Journal of the West African College of Surgeons最新文献

{"title":"Vascular Surgery Training and Practice in West Africa: A Narrative Review of Current Capacity and Challenges.","authors":"Jonathan Ajah, Quadri A Sanni, Taye M Tiamiyu, Adaobi S Okezie, Olabode Opeyem, Oluwaseun A Oyekan, Chiedozie K A Ikwu","doi":"10.4103/jwas.jwas_130_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_130_25","url":null,"abstract":"<p><strong>Background: </strong>Globally, the burden of peripheral vascular disease and other diseases in the remit of the vascular surgeon has been on the rise. Health systems globally have responded to the rise in the burden of peripheral vascular disease, particularly in their regions, by investing in training, research, and other initiatives to improve access and the quality of care. Unfortunately, regions in the Global South, especially West Africa, have significantly lagged behind.</p><p><strong>Methods: </strong>This narrative review synthesised existing evidence on the current state of vascular surgical training and clinical practice in West Africa using a search strategy across databases, including PubMed, MEDLINE, Google Scholar, African Journal Online, and other credible institutions like the World Health Organisation.</p><p><strong>Discussion: </strong>Our article highlights a significant unmet need across West Africa for access to care for patients with vascular diseases. It also found a significant lag in the training of vascular surgeons and the requirement for modern technology to provide the necessary level of modern vascular care. Furthermore, investment in this area across West Africa has been low.</p><p><strong>Conclusion: </strong>In the West African sub-region, vascular surgery is a specialty with inadequate manpower, while the incidence of vascular disease is increasing in the region. There is a need to improve vascular care through increased training centres and opportunities, incentivised training, local, regional, and global collaboration, in addition to improving local and global funding and investment in the specialty across West Africa.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"365-385"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171440","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":"Testicular Volume Measurement: Comparison of Prader Orchidometer, Calliper and Ultrasound Estimates with Actual Volume Obtained by Water Displacement.","authors":"Olufemi O Ojewuyi, Emmanuel A Jeje, Amogu Kalu Eziyi, Abimbola A Abolarinwa, Abiodun Ronke Ojewuyi","doi":"10.4103/jwas.jwas_39_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_39_25","url":null,"abstract":"<p><strong>Introduction: </strong>The volume of the testis, mainly made up of seminiferous tubules, is a reflection of spermatogenesis. The accurate measurement of the testicular volume is therefore critical in the evaluation of testicular function. Aim is to compare the volumes obtained by Prader orchidometer, calliper and ultrasound with actual volume in humans.</p><p><strong>Materials and methods: </strong>One hundred testicles from 50 men with advanced prostate cancer were recruited into the study over a 12-month period. Testicular volume was estimated <i>in vivo</i> using Prader orchidometer, calliper, ultrasound scan and <i>in vitro</i> after orchidectomy by water displacement.</p><p><strong>Statistical analysis used: </strong>Statistical analysis used paired <i>t</i> test, Pearson correlation coefficient and simple linear regression analysis.</p><p><strong>Results: </strong>The age of the patients ranged from 55 to 82 years (mean 71.66 ± 6.5). The mean testicular volumes were 16.13 ± 4.5, 9.07 ± 3.5 and 13.48 ± 4.3mL for Prader orchidometer, calliper and ultrasound (Lambert formula), respectively. The mean volume from water displacement was 15.08 ± 4.3 mL. The Prader orchidometer most appropriately estimates the actual volume, (<i>P</i> = 0.657). Calliper significantly underestimated the actual volume. Ultrasound estimation by Lambert formula showed no significant mean difference from the actual volume (<i>P</i> = 0.362). In addition, the orchidometer and Lambert ultrasound formula showed excellent positive correlation with the actual volume (<i>r</i> = 0.931, <i>P</i> < 0.001) and (<i>r</i> = 0.869, <i>P</i> < 0.001), respectively.</p><p><strong>Conclusions: </strong>Prader orchidometer provides an accurate and rapid assessment of testicular volume; it is, therefore, useful in clinical practice. Calliper does not give an accurate assessment of testicular volume. Of the three ultrasound formulae, Lambert formula is the best in providing a near accurate testicular volume measurement.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"438-444"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169753","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":"Comparison of Povidone-Iodine against a Combination of Chlorhexidine, Cetrimide, and Methylated Spirit Skin Preparation for Clean-Contaminated Laparotomy Operations at Jos University Teaching Hospital.","authors":"Peter Oyinu Onuminya, Moses Ahangba Adamgbe, Joshua Adejo Okpanachi, Ossai Abambah, Iorwuese Joshua Agbatse, Nasir Jibril, Michael Ayedima Misauno","doi":"10.4103/jwas.jwas_52_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_52_25","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infection is a major cause of post-operative morbidity and mortality, and pre-operative skin preparation is a measure taken to reduce it. The agents used for skin preparation are either chlorhexidine-based or iodine-based, with no consensus on the ideal pre-operative skin preparation method.</p><p><strong>Objective: </strong>To compare the surgical site infection rate for clean-contaminated laparotomy operations when pre-operative skin preparation was done with 10% povidone-iodine or with a combination of chlorhexidine, cetrimide (Savlon), and methylated spirit at Jos University Teaching Hospital.</p><p><strong>Materials and methods: </strong>This was a retrospective study, and patients' information was accessed from their medical records. Data was analysed using Statistical Package for Social Sciences version 22 statistical software. Comparison of qualitative variables was analysed using Fisher's exact test and quantitative variables with Student's <i>t</i> test. The level of significance was at 0.05, and the confidence interval of 95% when the surgical site infection (SSI) rates were compared.</p><p><strong>Results: </strong>Seventy-five patients were enrolled into the study, 36 (48%) were in the povidone-iodine group, while 39 (52%) were in the chlorhexidine group. In all, three (8.3%) patients from the povidone-iodine group developed SSI, while for the chlorhexidine group, it was 3 (7.7%). There was no statistically significant difference in the SSI rate between the two groups (<i>P</i> = 0.919).</p><p><strong>Conclusion: </strong>There was no significant difference in the SSI rate between the povidone-iodine and chlorhexidine method of skin preparation. Hence, either of the two methods could be used for clean-contaminated laparotomies.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"467-471"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171295","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":"Outcome Prediction Following Peritonitis Secondary to Perforated Peptic Ulcer: A Comparison of the Jabalpur Prognostic Scoring System with Mannheim Peritonitis Index in Irrua Specialist Teaching Hospital, Nigeria.","authors":"L A Ehiagwina, E Tagar, J Kpolugbo, E Irekpita, E O Ijiogbe, G C Obonna","doi":"10.4103/jwas.jwas_12_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_12_25","url":null,"abstract":"<p><strong>Background: </strong>Perforation of a peptic ulcer is a serious and potentially fatal complication, requiring prompt resuscitation and appropriate management to reduce the morbidity and mortality. Early stratification scoring systems have been developed to assist in evaluating and caring for patients with this condition.</p><p><strong>Aim and objectives: </strong>To compare the Jabalpur Prognostic Scoring System (JPSS) and Mannheim Peritonitis Index (MPI) in predicting outcomes of patients with peritonitis caused by a perforated peptic ulcer (PPU).</p><p><strong>Materials and methods: </strong>This descriptive cross-sectional study was conducted over a 1-year period and included 44 patients diagnosed with PPU disease. Patients were assessed using the Jabalpur Prognostic and MPI Scoring Systems at admission and during laparotomy. Statistical analysis was performed to compare the results of both scoring systems and determine their predictive values.</p><p><strong>Results: </strong>The MPI had a higher area under the curve (AUC) of 89% compared to the JPSS, which had an AUC of 75%. The sensitivities of the MPI and JPSS were 82% and 69%, respectively, with specificities of 88% and 83%, respectively.</p><p><strong>Conclusion: </strong>Higher MPI and Jabalpur Prognostic scores were associated with poor outcomes. Both scoring systems were good predictors of outcomes in cases of peritonitis from PPU disease in the subjects studied. However, the MPI scoring system proved to be a more accurate predictor of outcomes compared to JPSS.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"472-479"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170535","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":"Role of Indocyanine Green in Laparoscopic Varicocele Ligation in a Tertiary Care Hospital.","authors":"Aishwarya S Dutt, Kavita V Jadhav, Harshal D Padekar, Veena Rajalakshmi, Sayuj Mathkar","doi":"10.4103/jwas.jwas_59_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_59_25","url":null,"abstract":"<p><strong>Introduction: </strong>Varicocele is surgically managed by an open or laparoscopic approach. The complications of the laparoscopic approach, such as artery ligation, lymphatic ligation, postoperative hydrocele, and recurrence, can be reduced with adequate visualisation and identification of the spermatic vein with the help of indocyanine green (ICG).</p><p><strong>Materials and methods: </strong>A randomised controlled trial was conducted on 20 patients presenting with symptomatic varicocele. They were divided into two groups - group I (patients not given intraoperative ICG) and group II (patients given intraoperative ICG). After giving a test dose of ICG, patients were taken up for laparoscopic varicocele ligation. The perioperative findings were noted and compared between the two groups.</p><p><strong>Results: </strong>Data were analysed with significance considered with a <i>P</i> value < 0.05. Eighty percent of the patients were between 21 and 40 years of age. The mean operative time was significantly less in group II (77.2 ± 28.54 vs. 55.1 ± 28.78 min) (<i>P</i> < 0.001). Postoperatively, there was a significant difference in sperm count (<i>P</i> = 0.04) and motility (<i>P</i> < 0.01) in group I, whereas in group II, there was a significant difference in sperm concentration (<i>P =</i> 0.03) and motility (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Intraoperative administration of ICG leads to a significant decrease in operative time due to the early identification of the spermatic vessels and early ligation of the spermatic vein. Postoperative complications such as hydrocele and recurrence of varicoceles are reduced when ICG is used in these cases, with a significant improvement in post-surgical sperm motility and concentration.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"445-452"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171598","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":"Tracheostomy Protocol in Maxillofacial Surgery Patients: Our Experience during Surgical Outreach Programmes.","authors":"Seidu Adebayo Bello, Azuka Raphael Njokanma, Paul Ojochenemi Ekpa, Adewale Francis Adejobi, Bamidele Adetokunbo Famurewa, Taofeek Akin Akinniyi, Ifeoluwa Oketade, Timothy Eromose Osodin","doi":"10.4103/jwas.jwas_142_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_142_25","url":null,"abstract":"<p><strong>Background: </strong>Airway management in maxillofacial surgery can be challenging due to anatomical and pathological obstructions.</p><p><strong>Aims and objective: </strong>To evaluate the indications of tracheostomy, duration of the surgical procedure, duration of tracheostomy cannulation, and the complications associated with tracheostomy in oral and maxillofacial surgical outreach programmes.</p><p><strong>Design of the study: </strong>A retrospective study.</p><p><strong>Setting: </strong>Cleft and Facial Deformity Foundation/International Craniofacial Academy, Abuja.</p><p><strong>Material and methods: </strong>Data collected included demographics, indications for tracheostomy, type of incision, procedural timing of the procedure, duration of cannulation, and postoperative complications. Ethical clearance was obtained, and data analysis was performed using Statistical Package for the Social Sciences version 20, with results presented as descriptive statistics. Statistical significance was set at <i>P</i> > 0.05.</p><p><strong>Results: </strong>The study included 27 patients (59.3% male, 40.7% female), with a mean age of 24.6 years. Primary indications for tracheostomy were temporomandibular joint ankylosis (48.1%), large orofacial tumors (40.7%), and ankylosis due to Noma (11.1%). Tracheostomies were performed electively in 81.5% of cases, while 18.5% were emergency procedures. The average time to complete each tracheostomy was approximately 27.5 min. Cannulation lasted between 24 and 48 h, with an average of 26.7 h. Complications were recorded in 2 (7.4%) cases.</p><p><strong>Conclusion: </strong>Tracheostomy was performed by oral and maxillofacial surgeons, with an average operation time of approximately 27.5 min. The procedure could be elective or emergency, and cannulation was maintained for a short duration of 27 h. Tracheostomy is a safe, adaptable, and essential technique for airway management in maxillofacial surgeries.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"460-466"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167715","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":"Typhoid Fever Surgical Outcomes in West Africa Improved with Ileostomies: A Single-Hospital Study.","authors":"Dena Ferguson, Bryce Nattier, Charles Filipi, Danielle B Dilsaver","doi":"10.4103/jwas.jwas_8_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_8_25","url":null,"abstract":"<p><strong>Background: </strong>Typhoid fever is a severe infectious disease prevalent in developing countries. This enteric fever can cause ulceration with perforation, typically in the terminal ileum. There is insufficient evidence regarding the prevalence and morbidity of perforated typhoid in endemic areas such as Togo, West Africa. Our aim was to evaluate and improve mortality rates in patients with typhoid perforation at Hospital of Hope (HOH).</p><p><strong>Materials and methods: </strong>A retrospective review of 180 patients with perforated typhoid at HOH in Togo, West Africa, examined surgical outcomes from January 1, 2020, to January 7, 2024. We assessed the effectiveness of a new institutional treatment protocol implemented in February 2023. The change was driven by a higher-than-expected mortality rate. Additionally, demographic, treatment, clinical, and surgical characteristics were abstracted.</p><p><strong>Results: </strong>From January 2020 to July 2024, the mortality rate was 20.00% (<i>n</i> = 36); 69.44% of patients who died suffered from septic shock (<i>n</i> = 25). To mitigate septic shock, HOH's protocol change lowered the threshold for damage control surgery including performing an ileostomy. This change was associated with 44% lower odds of death (15.45% vs. 25.14%, <i>P</i> = 0.056). The mortality rate of patients undergoing surgery with only one perforation (13.51%, <i>n</i> = 15/111) was lower compared to those with moderate (6.52% <i>n</i> = 3/46) or severe contamination (40.74%, <i>n</i> = 22/54) and/or multiple perforations (26.58%, <i>n</i> = 21/79). Of surviving patients (<i>n</i> = 55) with an ostomy, 85.45% (<i>n</i> = 47) underwent stoma reversal.</p><p><strong>Discussion: </strong>This demonstrates that ileostomies can be a safe and effective management therapy of typhoid perforations in settings of late presentation, malnutrition, and low resources.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"418-424"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171242","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":"Cutaneous Malignancy of the Head and Neck in Patients with Xeroderma Pigmentosum: A Report of Three Cases.","authors":"Joshua D Choji, Akintunde J Akintayo, Silas S Kaffi, Akpomushi Egga, Stanley O Akubuko, Utobong O Udo, Gerald N Nduka, Simon J Yiltok","doi":"10.4103/jwas.jwas_22_25","DOIUrl":"10.4103/jwas.jwas_22_25","url":null,"abstract":"<p><p>Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder resulting from mutations in nucleotide excision repair. It is characterised by severe photosensitivity, cutaneous pigment changes, malignant tumour development, and occasionally progressive neurologic degeneration. The aim is to report three cases of XP with cutaneous malignancies with emphasis on the importance of prevention of malignant transformation in these patients. Three adults within their 3rd and 4th decades with XP were managed for cutaneous malignancies: two males and one female, two of whom were siblings. Two had fungating lesions on the forehead, and one had multiple scalp lesions. The histology in all the three patients revealed squamous cell carcinoma (SCC). All underwent wide local excision, followed by full and split thickness skin grafting to cover the defects, except the one that had transposition flap at a second surgery, and were co-managed with a dermatologist. Skin malignancies especially SCC and basal cell carcinoma are common in the facial regions of patients with XP. Adequate education of the patients on the importance of protection from the ultraviolet radiation radiations will prevent malignant transformation, and early presentation with appropriate treatment will improve prognosis.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 3","pages":"351-355"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13362884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439219","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":"A Randomised Comparison of Barbed and Non-barbed Absorbable Sutures for Peritoneal Closure in TAPP Hernia Repair.","authors":"Tushar Deoria, Manoj Kumar Dokania, Veer Kavita, Atul Jain, Gyan Ranjan, Nitin Agarwal, Manidip Chakravorty","doi":"10.4103/jwas.jwas_71_25","DOIUrl":"https://doi.org/10.4103/jwas.jwas_71_25","url":null,"abstract":"<p><strong>Background: </strong>Closure of the peritoneal flap during laparoscopic transabdominal preperitoneal (TAPP) repair is a critical step. Barbed sutures have been proposed to simplify this process, but comparative data with non-barbed sutures are limited. We conducted this study to compare absorbable barbed sutures (polyglyconate) with absorbable non-barbed sutures (polyglactin 910) for peritoneal flap closure in TAPP repair of primary inguinal hernias, focusing on closure time, operative time, postoperative pain, and complications.</p><p><strong>Materials and methods: </strong>This randomised comparative study was conducted at ABVIMS and Dr. RML Hospital, New Delhi, including 60 adult patients with primary unilateral inguinal hernia undergoing TAPP repair. Patients were divided into two groups: Group A (barbed sutures, <i>n</i> = 30) and Group B (non-barbed sutures, <i>n</i> = 30). Primary outcomes included peritoneal closure time and total operative time. Secondary outcomes were postoperative pain (visual analogue scale), ease of surgery, and incidence of seroma or haematoma. Statistical analysis was performed using Statistical Package for the Social Sciences v23, with <i>P</i> < 0.05 considered significant.</p><p><strong>Results: </strong>Barbed sutures significantly reduced peritoneal closure time (8.61 ± 0.78 min vs. 13.40 ± 0.81 min, <i>P</i> < 0.001) and total operative time (102.5 ± 16.65 min vs. 110.53 ± 11.09 min, <i>P</i> = 0.013). However, postoperative pain was higher in the barbed suture group at 48 h (<i>P</i> = 0.005) and 7 days (<i>P</i> = 0.043). There was no significant difference in seroma or haematoma formation between the groups (<i>P</i> = 0.472).</p><p><strong>Conclusion: </strong>Absorbable barbed sutures are effective in reducing closure and operative times in TAPP hernia repair but may be associated with higher early postoperative pain. They offer a useful option for improving operative efficiency without increasing complication rates.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 4","pages":"403-407"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171724","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":"Pneumatosis Intestinalis: Identifying the Need for Surgery for Gas in the Gut Wall and Outcomes.","authors":"Katha H Dave, Sagar J Vaghela, Archana D Dalal, Kalpit R Suthar, Nidhi A Saraf","doi":"10.4103/jwas.jwas_77_25","DOIUrl":"10.4103/jwas.jwas_77_25","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumatosis intestinalis (PI) is a rare (0.03%) pathology defined as the presence of gas within the small or large bowel wall. It was first described by Du Vernoi in autopsy studies in 1730. There are two types of PI: primary (15% cases) with benign and cystic intramural gas and secondary (85% cases) having a linear collection of gas reflecting an underlying pathology. It is usually diagnosed radiologically. Management of PI varies from conservative to emergency surgical intervention.</p><p><strong>Aims: </strong>We report this study to make the clinicians aware about this rare, but important differential diagnosis in patients who present with acute abdominal pain.</p><p><strong>Materials and methods: </strong>This retrospective observational study includes 10 patients who presented with acute abdominal pain to the emergency department of a tertiary care hospital over a span of 24 months. Patients with radiological diagnosis of PI on contrast-enhanced computed tomography (CECT) abdomen were selected for the study.</p><p><strong>Results: </strong>All patients presented with severe abdominal pain; 60% had abdominal distension, and 40% showed signs of peritonitis and septic shock. Surgical management was needed in 60%, and the rest were treated conservatively with intravenous fluids, antibiotics and analgesics. About 20% patients could not survive despite surgery. All patients managed conservatively survived. Histopathological reports showed gangrenous changes of intestinal walls with vascular occlusion. Patients who have survived came for regular follow-up and does not show any complications.</p><p><strong>Conclusion: </strong>PI, though rare, must be recognized early to improve outcomes. Surgical intervention is necessary in cases with ischaemia on CECT abdomen. They have high mortality rates even after surgical intervention. Patients having long-term onset of symptoms with healthy bowels can be managed conservatively.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 3","pages":"297-302"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13362888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439288","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}