Journal of the West African College of Surgeons最新文献

{"title":"Value of Ultrasonography in Assessment of Screen-Detected Calcified Ductal Carcinoma <i>In Situ</i>: A Clinical Audit.","authors":"Ukamaka Dorothy Itanyi, Deborah Allen, Ivy Okereke","doi":"10.4103/jwas.jwas_8_24","DOIUrl":"10.4103/jwas.jwas_8_24","url":null,"abstract":"<p><strong>Background: </strong>Approximately 80% of ductal carcinoma <i>in situ</i> (DCIS) cases are asymptomatic and manifest as microcalcifications, usually detected on screening mammograms. Stereotactic biopsy is used as the primary modality for histopathologic diagnosis. Ultrasonography has been relied upon as a potentially viable alternative for early breast cancer detection, especially in low- and medium-income countries.</p><p><strong>Aim: </strong>Determine the role and reliability of breast ultrasonography in the evaluation of screen-detected microcalcifications using histologically proven calcified DCIS as a case study.</p><p><strong>Materials and methods: </strong>Cross-sectional evaluation of records of patients recalled for M3-M5 (indeterminate to malignant) type microcalcifications on screening mammograms, with a histological diagnosis of pure DCIS, in an NHS Trust Hospital, Kent, England, from March 2021 to April 2023.</p><p><strong>Results: </strong>Eighty women included were within the age range of 46-79 years, with mean age of 60 years. Background breast density was predominantly fatty in 51/80 (63.8%), without any correlation with mammographic abnormalities. Microcalcifications were classified as indeterminate (M3) in 42/80 (52.5%), while suspicious (M4) and malignant (M5) types were seen in 38/80 (47.5%). No targeted sonographic abnormalities were noted in 69 (86.2%) of the patients, while 11 (13.8%) had sonographic abnormalities. The predominant sonographic feature was non-mass hypoechogenicity in 6/11(55%). There was a correlation between mammographic code, lesion size, and ultrasonic abnormality, with 9/11 (81.8%) patients with sonographic lesions having suspicious and malignant type calcifications. The mean mammographic lesion size was significantly greater in women with abnormal ultrasound findings, 42 vs. 20 mm. Histological tumour grade was high grade in 10/11 (90.9%) lesions.</p><p><strong>Conclusion: </strong>The accuracy of breast ultrasonography as an adjunct in the detection of screen-detected microcalcifications and subsequent guided biopsy is higher when dealing with malignant type microcalcifications >15 mm in size.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"164-170"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Avascular Necrosis of the Hip in Patients with Sickle Cell Disease.","authors":"Agbeko K Ocloo, Abena Kwafo-Armah, Samuel Quarshie Lartey","doi":"10.4103/jwas.jwas_21_24","DOIUrl":"10.4103/jwas.jwas_21_24","url":null,"abstract":"<p><strong>Background: </strong>Avascular necrosis (AVN) of the femoral head is a devastating complication of sickle cell disease characterised by hip pain and dysfunction. The prevalence of this condition in patients with sickle cell disease in Ghana is unknown.</p><p><strong>Objectives: </strong>This study aims to look at the demographics of sickle cell disease patients presenting with AVN, the pattern of the disease on presentation, and the severity of the disease.</p><p><strong>Materials and methods: </strong>Data were collected from patients referred to the Orthopaedic clinic over three years. Data collection forms were created and filled out for all patients. Analysis was done with Microsoft Excel (Windows 10 version), and the ensuing data were represented with descriptive statistics such as proportions, ratios, percentages, tables, and histograms.</p><p><strong>Results: </strong>A total of 134 patients were seen over a 3-year study period. The vast majority, 109 (85.3%), were below 40 years of age. The sex distribution of the patients was predominantly female (78%). Genotype SS was in the majority (89), representing (66.4%).The majority of the patients, 104 (77.6%), were regular attendees of the Ghana Institute of Clinical Genetics or other specialised sickle cell disease clinics. The main reason for referral was on account of X-ray changes seen by the referring doctor (90, 67.1%). Unilateral disease was seen in 94 (70%) patients. Seventy (52.2%) presented with stage III disease, and 42 (31%) had symptoms for more than 2 years.</p><p><strong>Conclusions: </strong>Most of our patients were young, predominantly with genotype SS. They presented late with advanced disease stages and were referred to the orthopaedic clinic only after X-ray changes were seen.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Vitelliform Macular Dystrophy Presenting with Choroidal Neovascular Membrane in an Adolescent: A Case Report and a Review of the Literature.","authors":"Yewande Olubunmi Babalola","doi":"10.4103/jwas.jwas_12_24","DOIUrl":"10.4103/jwas.jwas_12_24","url":null,"abstract":"<p><p>An 11-year-old boy presented to the retina outpatient clinic with a -5-year history of poor vision in the left eye. The best corrected visual acuity at presentation was 6/5 and 6/36, respectively, in the right and left eyes. Ocular examination revealed normal anterior segments in both eyes. Binocular indirect ophthalmoscopy of the right eye revealed a pink disc with a cup disc ratio (CDR) of 0.3, normal vessels while the macula had a yellowish lesion with a scrambled egg appearance and surrounding dome-shaped subretinal fluid with a flat retina and no treatable peripheral retinal lesions. The left eye had a pink disc with CDR O.3, normal vessels with a hyperpigmented lesion at the macula surrounded by a small cuff of subretinal fluid with a flat retina and no treatable peripheral retinal lesions. Optical coherence tomography scan revealed subretinal fluid in both eyes with an active choroidal neovascular membrane in the left eye. He was advised on the need for left intravitreal anti-vascular endothelial growth factor injections.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"240-242"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strangulated Intestinal Obstruction due to Appendiceal Tourniquet: A Case Report.","authors":"Kajali Camara, Charles A Roberts, Lamin S Minteh, Ndumbeh Manneh","doi":"10.4103/jwas.jwas_177_23","DOIUrl":"10.4103/jwas.jwas_177_23","url":null,"abstract":"<p><p>Intestinal obstruction is a common surgical emergency. It has many causes, which may be either benign or malignant. However, appendicitis is not a common cause of intestinal obstruction, hence the challenge in making a diagnosis. Radiological and clinical diagnoses of this could be difficult; hence, diagnosis is mostly intraoperative. This case study involved a 54-year-old male, who presented at Edward Francis Small Teaching Hospital with features of acute intestinal obstruction for 5 days. During surgery, a gangrene of a loop of the bowel was found with an inflamed and partly gangrenous appendix, forming a tourniquet around the loop of the bowel. Appendicectomy and resection of the gangrenous bowel were performed. The postoperative period was uneventful. The patient was discharged on postoperative day 12. We publish this case report to add to the existing literature. In addition, no such case has been reported in the subregion. Appendicitis is not common in the age group in our case study, which makes it different from other cases presented in literature.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"232-234"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Site Infections: Prospective Study in a Medical College Teaching Hospital at Port Blair, India.","authors":"Kandregula Snehaa, Nagma Rafi, Hosdurg Sanjeev, Shahina Mustaqim, Nilesh Patil, Abhay Kumar, Manju Mehrotra","doi":"10.4103/jwas.jwas_9_24","DOIUrl":"10.4103/jwas.jwas_9_24","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical site infections (SSIs) continue to be a prevalent and pervasive issue, contributing to healthcare expenditures, extended hospital stays, and significantly increased morbidity and death. The purpose of the current study was to evaluate the risk factors and prevalence of SSIs amongst patients undergoing various surgical procedures at a tertiary care facility in Port Blair, India.</p><p><strong>Materials and methods: </strong>This prospective study was conducted at a tertiary medical college hospital setting in Port Blair, India, within the Department of Microbiology. The study was conducted from January 2018 to June 2018.</p><p><strong>Results: </strong>During the study period, 776 individuals underwent various surgeries, including both elective and emergency procedures. The total prevalence of the SSI rate during the study period was 12.88% (<i>n</i> = 776) based on the documentation of approximately 100 SSIs. Amongst these, 44% were associated with obstetrics and gynaecology surgery. The category of post-lower segment caesarean section (LSCS) stitch line had the greatest prevalence rate of SSIs (34 patients out of 175 developed infections; LSCS approximately 19.42% of these patients developed SSIs).</p><p><strong>Conclusions: </strong>In Indian adult patients undergoing any form of surgical procedure, the SSI prevalence was 12.88%. SSIs occurred more frequently after obstetrics and gynaecology operations. Following any type of surgery, patients who are women, younger, had emergency surgery, have diabetes, and require a lengthy hospital stay are more likely to experience SSIs. The most commonly encountered pathogens were <i>Staphylococcus aureus</i> and coagulase negative <i>Staphylococcus</i>.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"171-175"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incidence of Primary Malignant Bone Tumour at the University College Hospital, Ibadan, Oyo State, Nigeria, from 2007 to 2022: A Current Update.","authors":"Tolulope Ogunrewo, Temitope Alonge, John Ogunbiyi","doi":"10.4103/jwas.jwas_180_23","DOIUrl":"10.4103/jwas.jwas_180_23","url":null,"abstract":"<p><strong>Background: </strong>Bone tumours constitute about 0.5% of documented cancer incidence. A previous study conducted in our hospital showed an incidence of 0.53% for primary malignant bone tumour (PMBT). Some of the predisposing factors to the development of these bone tumours include trauma, irradiation, foreign bodies, and genetic malfunctioning or mutation. They present symptoms, such as bone pain, swelling and tenderness of the affected bone, and weight loss, and in some cases, the first presentation may be a pathological fracture through the bone tumour. The last review of primary malignant bone tumours carried out in our centre was in September 2007; therefore, this study is designed to provide an update on the current pattern of these tumours.</p><p><strong>Aims and objectives: </strong>The aim and objectives of this study are to provide an update on the current pattern of primary malignant bone tumours. To determine their relative frequencies, age and sex distributions, anatomical sites of occurrence as well as the histological types of the tumours.</p><p><strong>Materials and methods: </strong>This is a retrospective hospital-based study to re-evaluate the incidence of primary malignant bone tumour at the University College Hospital, Ibadan, Oyo State, Nigeria. The histopathology records of patients with primary malignant bone tumours were reviewed through the Cancer Registry of the University College Hospital, Ibadan from January 2007 to December 2022. The information retrieved from the Cancer Registry records includes the age of the patient, the sex, the histological type of tumour, and the bone involved. The data retrieved were analysed using version 23 of the Statistical Package for the Social Sciences.</p><p><strong>Results: </strong>The results revealed that data from 170 patients with primary malignant bone tumours were reviewed within the study period. In all, there were 93 males and 77 females with a male-to-female ratio of 1.2:1. However, 145 patients had complete records and were reviewed. Primary malignant bone tumours occurred more in the second and third decades of life, and the most common primary malignant bone tumour was osteosarcoma.</p><p><strong>Conclusion: </strong>This study concludes that the annual average occurrence of primary malignant bone tumour seems to be on the increase when compared with previous studies with a higher preponderance in the male gender with osteosarcoma being the most common PMBT. The younger age group, especially teenagers and young adults within the second and third decades of life are the most affected.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"142-145"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Corneal Thickness and Its Association with the Severity of Primary Open-Angle Glaucoma.","authors":"Ibitola Enesi, Thelma Ndife, Fatima Kyari, Abimbola Odi","doi":"10.4103/jwas.jwas_1_24","DOIUrl":"10.4103/jwas.jwas_1_24","url":null,"abstract":"<p><strong>Background: </strong>Understanding the relationship between central cornea thickness and glaucoma severity will help in assessing individualised risk and will enhance evidence-based decision-making in the early diagnosis and management of glaucoma.</p><p><strong>Aim: </strong>We aimed to determine the correlation between central corneal thickness (CCT) and the severity of glaucoma at different stages of primary open-angle glaucoma (POAG) at the Federal Medical Centre (FMC), Lokoja, Nigeria.</p><p><strong>Materials and methods: </strong>A cross-sectional study of POAG patients at presentation to FMC, Lokoja. Biodata, use of anti-glaucoma medications, and family history of glaucoma were obtained. Examinations included visual acuity, central visual fields, slit lamp examination, pachymetry, gonioscopy, indirect fundoscopy, and fundus photograph. The correlation between CCT and the above parameters was ascertained. Using the mean deviation, the severity of glaucoma was classified: as mild glaucoma <-6 dB, moderate glaucoma -6 to -12 dB, severe glaucoma -12 to -18 dB, and end-stage glaucoma >-18 dB.</p><p><strong>Results: </strong>A total of 242 eyes of 121 POAG patients were studied. The male-to-female ratio was 1.5:1. The mean age was 55 ± 10 years (range = 40-78 years). Most (65.7%) had not used anti-glaucoma medications and 17.4% gave a positive family history of glaucoma. There was no clinical correlation between positive family history and CCT (<i>P</i> = 0.71) and no correlation between family history and glaucoma severity (<i>P</i> = 0.96). The patients were classified as mild glaucoma 63(29.9%), moderate glaucoma 95(45%), severe glaucoma 30 (14.2%), and end-stage glaucoma 23 (10.9%). The mean CCT was 508.0 ± 32μm. There was a decrease in CCT from 517.94 ± 26μm in mild glaucoma to 504.96 ± 40μm in end-stage glaucoma; this difference was statistically significant (<i>P</i> = 0.031). The mean intraocular pressure (IOP) was 24 ± 7 mm Hg, whereas the mean corrected IOP was 27 ± 8 mm Hg.</p><p><strong>Conclusion: </strong>There was a negative significant correlation between CCT and glaucoma severity and between CCT and true IOP. CCT did not correlate with age, sex, family history, or laterality of POAG.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"146-156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Experience with Surgical Management of Non-Cirrhotic Portal Hypertension in Nigeria: Report from a Single Centre.","authors":"Ibrahim Umar Garzali, Abdulrahman Abba Sheshe, Ibrahim Eneye Suleiman, Amina Ibrahim El-Yakub","doi":"10.4103/jwas.jwas_10_24","DOIUrl":"10.4103/jwas.jwas_10_24","url":null,"abstract":"<p><strong>Introduction: </strong>Portal hypertension is characterised by an increase in portal pressure. It may be a result of cirrhosis of the liver or non-cirrhotic hepatic and portal vein diseases. Non-cirrhotic portal hypertension (NCPH) is caused by a heterogeneous group of diseases affecting the liver and extrahepatic locations. In our setting, the most common cause of NCPH is schistosomiasis. We describe our experience in the surgical management of NCPH.</p><p><strong>Materials and methods: </strong>This is a single centre retrospective study of all patients who had surgery for NCPH from January 2015 to December 2023 was retrieved for data collection. Data collected included the cause of portal hypertension, age, gender, indication for surgery, type of surgery, and outcome of surgery. Data were analysed using SPSS version 26.</p><p><strong>Results: </strong>A total of 13 patients had surgery for NCPH. The most common cause of NCPH was hepatosplenic schistosomiasis in 10 patients, whereas the remaining 3 patients had idiopathic NCPH. The indication for surgery was upper gastrointestinal bleeding secondary to oesophageal varices refractory to endoscopic therapy. The surgical intervention of choice includes the modified Sugiura procedure in five patients and the Hassab procedure in eight patients. Variceal rebleeding was seen in two patients within 1 year of surgery (15%) and in only three patients within 3 years of surgery (23%).</p><p><strong>Conclusion: </strong>Surgical treatment of NCPH is associated with good outcomes in patients with failed endoscopic therapy.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"176-180"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Wound Irrigation with Povidone Iodine Versus Normal Saline on Superficial Incisional Surgical Site Infection Following Laparotomy for Peritonitis.","authors":"Akeem Aderogba Adeleke, Funmilola Olanike Wuraola, Olalekan Olasehinde","doi":"10.4103/jwas.jwas_24_24","DOIUrl":"10.4103/jwas.jwas_24_24","url":null,"abstract":"<p><strong>Background: </strong>Peritonitis is a surgical emergency arising mostly from the perforation or rupture of an abdominal hollow viscus. Surgical operations for peritonitis are often attended by high morbidity and sometimes mortality in severe cases. Surgical site infection (SSI) is perhaps the most common post-operative morbidity following laparotomy for peritonitis.</p><p><strong>Objective: </strong>To compare the rate of SSI in abdominal operations for peritonitis following wound irrigation with povidone iodine versus normal saline at a tertiary health institution in Nigeria.</p><p><strong>Materials and methods: </strong>This was a prospective, comparative hospital-based study over a year. Consecutive consenting adult patients were randomised into two groups in this study. The first group (A) used 500 mL of 1% povidone iodine for subcutaneous wound irrigation, while the second group (B) used 500 mL of normal saline for subcutaneous wound irrigation. Wound irrigation was done after an appropriate surgical procedure had been carried out based on the pathology. Wounds were assessed for SSI for up to 30 days after operation using the definition criteria by the Centre for Disease Control and Prevention (CDC). SSI rates were compared between the two groups.</p><p><strong>Result: </strong>Fifty-eight consecutive patients with generalised peritonitis over a one-year period were enrolled in this study, but 53 patients who completed the study were analysed. Thirty patients were males and 23 were females, and their mean age was 40.83 ± 17.96 years. Overall, 15 (28.3%) patients had incisional SSI. There were nine (34.6%) cases in the povidone group, while there were six (22.2%) in the saline group. This difference was not statistically significant (<i>P</i> = 0.32). Klebsiella species were the dominant organisms isolated from the infected wounds.</p><p><strong>Conclusion: </strong>Wound irrigation with povidone iodine after laparotomy for peritonitis did not reduce the rate and severity of surgical site infection more when compared to normal saline. We suggest further studies with a large number of patients in a multi-centre study to explore further the effect of povidone iodine versus normal saline wound irrigation on SSI following laparotomy for peritonitis.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aetiology and Feasibility of Endoscopic Interventions for Massive Upper Gastrointestinal Bleeding in Makurdi, North-Central Nigeria.","authors":"Bamidele Israel Omolabake, Emmanuel Iwuozo, Innocent Abi, Joseph O Oche, Martha Ochoga, Lewis Ashinze","doi":"10.4103/jwas.jwas_22_24","DOIUrl":"10.4103/jwas.jwas_22_24","url":null,"abstract":"<p><strong>Introduction: </strong>Massive upper gastrointestinal bleeding (UGIB) is a life-threatening emergency with high mortality. Emergency upper gastrointestinal (GI) endoscopy, endotherapy, interventional radiology, and surgery are necessary to control the bleeding source and restore normal physiology. However, these interventions are suboptimal in most centres in Nigeria, contributing to the dismal mortality observed in this condition.</p><p><strong>Objectives & methodology: </strong>We aimed to determine the aetiology, feasibility of endoscopic intervention, and outcome of management of massive UGIB in Madonna Hospital, Makurdi, over a 30-month-period by retrospectively reviewing the medical and procedural records of patients presenting with hypotension from an endoscopically diagnosed upper GI bleeding source.</p><p><strong>Result: </strong>A total of 39 patients were identified, with a mean age of 49.3 ± 17.7 years. Among them, 27 were males (69.2%) and 12 were females (30.8%). Bleeding peptic ulcers were the cause of massive UGIB in 21 cases (53.8%), followed by variceal bleeding, observed in 10 (25.6%) cases. Most of these cases were amenable to endoscopic treatment using adrenaline injection, endoclips, endoscopic variceal band ligation, and diathermy fulguration. Thirty-three (84.6%) patients survived, while the in-hospital mortality following initial endoscopic intervention was 6 out of 39 patients (15.4%), which is comparable to figures from more advanced climes.</p><p><strong>Conclusion & recommendation: </strong>Endoscopic management of massive UGIB is feasible in a low-resource setting. However, timely access to emergency endoscopy is vital to reduce mortality. Strategies to reduce risk factors for peptic ulcers and oesophageal varices are necessary to reduce the incidence of massive UGIB in Makurdi, Nigeria.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 2","pages":"191-196"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}