Annals of African Surgery最新文献_第5页

Superior mesenteric venous thrombosis presenting with hematemesis: a case report 以呕血为表现的肠系膜上静脉血栓1例

Annals of African Surgery Pub Date : 2022-08-29 DOI: 10.4314/aas.v20i1.5

E. Mackutwa, F. Kuria, J. Rono, Desmond Mang’oka

{"title":"Superior mesenteric venous thrombosis presenting with hematemesis: a case report","authors":"E. Mackutwa, F. Kuria, J. Rono, Desmond Mang’oka","doi":"10.4314/aas.v20i1.5","DOIUrl":"https://doi.org/10.4314/aas.v20i1.5","url":null,"abstract":"The superior mesenteric vein (SMV) is one of the two tributaries to the portal vein, which is the main pre- hepatic drainage channel of the splanchnic circulation. Venous thrombosis in the SMV is one of the rare causes of splanchnic ischemic syndrome. Clinical presentation is often vague abdominal symptoms. It seldom presents with hematemesis, which may further confound diagnosis, thereby increasing the risk of poor outcomes. This case highlights an otherwise healthy 31-year-old woman, who presenting at a tertiary hospital in Nairobi with a 2-day history of epigastric pain and copious hematemesis. She had been treated for Helicobacter pylori gastritis 2 months prior. Common differentials were considered. However, with normal esophagogastroduodenoscopy findings and dark- colored fluid sequestered in the upper gastrointestinal tract, mesenteric venous congestion with associated small bowel ischemia was suspected. Three-phase abdominal computed tomography angiogram confirmed proximal superior mesenteric venous thrombosis extending into the portal vein confluence. Associated small bowel necrosis was suspected, and surgery involving resection and primary ileo-jejunal anastomosis was performed. Post-operative 2-week parenteral nutrition and anticoagulation were administered. The patient was discharged after 3 weeks of hospitalization and remains in excellent condition.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85576987","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

Empyema Thoracis- the role of open thoracotomy with decortication in the era of video-assisted thoracoscopic surgery 胸脓肿——开胸去皮术在电视胸腔镜手术时代的作用

Annals of African Surgery Pub Date : 2022-08-26 DOI: 10.4314/aas.v19i4.3

Vikram Sindgikar, Tejaswini Vallabha, Mallikarjun Patil, Girish Kullolli, Samhitha Reddy

{"title":"Empyema Thoracis- the role of open thoracotomy with decortication in the era of video-assisted thoracoscopic surgery","authors":"Vikram Sindgikar, Tejaswini Vallabha, Mallikarjun Patil, Girish Kullolli, Samhitha Reddy","doi":"10.4314/aas.v19i4.3","DOIUrl":"https://doi.org/10.4314/aas.v19i4.3","url":null,"abstract":"Background: Empyema Thoracis, a condition in which purulent fluid accumulates within the pleural cavity, is commonly caused by bacterial infection (both Gram- positive and Gram-negative), such as Mycobacterium tuberculosis, and rarely by fungal infection. Timely intervention significantly reduces morbidity and mortality. Surgical intervention is needed in advanced disease. This study aimed evaluate decortications performed through video-assisted thoracoscopic surgery (VATS) and open thoracotomy. Methods: This retrospective study included 47 patients who underwent decortications by either VATS or open thoracotomy for empyema Thoracis at the Department of Surgery of, BLDE DU Shri B M Patil Medical College from May 2015 to August 2020. Results: Tuberculosis was the most common etiological factor for empyema Thoracis. In 19 patients who underwent VATS decortications, VATS was converted to open thoracotomy in 11 patients. Only 8 patients achieved successful decortication with VATS. Thirty- nine patients (including 11 whose VATS was converted \u0000to open thoracotomy) underwent successful open thoracotomy decortications. Thirty-two patients had postoperative bronchopleural fistula, and all cases were successfully managed conservatively. The timing of the surgical intervention is critical in reducing morbidity and mortality. The more advanced the disease, the higher the failure rate of VATS in attaining complete decortications. Conclusion: Open thoracotomy decortication remains the gold standard in attaining complete decortications in advanced empyema Thoracis.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87913231","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

Mesenteric ischemia: a case of extrapulmonary presentation in COVID-19 肠系膜缺血:新冠肺炎肺外表现1例

Annals of African Surgery Pub Date : 2022-08-25 DOI: 10.4314/aas.v20i1.6

Radhika Salpekar, Sunil Krishna

{"title":"Mesenteric ischemia: a case of extrapulmonary presentation in COVID-19","authors":"Radhika Salpekar, Sunil Krishna","doi":"10.4314/aas.v20i1.6","DOIUrl":"https://doi.org/10.4314/aas.v20i1.6","url":null,"abstract":"Coronavirus 2019 (COVID-19) is a predominantly respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It creates a hypercoagulable milieu, manifesting at varied extrapulmonary sites as pulmonary embolism, deep venous thrombosis, stroke, myocardial infarction, and mesenteric ischemia. The pathophysiology behind this hypercoagulability is still not entirely understood, although a heightened systemic inflammatory response to the virus is deemed responsible. We herein report a case of a 36-year-old healthy male who presented with an acute abdomen and was found to have extensive mesenteric and portal venous thrombosis with bowel gangrene. The patient underwent emergency exploration with ileal resection and end-ileostomy. The hypercoagulability panel was negative, but a postoperative chest radiograph revealed suspicious ground-glass opacities. Given the ongoing global COVID-19 pandemic, we considered testing for SARS-CoV-2. A positive test for SARS-CoV-2 led us to attribute the thrombotic event to COVID-19. With anticoagulation and supportive therapy, the patient went on to make a steady recovery. A non-specific clinical manifestation of COVID-19 necessitates considering mesenteric venous thrombosis as a differential diagnosis in patients with acute abdomen.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73254889","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

Assessment of surgical care capacity at non-tertiary hospitals in Botswana 评估博茨瓦纳非三级医院的外科护理能力

Annals of African Surgery Pub Date : 2022-08-24 DOI: 10.4314/aas.v19i4.6

M. Motsumi, Nkhabe Chinyepi, K. Difela, Karabo Ngwako, Maranatha Sentsho, Unami Chilisa, T. Leshomo

{"title":"Assessment of surgical care capacity at non-tertiary hospitals in Botswana","authors":"M. Motsumi, Nkhabe Chinyepi, K. Difela, Karabo Ngwako, Maranatha Sentsho, Unami Chilisa, T. Leshomo","doi":"10.4314/aas.v19i4.6","DOIUrl":"https://doi.org/10.4314/aas.v19i4.6","url":null,"abstract":"Background: Most low- and middle-income communities (LMICs) live in rural areas and are served mainly by primary and district hospitals. This study seeks to geographically map these hospitals and measure their surgical care capacity in Botswana. Methods: This 3-month cross-sectional observational study was conducted at the Department of Surgery, University of Botswana. Google Map was used to map hospitals geographically. The PIPES (personnel, infrastructure, procedures, equipment, and supplies) tool was used to assess the surgical care capacity of hospitals. This tool was developed by Surgeons Overseas to quantify surgical capacity in low-resource settings. Consent was obtained. Results: Nine districts and ten primary hospitals were assessed. The distance from settlements to the nearest healthcare facility in sparsely populated areas was relatively larger, making timely healthcare access potentially problematic. Intensive care services were unavailable except at three hospitals. None of the hospitals had full blood bank services. X-ray and ultrasound machines and basic supplies were available at over 90% of the hospitals. Conclusion: There was a general lack of surgical care specialists. Hospitals with a full complement of surgical care specialists had relatively higher PIPES indices. We recommend investing in deploying specialized surgical care providers to primary and district hospitals.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"231 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77061644","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

Infections Mimicking Malignancy in Kano, Nigeria: A Teaching Hospital Experience 尼日利亚卡诺的模仿恶性肿瘤感染:教学医院经验

Annals of African Surgery Pub Date : 2022-05-30 DOI: 10.4314/aas.v19i2.4

Abdulrazaq Jimoh Ajanaku, A. A. Taoheed, U. Mohammed, Muhammad Haruna Sanusi, Zubaida Adamu Gwaram

{"title":"Infections Mimicking Malignancy in Kano, Nigeria: A Teaching Hospital Experience","authors":"Abdulrazaq Jimoh Ajanaku, A. A. Taoheed, U. Mohammed, Muhammad Haruna Sanusi, Zubaida Adamu Gwaram","doi":"10.4314/aas.v19i2.4","DOIUrl":"https://doi.org/10.4314/aas.v19i2.4","url":null,"abstract":"Objective: This study aimed to evaluate the pattern of presentation of infectious lesions mimicking malignancy. This will serve to heighten clinical indices of suspicion and prevent unwarranted aggressive management. \u0000Methods: This is a 19-year (1999-2017) audit review of all morphologically diagnosed infection-related lesions in which malignancy was primarily clinically suspected. \u0000Results: Fifty-six cases of infection-related mimics of malignancy were diagnosed in the study period: schistosomiasis related, 22 (39.2%); actinomycosis, 21(37.5%); tuberculosis-related, 10 (17.9%); fungi-related, 3(5.4%). Twenty-one cases of actinomycosis of the lower limbs and oropharynx were mistaken for melanoma, squamous cell carcinoma, sarcoma, and oropharyngeal carcinoma. The mean age was 33±17years.The 10 patients with atypical Mycobacterium tuberculosis-mimicking malignancy had mean age of 37±14 years and included three in the testes, testicular cases, one from the jaw, and two cases each from ovary, breast, and uterus. Of the three fungal lesions, there was a case each from the brain, skin, and bone. All were males with mean age of 21±7 years. \u0000Conclusion: For accurate diagnosis of infection-related mimics of malignancy, a high index of clinical suspicion, knowledge of and attention to characteristic radiological signs, and obtaining representative tissues for histopathologic and cytopathologic diagnoses are paramount.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75907707","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

Double Trouble – Synchronous Primary Malignant Neoplasms: A Case Report 双重困扰-同步原发恶性肿瘤1例报告

Annals of African Surgery Pub Date : 2022-05-30 DOI: 10.4314/aas.v19i2.10

Sejal V. Jain, A. Anandhi, S. Sureshkumar, D. Barathi, Bheemanathi Hanuman Srinivasan, V. Kate

引用次数: 0

Management of Peritonsillar Abscess in a Tertiary Hospital in Southwest Nigeria 尼日利亚西南部一家三级医院扁桃体周围脓肿的处理

Annals of African Surgery Pub Date : 2022-05-30 DOI: 10.4314/aas.v19i2.2

O. Sogebi, E. A. Oyewole

{"title":"Management of Peritonsillar Abscess in a Tertiary Hospital in Southwest Nigeria","authors":"O. Sogebi, E. A. Oyewole","doi":"10.4314/aas.v19i2.2","DOIUrl":"https://doi.org/10.4314/aas.v19i2.2","url":null,"abstract":"Background: Peritonsillar abscess (PTA) occurs when pus accumulates in the peritonsillar space. There are controversies about the most adequate form of treatment. The objectives of this study were to describe the clinical profile of patients, PTA and bacteriological profile of aspirates, and management of PTA. \u0000Methods: This retrospective study included patients with PTA managed in a tertiary hospital. The clinico-demographic characteristics, oropharyngeal examination findings, including that of the tonsils, test aspiration of swelling, and culture results were documented. The treatment modalities, hospitalization period, and outcome were recorded. \u0000Results: Seventeen records of adults were available (mean age, 33.3±9.7 years; female, 58.8%). All patients presented with fever, odynophagia, and trismus within 3 days. Five (29.4%) had previous sore throat, 94.1% had previous medications, and 52.9% had the abscesses on the left side. Test aspirate yielded pus in 76.5% of patients, whereas 8 aspirates cultured micro-organisms; 70.6% of the patients had incision and drainage (I&D) of the abscess, and the average hospitalization period was 3 days. Most (94.1%) of the patients had favorable outcomes. \u0000Conclusion: PTA is common in adults, and they present early with classical symptoms. Purulent aspiration is usually positive, and patients are treated with I&D with antibiotic coverage, which leads to a generally good outcome.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84408522","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

Pattern of Skin Cancers in a Tertiary Medical Center in Southwest Nigeria 尼日利亚西南部某三级医疗中心的皮肤癌模式

Annals of African Surgery Pub Date : 2022-05-30 DOI: 10.4314/aas.v19i2.3

A. Salawu, O. Babalola, O. Omoseebi, O. Erinomo, T. Ipinnimo, Shiyanbola Akinlolu Christopher, Adeniyi Steven Hassa

{"title":"Pattern of Skin Cancers in a Tertiary Medical Center in Southwest Nigeria","authors":"A. Salawu, O. Babalola, O. Omoseebi, O. Erinomo, T. Ipinnimo, Shiyanbola Akinlolu Christopher, Adeniyi Steven Hassa","doi":"10.4314/aas.v19i2.3","DOIUrl":"https://doi.org/10.4314/aas.v19i2.3","url":null,"abstract":"Background: Skin cancers are the most common malignancies in the western world, and their incidence is increasing globally. However, the data about the pattern in sub-Saharan Africa are limited. This study evaluates the pattern of primary skin malignancies in a tertiary medical center located in a sub-urban area. \u0000Methods: The histo-pathological records of patients managed for malignancies from January 2012 to December 2020 were retrieved from the pathology department of a tertiary medical center in Ekiti State, Southwest Nigeria. All primary skin cancers seen within this study period were extracted from the records and then reviewed retrospectively. \u0000Results: The male-to-female ratio of primary skin malignancies was 1:1.06, and the mean age of patients was 57.2 ± 17years. All patients were black Africans who were mainly of the Yoruba ethnicity (97.2%). Squamous cell cancer had the highest frequency (34.7%), followed by melanoma (27.8%), dermatofibrosarcoma (12.5%), and basal cell carcinoma (11.1%). The most commonly affected anatomic region is the lower limbs (50.6%). \u0000Conclusion: The pattern of primary skin cancers seen in black Africans differ from that of Caucasians: however, larger community-based studies in our environment is recommended to provide more conclusive information about the pattern of skin cancers.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75015280","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

Conforming an Extracorporeal Lithotripter System for Video Urodynamic Studies 用于视频尿动力学研究的体外碎石机系统

Annals of African Surgery Pub Date : 2022-05-30 DOI: 10.4314/aas.v19i2.6

N. Xiao, Qiaoxia Tang, Sheng Zhu, G. Guo, Lianhua Chen, Jianfeng Wang, Huasheng Zhao

{"title":"Conforming an Extracorporeal Lithotripter System for Video Urodynamic Studies","authors":"N. Xiao, Qiaoxia Tang, Sheng Zhu, G. Guo, Lianhua Chen, Jianfeng Wang, Huasheng Zhao","doi":"10.4314/aas.v19i2.6","DOIUrl":"https://doi.org/10.4314/aas.v19i2.6","url":null,"abstract":"Objectives: This study aimed to evaluate the efficiency using existing fluoroscopic unit and lithotripter table of an extracorporeal lithotripter system for video urodynamic studies (VUDS) to determine anatomical abnormalities in patients with neurogenic lower urinary tract dysfunction (NLUTD). \u0000Methods: The extracorporeal lithotripsy system was adapted to obtain optimum fluoroscopic view according to body shape and observed organs of patients. We reviewed the VUDS data of 25 patients with NLUTD. \u0000Results: “Christmas tree bladder” (CTB) was found in 5 (20%) patients. Vesicoureteral reflux (VUR) and external detrusor sphincter dyssynergia (DESD) were detected in 3 (12%) and 4 (16%) patients, respectively. Four (16%) patients with normal coordination between detrusor contraction and external sphincter relaxation were proven by VUDS. CTB, VUR, or DESD was not observed in 10 (40%) patients with flaccid bladder. Hematuria, urinary tract infection, or autonomic dysreflexia did not occur in any of the patients. \u0000Conclusions: VUDS can discern anatomical abnormalities of the urinary tract, and patients in undeveloped areas of the world who have NLUTD can have easier access to VUDS because of the decreasing capital cost of VUDS.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89290634","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

Changes in Astigmatism and Visual Acuity after Pterygium Excision in the Ashanti Region of Ghana 加纳阿散蒂地区翼状胬肉切除后散光和视力的变化

Annals of African Surgery Pub Date : 2022-05-30 DOI: 10.4314/aas.v19i2.5

K. Amoah, S. Lartey, A. Mohammed, Abdul-Sadik Ahmed, Kwesi Amissah Nyan Arthur, Ernest Nkansah Kyei

{"title":"Changes in Astigmatism and Visual Acuity after Pterygium Excision in the Ashanti Region of Ghana","authors":"K. Amoah, S. Lartey, A. Mohammed, Abdul-Sadik Ahmed, Kwesi Amissah Nyan Arthur, Ernest Nkansah Kyei","doi":"10.4314/aas.v19i2.5","DOIUrl":"https://doi.org/10.4314/aas.v19i2.5","url":null,"abstract":"Background: Pterygium is a conjunctival subepithelial fibrovascular growth commonly occurring in the inter-palpebral conjunctiva nasally or temporally. It tends to grow over the cornea, leading to visual impairment due to various factors, including astigmatism. \u0000Methods: This was a prospective, multi-centered, hospital-based, interventional study carried out within 12 months in three eye centers in the Ashanti region of Ghana. One hundred eyes of 100 adults (≥18 years) with primary pterygia were recruited. Operated eyes had measurements of uncorrected visual acuity (UVA), aided visual acuity (AVA), and keratometry readings (K-readings) before pterygium excision with conjunctival autograft (CAG), 2 weeks after surgery, and 6 weeks after surgery. \u0000Results: The mean age of patients was 47.1±11.5 years. The mean pre-operative astigmatism was 5.0±5.9 D. The mean astigmatism values at 2 and 6 weeks post-operatively were 1.7±1.5 and 1.3±1.0 D, respectively. Eighty-nine eyes had AVA ≥6/12 (0.11 mean logMAR) before surgery, whereas 97 eyes had AVA ≥6/12 (0.02 mean logMAR) 6 weeks after surgery, and the increase was statistically significant. \u0000Conclusion: Pterygia excision with CAG leads to an approximately fourfold reduction in mean pterygium-induced astigmatism by 6 weeks after surgery.","PeriodicalId":37442,"journal":{"name":"Annals of African Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78146248","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