East and Central African Journal of Surgery最新文献

{"title":"Factors Associated With Manual Reduction of Incarcerated Inguinal Hernia in Children","authors":"T. Lawal, D. Olulana, O. Ogundoyin, K. Egbuchulem","doi":"10.4314/ECAJS.V21I3.20","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.20","url":null,"abstract":"Background: In patients with incarcerated inguinal hernia, initial manual reduction, which is not always feasible, rather than immediate surgery, is associated with fewer complications. The aim of the study was to evaluate factors associated with successful manual reduction of incarcerated inguinal hernia in children. Methods: A prospective cohort study between January 2010 and December 2014 of children admitted with incarcerated inguinal hernia to a single surgical unit. Results: A total of 34 patients with a median age of 4.2 months (range: 2 weeks to 14 years) were recruited. Manual reduction was attempted in 23 (67.6%) patients and successful in 13 (56.5%). A total of 9 (26.5%) patients had bowel strangulation. Shorter incarceration (median of 18.2 vs. 48.4 hours, p = 0.004) and longer duration of previous swelling (median of 20 vs. 3.5 weeks, p = 0.029) were associated with successful manual reduction. Bowel strangulation rate was higher amongst patients excluded from manual reduction, using the set criteria, compared to those who had failed reduction (77.8% vs. 22.2%, p = 0.044). Conclusions: Manual reduction is more likely to be successful in patients who present early after incarceration as well as those with wider internal rings. Keywords : children, incarceration, inguinal hernia, manual reduction, strangulation","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121627009","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":"PDA Ligation in Adults – A 2-years Experience in Tikur Anbassa Hospital, Addis Ababa University College of Health Sciences, School of Medicine","authors":"Abebe Bezabih","doi":"10.4314/ecajs.v21i3.4","DOIUrl":"https://doi.org/10.4314/ecajs.v21i3.4","url":null,"abstract":"Backdround: Persistent Ductus Arteriosus (PDA) is commonly diagnosed & treated in infancy.It is unusual to see patients with PDA in adults in developed countries. Methods: Retrospective analysis of charts of adult patients who were operated & PDA ligation done in Tikur Anbasa specialized hospital starting from September 1, 2009 to August 31,2011 was made. Results: Out of thirty one patients operated in two years time, twenty six(84%) charts could be retrieved. Nineteen pts(73 %) were female & Seven pts(27 %) were male. The commonest age group was 16-20(46%). The commonest presenting symptom was exertional dyspnea(61%), three pts(12%) were asymptomatic. Twelve pts(46%) were on medical treatment preoperatively. Fifty four percent of pts had PDA size 5-8mm.One patient died during reoperation . Conclusion: In developed countries , PDA is exclusively managed at infancy but in developing countries like ours, PDA may present in adults with symptoms and if there is no evidence of significant pulmonary hypertension ,PDA ligation is safe and effective. Key words : Ductus, arteriosus, patent","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131279892","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":"Cerebellar Pilomyxoid Astrocytoma","authors":"H. Biluts, Kibruyisfaw Zewdie, T. Gemechu","doi":"10.4314/ECAJS.V21I3.22","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.22","url":null,"abstract":"Pilomyxoid astrocytomas (PMA) are new class of Pilocytic Astrocytoma (PA.), which typically have their origin in hypothalamus and Chiasmatic region. There are very few case reports of PMAs arising from cerebellum. Their imaging features are similar to PA but they behave more aggressively than PA. To increase awareness of PMA within the neurosurgical community, the authors reviewed a case of 11-year-old male child who presented with truncal and cerebellar ataxia and vomiting and right cerebellar tumor diagnosed as PA radiologically but PMA on histopathology examination. These findings indicate that PMA may be a unique entity that is distinct from PA, or it may be an unusual variant. Key words : -Pilocytic astrocytoma • pilomyxoid astrocytoma • diagnosis • cerebellar","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134206947","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":"Strong Support for a Context-Specific Curriculum on Non-Technical Skills for Surgeons (NOTSS)","authors":"Yihan Lin, J. Scott, Zeta A. Mutabazi, D. Smirk, S. Yule, R. Riviello, G. Ntakdyiruta","doi":"10.4314/ECAJS.V21I3.1","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.1","url":null,"abstract":"[None] \u0000http://dx.doi.org/10.4314/ecajs.v21i3.1 \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":"1027 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134281115","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":"Manual Detorsion of Testicular Torsion - A Primary Care Intervention Procedure. Case Reports.","authors":"E. Mugalo","doi":"10.4314/ECAJS.V21I3.21","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.21","url":null,"abstract":"Testicular torsion is one of the known acute urological emergencies that require prompt intervention. Salvage of the testis is only possible if derotation is performed within 6 hours of onset of symptoms. The objective of this paper is to report successful manual detorsion of the testes of patients with testicular torsion. Three cases with testicular torsion requiring emergency scrotal exploration underwent manual detorsion after sedation while waiting to be taken to theatre. Case 1, a 15 year old male diagnosed with right sided testicular torsion. Case 2, a 28 year old male with right testicular torsion. Case 3, a 15 year old male who presented with a 6 hour history of left testicular torsion. Attempting manual detortion in patients with acute testicular torsion can salvage the testis against loss. Key Words : testicular torsion, manual detorsion, testicular survival, orchidopexy.","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115226207","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":"Separation of Conjoined Twins in Harare, Zimbabwe: Case Report.","authors":"F. Madzimbamuto, B. Mbuwayesango, T. Zimunhu","doi":"10.4314/ECAJS.V21I3.15","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.15","url":null,"abstract":"Conjoined twins are rare, and those surviving beyond the first 24hrs occur about 1:200,000 pregnancies. There are often conflicting interests in their management. Medically, few are separable. The families may not want separation for emotional, religious and ethical reasons. Technically the surgery is often difficult and resource intensive. The occurrence of conjoined twins in a resource poor setting presents all these challenges. We present a case of successful elective separation of conjoined twins, in a resource poor setting. Key words : Conjoined, twins, separation","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128381698","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":"Uncovering the Burden of Urologic Disease: Admissions Patterns at the Main Teaching Hospital of Ethiopia","authors":"I. Feldhaus, G. Temesgen, A. Laytin, A. Odisho, A. Beyene","doi":"10.4314/ecajs.v21i3.13","DOIUrl":"https://doi.org/10.4314/ecajs.v21i3.13","url":null,"abstract":"Background: Limited data exists profiling the urologic needs of populations in sub-Saharan Africa. As the region builds training programs for urology, such data can inform strategic program planning and investment. The objective of this study was to describe admissions patterns for urologic disease at an academic medical center in Ethiopia. Methods: Retrospective review of admission, discharge, and operative logs of the urology service from November 2011 to October 2014 was conducted at Tikur Anbessa Specialized Hospital. Data were collected on patient demographics, length of hospital stay, specific diagnoses, condition classifications, and procedures performed, generating descriptive statistics. Results: A total of 1,149 urologic procedures were reviewed. Patients were predominantly male (74%) with median age of 43 years. The most common condition was urolithiasis (31%), followed by malignant tumors (25%) and benign tumors (14%). Almost half of patients underwent open surgical procedures (47%). Median inpatient stay was 14 days. Conclusions: The breadth and volume of patients treated hints at the large, unmet burden of urologic disease in Ethiopia. A large percentage of patients underwent open procedures and had prolonged inpatient lengths of stay. Continued research to understand urologic disease patterns and increase access to specialty care in this setting is needed. Keywords : Ethiopia; Sub-Saharan Africa; Urological Surgical Procedures; Health Care Utilization;","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132611388","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":"Congenital diaphramatic hernia outcomes in East Africa: The Ethiopian experience","authors":"M. Derbew","doi":"10.4314/ECAJS.V21I3.2","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.2","url":null,"abstract":"Background: Despite advances in care leading to improved survival rate in high-income countries, congenital diaphragmatic hernia (CDH) continues to have a poor prognosis in sub-Saharan Africa. This retrospective analysis documents the demographics, presenting symptoms, initial diagnosis and outcomes of those CDH patients on whom operations are performed at TikurAnbessa Specialized Hospital (TASH), Ethiopia’s largest tertiary referral center, from September 2012 to August 2016. \u0000Methods: The pediatric surgery database was reviewed for those patients who underwent CDH repair, and these cases were retrospectively analyzed. All work was performed in compliance with the Addis Ababa University institutional review board. \u0000Results: Out of 15 patients who underwent operations, twelve cases were included in our study. Average age at presentation to TASH was 233 days. 83.3% of our study patients were initially misdiagnosed; 50% were initially diagnosed with pneumonia. The diaphragmatic defect was on the left in six (50%) of our patients and on the right in six (50%). Two patients died after surgery. The remaining ten survived. All patients underwent primary repair via lateral subcostal incision. Average length of stay was 24.5 days. \u0000Conclusion: Misdiagnosis of CDH remains to be a major problem in sub-Saharan Africa, likely contributing to delay in diagnosis and early appropriate care. First line physicians and neonatal care units should consider the possible diagnosis of CDH when neonates and infants present with respiratory symptoms. \u0000http://dx.doi.org/10.4314/ecajs.v21i3.2 \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":"183 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115069469","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":"Factors Associated with Interpersonal Violence Injuries as Seen at Kigali and Butare University Teaching Hospitals In Rwanda","authors":"S. Safari, Ahmed Kiswezi Kazigo","doi":"10.4314/ecajs.v21i3.8","DOIUrl":"https://doi.org/10.4314/ecajs.v21i3.8","url":null,"abstract":"Background: Interpersonal conflicts often result into physical injuries of different magnitudes. Every year, a significant portion of patients admitted with injuries to the Accident and Emergency units of the hospitals in Rwanda, like in other African countries, are victims of intentional interpersonal violence. Globally, studies indicate that the problem of interpersonal violence related-injuries is a significant contributor to surgical morbidity and mortality. The aim of this study was to analyze and document the patterns and risk factors associated with interpersonal violence injuries in two referral hospitals in Rwanda (University Teaching Hospitals – Butare (CHUB) and Kigali (CHUK). Methods: This was a prospective observational study. All patients with interpersonal violence injuries (physical injuries) willing to participate in the study were included. Each participant was assessed using the abbreviated injury sore (AIS), by which we categorized their injuries as minor, moderate, and serious or severe, according to the anatomical distribution and severity of the injuries. The variables studied included types of injuries, weapons used, relationship between assailant and victim, and factors leading to the violence. The study population consisted of 138 patients seen from August 2015 to January 2016. Results: Among the 138 participants (victims) the risk factors identified were: Alcohol abuse (31%); Land conflicts (17%); Robbery (14.3%); Business-related / money issues (12.3%); Domestic violence, including child abuse (5.8%); others (2%). Outcome: 119 patients improved well, 17 died and 2 were left with permanent injuries. The total number of trauma cases admitted in the two referral hospitals in this period was 1004, and the trauma mortality for the two hospitals in the same period was 156. This meant a morbidity of 14%, and a mortality of 10% due to interpersonal violence. Conclusion: The predisposing factors for interpersonal violence in Rwanda, as indicated by this study, included land conflicts, alcohol abuse, robbery, unemployment, domestic violence, and low levels of education. Interpersonal violence injuries contributed significantly to trauma related surgical morbidity and mortality. Key words: Interpersonal violence, Physical injuries, predisposing factors","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115689703","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":"Colorectal Polyposis in a 15 Year Old Boy in Uganda - Case Report","authors":"N. Kakembo, P. Kisa, J. Sekabira, D. Ogdzediz","doi":"10.4314/ECAJS.V21I3.16","DOIUrl":"https://doi.org/10.4314/ECAJS.V21I3.16","url":null,"abstract":"Colorectal polyps usually present as rectal bleeding and are associated with increased risk of colorectal carcinoma. This is a 15 year old boy who presented with painless rectal bleeding for 9 years and mass protruding from the anus for 2 years after passing stool. He had history of 3 nephews with similar symptoms. On clinical assessment an impression of Adematous familial colorectal polyposis was made and biopsy was taken from the mass that revealed inflammatory polyps. He subsequently had a total colectomy and ileall pouch anal anastomosis with good outcome. In absence of endoscopic surveillance and diagnostic services diagnosis of colorectal polyposis syndromes is a challenge because clinicians rely on digital rectal assessment and examination under anesthesia. Key words : polyposis, polyps, Uganda","PeriodicalId":302666,"journal":{"name":"East and Central African Journal of Surgery","volume":"36 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120846228","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}