, children, management, outcome, Kenya","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"3a 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128197678","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}

引用次数: 3

Experience with enterocutaneous fistula management in a district hospital in Nigeria 尼日利亚一家地区医院处理肠皮瘘的经验

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.3

D. Bawa, A. Sule, V. Grimah, A. Ale, J. Ngbea, R. Adabe-Bello, N. I. Kyesmen

{"title":"Experience with enterocutaneous fistula management in a district hospital in Nigeria","authors":"D. Bawa, A. Sule, V. Grimah, A. Ale, J. Ngbea, R. Adabe-Bello, N. I. Kyesmen","doi":"10.4314/ecajs.v21i2.3","DOIUrl":"https://doi.org/10.4314/ecajs.v21i2.3","url":null,"abstract":"Background: Enterocutaneous fistula (ECF) is an abnormal communication between gastrointestinal tract and skin. It is a difficult condition to treat and morbidity and mortality remain high in many centers. Malnutrition and sepsis are the leading causes of death. There are no clear guidelines for optimal nutritional management. Aggressive measures to maintain positive nitrogen balance is the ultimate goal of nutritional management. Our objective was to review the practice of the nutritional management and outcome of ECF in a resource limited setting in Nigeria. Methods: A retrospective study of all patients with ECF managed between 2006 and 2015. Management included resuscitation, control of sepsis, enteral feeding, skin care and timely surgical intervention. Results: A total of 57 patients were managed. Aetiology of ECF in this study was post-operative in 96.5% of cases. Fistula closure was achieved in 51/57 patients (89.5%). Thirty-nine (68.42%) fistulae closed spontaneously on conservative management while 12 (21.05%) fistulae healed following restorative surgery. Mortality rate was 10.5%. Rate of healing was related to serum albumin level and fistula output. Conclusion: Aggressive enteral feeding allows a favorable outcome in enterocutaneous fistula after a convalescence period. High output and hypoalbuminaemia were important prognostic variables. Keywords: Enterocutaneous fistula,enteral feeding, outcome, resource-limited setting","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123916071","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}

引用次数: 1

Flap ischemia after tissue expander filling session 组织扩张器填充后皮瓣缺血

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ECAJS.V21I2.19

Sajad Ahmad Salati

引用次数: 0

A rare case of extraosseous osteosarcoma of the parotid gland 腮腺骨外骨肉瘤一例

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ECAJS.V21I2.17

A. Adeyemo, A. Komolafe, S. Ameye, A. Owojuyigbe, A. Olakanmi, S. Ohuche

引用次数: 1

A case of osteosarcoma presenting primarily as breast mass 以乳房肿块为主的骨肉瘤1例

East and Central African Journal of Surgery Pub Date : 2016-11-14 DOI: 10.4314/ecajs.v21i2.16

N. Seyoum, B. Yishak

引用次数: 0