East and Central African Journal of Surgery最新文献

{"title":"Endoscopic third ventriculostomy versus ventriculoperitoneal shunt placement in children with obstructive hydrocephalus","authors":"H. Mersha","doi":"10.4314/ECAJS.V22I3.2","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I3.2","url":null,"abstract":"Background: Uncertainty persists on the best treatment for patients with obstructive hydrocephalus: endoscopic third ventriculostomy (ETV) or ventriculoperitoneal shunt (VPS), particularly in the younger age groups. The author investigated and compared 1-year outcomes for ETV and VPS treatment categories at Zewditu Memorial Hospital (ZMH), Ethiopia. Methods: This was a retrospective, hospital-based study. The study reviewed 259 paediatric patients with hydrocephalus in whom VPS or ETV with or without choroid plexus cauterisation (CPC) was done as a primary treatment, between January 2013 and January 2016 at ZMH. Patients’ medical records, operative notes, and neural tube database records were used to complete a structured questionnaire. The difference in proportions was examined using the chi-square test. Results: Sixty-seven (25.9%) children initially underwent ETV and 192 (74.1%) underwent VPS placements. The median age was 5 months (range 3 days-168 months). Children who underwent VPS placement rather than ETV had a statistically significant higher risk of postoperative infection (27.0% vs 6.1%; P = 0.001), complications (27.0% vs 12.2%; P = 0.025), and a higher but insignificant operative failure rate at 1 year (45.3% vs 38.8%; P = 0.27). Sex and age were not associated with the occurrence of complications, while VPS and myelomeningocele or encephalocele (MMC/EC) were strongly associated. Complication and infection were significantly and negatively associated with complication-free 1-year survival rate (P < 0.001 each), while gender, age, procedure, and cause of hydrocephalus did not show any association with survival. There was a significant reduction of VPS success rate from 76.9% at 6 months postsurgery to 54.7% at 1 year (P < 0.001), while ETV success rate remained constant during the same period (66.7% and 61.2%, respectively). Mortality frequencies for ETV and VPS insertion were 3 (4.5%) and 9 (4.7%), respectively, for a combined total of 12 deaths (4.6%). Conclusions: Sex and age were not associated with complications, while VPS and MMC/EC were strongly associated. Children who underwent VP shunt placement rather than ETV had a higher risk of postoperative infection and complications, but there was no difference in operative failure or success rate and mortality rates between the procedures. ETV failure rate was less likely after 6 months. Keywords: obstructive hydrocephalus; endoscopic third ventriculostomy; ventriculoperitoneal shunt; children; paediatric surgery; neurosurgery; Ethiopia","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130492646","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":"Epidemiological study of peritonitis among children and factors predicting mortality at a tertiary referral hospital in Rwanda","authors":"Emmanuel Mutabazi, A. Bonane, A. J. Ndibanje, J. Rickard","doi":"10.4314/ECAJS.V22I3.3","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I3.3","url":null,"abstract":"Background: Peritonitis is a commonly encountered paediatric surgical emergency. We conducted this study to identify common causes of peritonitis among Rwandan children and factors affecting morbidity and mortality. Methods: The study sample consisted of children with peritonitis who underwent surgical treatment at a tertiary referral hospital in Rwanda from 1 September 2015 to 28 February 2016. Collected data included sociodemographic, clinical, paraclinical, management, and outcome information. The analysis included Pearson's chi-square test and multivariate logistic regression to determine factors associated with morbidity and mortality. Results: Of 63 patients, 28 were female. Ages ranged from 4 months to 15 years, with a mean of 8.8 years. Seventy-three percent of patients presented within the first week of symptom onset. Appendicular perforation (25.4%) and gangrenous intussusception (23.8%) were the most common causes of peritonitis. Fourteen patients (22.2%) died. On multivariate analysis, factors associated with mortality included sepsis (odds ratio [OR] = 11.60; 95% confidence interval [CI] = 2.15 to 62.5; P = 0.004) and intensive care unit (ICU) admission (OR = 7.38; 95% CI = 1.20 to 45.3; P = 0.031). Conclusions: Peritonitis among children is common and bears significant morbidity and mortality at our centre. Training of healthcare providers in district hospitals for early recognition of peritonitis, and improved ICU care availability may reduce mortality secondary to peritonitis in children. Keywords: epidemiology; peritonitis; paediatric surgery; Rwanda","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122673141","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":"Post-traumatic gangrenous acalculous cholecystitis: A case report","authors":"P. Runodada, C. Mbanje, A. Maunganidze, S. Mungazi","doi":"10.4314/ECAJS.V22I3.9","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I3.9","url":null,"abstract":"Acute acalculous cholecystitis in trauma patients is an elusive diagnosis, more so if the patient sustained blunt abdominal trauma. It can arise as a post-traumatic or postsurgical complication, occurring more in critically ill patients. A high index of suspicion for acalculous cholecystitis must be maintained for critically ill patients with newly developing symptoms or septicaemia. \u0000We describe a case of a 27-year-old male patient who sustained blunt abdominal trauma in a road traffic accident. He had at least grade III liver injury and later developed gangrenous acalculous cholecystitis, which was confirmed histopathologically after open cholecystectomy. \u0000https://dx.doi.org/10.4314/ecajs.v22i3.9 \u0000  \u0000This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source (including a link to the formal publication), provide a link to the Creative Commons license, and indicate if changes were made.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"223 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127295949","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":"Childhood blindness and visual impairment in an underserved population in South West Nigeria: A clinic-based study","authors":"M. Isawumi","doi":"10.4314/ECAJS.V22I3.1","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I3.1","url":null,"abstract":"Background: Knowledge of the causes of poor vision among children will contribute to interventions and policies to prevent childhood blindness and visual impairment. \u0000Methods: This was a 3-year descriptive study of consecutive cases presenting to the secondary eye clinic at State Specialist Hospital in Osogbo, Nigeria. Sociodemographic characteristics were documented, and full clinical eye examinations were done. Descriptive analyses were carried out. \u0000Results: Among 214 children examined, 59.3% were male and the mean age was 9.3 ± 3.5 years. The predominant age group was 0 to 5 years (40.2%). Common causes of blindness and visual impairment were: refractive error (22.9%), corneal disease (21.5%), and cataract (19.6%). Refractive error was significantly more common among participants between 11 and 16 years of age (P < 0.001). All cases of retinoblastoma occurred among participants 0 to 5 years old (P < 0.001). Blindness most commonly resulted from corneal opacities (31.1%), severe visual impairment most commonly resulted from cataracts (35.4%), and moderate visual impairment was most often the result of refractive error (47.8%). According to the World Health Organization classification of visual impairment, 74 participants (34.6%) were blind, 48 (22.4%) had severe visual impairment, and 92 (42.9%) had moderate visual impairment. \u0000Conclusions: The causes of blindness and visual impairment are mainly avoidable. Provision of adequate manpower, necessary equipment in the hospitals for subsidised refractive and cataract surgical services, and uptake of these services are required towards prevention. \u0000https://dx.doi.org/10.4314/ecajs.v22i3.1 \u0000  \u0000This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source (including a link to the formal publication), provide a link to the Creative Commons license, and indicate if changes were made.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126947571","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":"Morbidity and mortality of paediatric burns patients at Maputo Central Hospital, Mozambique","authors":"V. Amado, Massada da Rocha, Dalva Khosa, Stella Langa, D. DeUgarte, Prem Yohannan","doi":"10.4314/ECAJS.V22I3.4","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I3.4","url":null,"abstract":"Background: The incidence of paediatric burn injuries is increasing in Africa. Paediatric burn injuries are among the leading causes of preventable morbidity and mortality in sub-Saharan Africa. Research on the morbidity and mortality in this setting is much needed. Methods: We conducted a prospective questionnaire-based analysis of paediatric burn patients presenting to the Maputo Central Hospital during a five-month period. Interviews were conducted with the children's caretakers by 2 paediatric surgery residents and 1 paediatrician at the Eduardo Mondlane Medical School in Maputo, with the aid of nursing staff. Results: Questionnaires were completed for 66 patients. Most burns occurred from scald injuries (n = 46), particularly from cooking (n = 27) and bathwater (n = 19), followed by fire injuries (n = 16). Burns occurred more frequently in the afternoon (n = 26) and morning (n = 23). Many patients reported no adult caretaker present at the time of the burn injury (n = 24). Most burns were grade II (n = 49). Nearly half of the patients received a blood transfusion (n = 30). One-third of the patients underwent operative surgical debridement (n = 21). Skin grafting was performed on a subset of these patients (n = 13). A large number of patients developed a wound infection (n = 39). All deaths occurred in patients who were admitted to the paediatric intensive care unit and had sepsis (n = 9). The mean total body surface area (TBSA) of burn deaths was 37% (range 20% to 50%), and many deaths were secondary to fire burns (6 of 9; 66.7%). Conclusions: Most paediatric burn injuries occur in association with domestic activities, such as cooking and bathing. Adult caretakers are frequently not present at the time of the burn injury. Mortality rates are high, especially for large body surface area burns caused by fire. Educational programmes may help reduce the incidence of burns and the associated morbidity and mortality. The improvement and expansion of emergency and intensive burn care services may help to improve survival. Keywords: burns; morbidity; mortality; paediatrics; paediatric surgery; Mozambique","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114251752","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":"Musculoskeletal injuries: A cross-sectional study in Irrua, Nigeria","authors":"E. Edomwonyi, O. Enoma","doi":"10.4314/ecajs.v22i3.7","DOIUrl":"https://doi.org/10.4314/ecajs.v22i3.7","url":null,"abstract":"Background: Injury is a leading cause of morbidity and mortality among people of various age groups globally. Its economic impact on victims and family is tremendous. Strengthening of legislation and enforcement of extant rules and regulations on prevention and treatment are crucial. The aim of this study as to determine the pattern of musculoskeletal injuries among patients as they present at Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo State of Nigeria.Methods: This is a prospective cross-sectional study of consecutive patients who presented at the accident and emergency department of ISTH with musculoskeletal injury, severe enough to require inpatient care for at least 24 hours, from January 1, 2014-December 31, 2014.Results: One hundred fifty-one patients were recruited. Median age was 35.6 years. Age range was 4 to 99 years. The majority of participants (72.9%) fell within the 20-to 50-year age group. Road traffic collision was the leading cause of injury (121 patients; 80%), and 67.8% of these injuries were motorcycle-related. Passengers constituted 48.8% of victims. Twenty-six (17.2%) patients had only soft tissue injuries while 125 (82.8%) had both bony and soft tissue injuries. The lower limb was the most frequently injured body part. The tibia and femur were the most frequently injured bones.Conclusions: Injury is a leading cause of morbidity in Irrua. Road traffic collisions were the leading cause, occurring among the economically viable age groups, thereby imposing severe social pressures on the victims, their families, as well as the health system. Enforcement of extant traffic rules and strengthening of trauma prevention and trauma service delivery systems is advised.Keywords: injuries; musculoskeletal; Irrua; Nigeria","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"198200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122057435","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":"Timing of death at National Trauma Center, Abuja, Nigeria","authors":"U. Gwaram, E. Ameh","doi":"10.4314/ECAJS.V22I3.8","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I3.8","url":null,"abstract":"Background: We aimed to analyse the burden and timing of trauma deaths over a 1-year period at a trauma centre in Nigeria. \u0000Methods: This was a retrospective review of in-hospital trauma deaths during the period of January to December 2015. Sociodemographic data, cause of injury, mode of presentation, time interval between presentation and death, injury diagnoses, treatment, and place of death were analysed. \u0000Results: There were 2230 trauma consultations during the study period; 85 were brought in dead from the scene. We analysed data from 103 of 121 in-hospital deaths. Patient ages ranged from 0 to 90 years, with a mean age of 31.1. The male-to-female ratio was 5:1. Following injury, 46.6% of the victims presented directly to our tertiary centre, while 53.4% were referred from other hospitals. Most of the injuries were from RTA. Isolated head injury was the predominant diagnosis (44.7%), followed by polytrauma (29%). Immediate deaths (exclusive of those brought in already dead) comprised 5.8% of cases; 37.9% were early deaths and 56.3% were late deaths. \u0000Conclusions: The timing of trauma deaths closely approximated the original trimodal description in North America about half a century ago even though advances in trauma care have resulted in changes from this pattern in developed countries. Regionalised integrated care including prehospital trauma services are recommended. \u0000https://dx.doi.org/10.4314/ecajs.v22i3.8 \u0000  \u0000This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source (including a link to the formal publication), provide a link to the Creative Commons license, and indicate if changes were made.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130878339","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":"Efficacy and safety of the use of infant feeding tubes as internal ureteral stents at Muhimbili National Hospital, Tanzania","authors":"R. Nyamsogoro","doi":"10.4314/ecajs.v22i3.5","DOIUrl":"https://doi.org/10.4314/ecajs.v22i3.5","url":null,"abstract":"Background: Infant feeding tubes are inexpensive, readily available, and have been used as urinary tract stents with some uncertainty about their effectiveness and safety. Double J ureteral stents are available on the market, but among other factors, availability and affordability limit their use in developing countries, including in our hospital. We aimed to compare the efficacy of infant feeding tubes compared to standard double J ureteral stents in patients undergoing open ureteral stenting at Muhimbili National Hospital in Dar es Salaam, Tanzania. Methods: We conducted a hospital-based cross-sectional analytical study over 12 months. Patients included in the study required open ureteral stenting for different indications and were divided into 2 groups: those for whom infant feeding tubes were inserted during surgery (study group) and those whose surgery used double J stents (control group). After surgery, patients were recruited and observed to ascertain the duration of hospital stay, as well as the presence of haematuria, dysuria, urinary frequency, flank and suprapubic pain, stent migration, and stent encrustation. Observations continued until the day of discharge, after which patients were followed up to the day of stent removal. Results: A total of 44 patients were enrolled in the study. The mean age of participants was 40 years (range 1 to 75). The majority of participants were female (n = 26; 60%). Among the 44 operations, 19 (43.2%) used the infant feeding tube as a stent whereas the remainder (n = 25; 56.8%) used the standard double J ureteral stent. The mean hospital stay among patients who underwent surgery with the infant feeding tube as a stent was 9.6 days, whereas those who used the standard double J stent stayed for 8.8 days (P = 0.37). Postoperatively, haematuria was observed in 19 (43.2%) of the patients; among these, 15 (79%) of them received infant feeding tube stents and 4 (4.3%) received standard double J stents (Χ 2 = 17.4; P = 0.001). The postoperative prevalences of dysuria, flank pain, and suprapubic pain were 6.8%, 20.4%, and 9.1%, respectively. These outcomes did not show association with the type of surgical stent used. None of our study patients experienced postoperative urinary frequency. Imaging studies showed that 57.8% of the infant feeding tube stents were in the normal position postsurgery, whereas all of the standard double J stents were in the normal position (Χ 2 = 12.86; P = 0.005). Further, we found that among the 44 patients, only 1 patient (who underwent surgery that used double J stenting) had postoperative stent encrustation (Χ 2 = 0.7; P = 0.4). Conclusions: Despite producing significantly higher incidences of haematuria and malposition, infant feeding tube as ureteral stents were comparable to double J stents in terms of hospital stay post-stenting, dysuria, flank pain, suprapubic pain and encrustation. Future larger prospective studies are needed to confirm these findings. Keywords: infant feedin","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116712835","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":"Management of obstructive nephropathy in a tertiary hospital in North West Nigeria: A five-year review","authors":"A. Muhammad, A. Abdulwahab-Ahmed, Peter Agwu, K. Abdullahi, I. Mungadi","doi":"10.4314/ecajs.v22i3.6","DOIUrl":"https://doi.org/10.4314/ecajs.v22i3.6","url":null,"abstract":"Background: Obstructive nephropathy is managed initially with urinary diversion and possibly haemodialysis before definitive therapy. This study was aimed at determining the pattern of presentation, aetiology and management options of obstructive nephropathy in our practice. Methods: This was a five-year retrospective study of the patients managed for obstructive nephropathy at our facility from January 2011-December 2015. Data were collected via a pro forma and analysed using SPSS version 20.0. Results: There were 106 patients managed for obstructive nephropathy with a mean age of 48.3 ± 17. 4 years and age range of 4 months to 85 years. The male: female ratio was 10:1. The most common causes of obstructive nephropathy were bladder cancer (49.1%), benign prostatic hyperplasia (BPH, 22.6%), bilateral ureteric stone (5.7%) and bilateral schistosomal lower ureteric obstruction (4.7%). Urethral or suprapubic catheterisation (22.6%), nephrostomy (2.8%) and dialysis (10.4%) were the initial treatments. Chemoradiation was done for the patients with bladder cancer and 17.9% of the patients had operative interventions, which included ureteroneocystostomy, open prostatectomy or transurethral resection of the prostate, and ureteroscopy + lithotripsy. Fifty-two patients (49.1%) died while awaiting dialysis and four patients (3.8%) developed end-stage renal disease. Conclusions: Bladder carcinomas, BPH, ureteric obstruction are the commonest causes of obstructive nephropathy in our practice. The initial treatment includes urinary diversion and or dialysis before definitive treatment. Keywords: obstructive nephropathy; bladder cancer; acute kidney injury; chronic kidney injury; urinary diversion; dialysis","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115147833","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":"Ileosigmoid knotting in pregnancy: A case report from Zimbabwe","authors":"B. Mlambo, S. Mungazi, A. Maunganidze","doi":"10.4314/ECAJS.V22I2.9","DOIUrl":"https://doi.org/10.4314/ECAJS.V22I2.9","url":null,"abstract":"Ileosigmoid knotting (ISK), also known as compound volvulus, is a rare cause of intestinal obstruction wherein the ileum wraps around the base of the sigmoid colon and forms a knot with rapid progression to gangrene. The worldwide incidence of ISK ranges from 1 in 1500 to 1 in 66,431. ISK is particularly rare in pregnancy, with the majority of cases occurring in the third trimester. The preoperative diagnosis of ISK in pregnancy is challenging because the condition is often mistaken for other obstructive or nonobstructive emergencies and delayed because of concerns regarding imaging in pregnancy. We report a case of a gravid woman presenting at 13 weeks' gestation with features suggestive of intestinal obstruction and who underwent an emergency laparotomy during which a diagnosis of ISK was made. Her recovery was uneventful, and she was able to carry the pregnancy to term. Keywords: ileosigmoid knotting; pregnancy; intestinal obstruction","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131969543","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}