Journal of the West African College of Surgeons最新文献

{"title":"Sonographic Diagnosis of Anterior Nutcracker Phenomenon and its Prevalence in Nigerian Males with Varicoceles.","authors":"Olalekan Abdul-Rafiu Abudu, Moses Adebisi Ogunjimi, Rufus Wale Ojewola, Rasheed Ajani Arogundade","doi":"10.4103/jwas.jwas_64_24","DOIUrl":"10.4103/jwas.jwas_64_24","url":null,"abstract":"<p><strong>Background: </strong>The nutcracker phenomenon (NCP) is a rare and often unrecognised cause of varicocele, haematuria, and chronic pelvic pain due to the left renal vein (LRV) compression between the aorta and the superior mesenteric artery (anterior nutcracker). Its varied clinical manifestations make the diagnosis difficult and usually delayed. A high index of clinical suspicion, with appropriate imaging studies is crucial for the diagnosis.</p><p><strong>Objectives: </strong>We used a colour Doppler ultrasound scan to investigate the anatomic and haemodynamic properties of testicular and renal venous drainage. The emphasis was to determine the presence or absence of NCP, its possible effects on varicocele formation and severity, and its relationship with the body mass index (BMI) of the subjects.</p><p><strong>Materials and methods: </strong>We carried out Doppler scrotal and upper abdominal ultrasound examinations of 100 subjects with male infertility and clinical varicoceles (group A), and 100 controls with male infertility but without varicoceles (group B). The mean peak velocity (PV) and the anteroposterior (AP) diameters of different segments of the renal veins, as well as the diameters of the testicular veins of the subjects in the two groups were measured and compared. The ratios of the PV and the diameters between the hilar portion and the aorto-mesenteric portion of the LRV were also calculated and compared. A PV ratio or anteroposterior diameter ratio between the two portions greater or equal to 5.0 was considered diagnostic of NCP. The diagnosis of varicocele was confirmed by visualising a dilated pampiniform plexus vein measuring greater than 2 mm in diameter using an ultrasound scan.</p><p><strong>Results: </strong>Six out of 100 subjects in group A had diameter and PV ratios (≥5.0) in the LRV that suggested the presence of NCP, and all participants in group B had neither diameter nor PV ratio suggestive of NCP. The prevalence of NCP seen within the varicocele group in this study was statistically significant (<i>P</i> = 0.038). Five (83.3%) of the six subjects in the NCP-associated varicocele subgroup had microscopic haematuria, orthostatic proteinuria, or both; these qualified them for the diagnosis of nutcracker syndrome (NCS), A significantly lower mean BMI (<i>P</i> = 0.004) was noted among the NCP-associated varicocele subgroup compared to those without NCP.</p><p><strong>Conclusion: </strong>Our findings indicate that the NCP is a significant finding in patients with varicoceles in our environment, and it is more common with lower BMI.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"344-349"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531504","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":"Clinical and Radiological Severity of Avascular Necrosis of the Femoral Head in Sickle Cell Disease Patients.","authors":"Ocloo Agbeko, Kwafo-Armah Abena, Samuel Quarshie Lartey","doi":"10.4103/jwas.jwas_68_24","DOIUrl":"10.4103/jwas.jwas_68_24","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) has a high prevalence in Sub-Saharan Africa. Avascular necrosis (AVN) of the femoral head is a devastating complication of SCD. Early presentation and diagnosis can be treated with hip-preserving procedures, resulting in good outcomes. Late presentations will require more complicated treatment procedures, such as hip replacement. A good knowledge of the clinical presentation and severity of the disease will aid in early detection and clinical management. This study was designed to establish the age and sex distribution, severity, and stages of AVN in SCD patients at Korle-Bu Teaching Hospital.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study of SCD patients referred to the orthopaedic clinic with AVN of the femoral head. An evaluation form was used to assess the patient's age, sex, genotype, and clinical symptoms. Hip X-rays were obtained to assess the severity of the disease. Chi-square tests were used to determine the association between demographic variables' data and AVN.</p><p><strong>Results: </strong>Most patients were in the 31- to 50-year age group and presented with profound and limiting clinical features and advanced features on X-rays (stages 3 and 4 of the disease). There was a statistically significant association between the radiological stage of disease and clinical symptoms (limping, difficulty climbing stairs, and hip abduction).</p><p><strong>Conclusion: </strong>The patients mostly presented with severe disease both clinically and radiologically and will require complex surgical procedures including hip arthroplasties. Clinicians at primary care centres need to look out for early signs so that they can refer them for treatment.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"329-334"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531493","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":"Intra-orbital Foreign Body.","authors":"Shuaib Abdulsalam, Eiman Bashir, Nasir Abdulrashid, Saudat Garba Habib","doi":"10.4103/jwas.jwas_47_24","DOIUrl":"10.4103/jwas.jwas_47_24","url":null,"abstract":"<p><strong>Background: </strong>This case report describes a young man with an intra-orbital foreign body (FB) in both eyes.</p><p><strong>Case report: </strong>Intra-orbital FBs are rare, with few cases reported in the literature. This is because the orbit protects the globe from external forces, and the orbit is a closed cavity with one opening. This report details the case of a 28-year-old man who presented to the emergency unit with an 11-hour history of an intra-orbital FB. The patient was lying on a bench when a stationary motorcycle fell on him. He noticed that he was unable to open both eyes and was rushed to a peripheral hospital, then subsequently referred to this tertiary center. On examination, he was ill-looking and anxious but not febrile or pale. Systemic examination did not reveal any abnormality. Unaided visual acuity in the right eye (OD) was nil perception of light, while left eye visual acuity (OS) was counting fingers. The right eyelid was ptotic due to edema. He underwent basic laboratory investigations that were all normal. A plain X-ray revealed a radio-opaque FB penetrating the left orbit, fracturing the medial walls into the right orbit, with the round end positioned behind the right globe. The FB was identified as a broken part of a brake/clutch lever from the motorcycle. A computerized tomography scan showed a metallic object in both orbits, accompanied by pneumocephalus, and suggested transection of the right optic nerve. The patient was prepared for FB removal and repair of the lid penetration under general anesthesia, following review by the ENT surgeon and neurosurgeon. The brake lever was successfully removed, and the patient was administered antibiotics. Post-operatively, visual acuity in the right eye remained at nil perception of light, while that in the left eye improved to 6/9 upon discharge.</p><p><strong>Conclusion: </strong>There is no established protocol for managing intra-orbital FBs, as removal depends on factors such as the size, composition, and potential compression damage to structures around the globe, which could further compromise vision or function. Small inert objects may be left in place if removal would cause damage. However, in this case, removal was deemed necessary for several reasons.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"362-365"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531496","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":"Primary Breast Necrotising Fasciitis in an Elderly Woman Managed with Nipple-Areola Conservation and Delayed Primary Closure in a Resource-Poor Setting A Case Report.","authors":"Chinedu Michael Okoli, Gideon Ahamefuna Oguwike, Tochukwu Daniella Chinedu-Okoli, Pascal Ndubuisi Egbujor","doi":"10.4103/jwas.jwas_44_24","DOIUrl":"10.4103/jwas.jwas_44_24","url":null,"abstract":"<p><p>Primary breast necrotising fasciitis is a rare disease that can rapidly progress with high morbidity and mortality rates. Due to its rare occurrence, it is often misdiagnosed. This case was a 65-year-old, obese, immobile, and newly diagnosed woman who presented with a 2-week history of progressive left breast pain and swelling with associated darkening of the breast skin and discharge of foul-smelling fluid. There was no history of fever and the nipple-areola complex was spared. The surrounding healthy skin has a characteristic peau d'orange and erythematous. Two discrete and slightly tender left axillary lymph nodes were noted. At the presentation, her blood sugar was high. Initially, a breast malignancy was suspected but later an ultrasound showed increased fibrous and fatty tissue architecture of the mammary gland. It also noted inflammatory collections within the mammary glands and thus concluded breast inflammation. Early intervention with antibiotic cover and wound debridement forestalled the progress of the disease and nipple-areola salvage. The wound was later covered by delayed primary closure after 14 days of wound dressing with a silver-based solution. Breast asymmetry was noted as a surgical complication. Early aggressive intervention in necrotising fasciitis of the breast in an elderly woman with comorbidities contributed to the preservation of nipple-areola complex with eventual satisfactory management using direct wound closure.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"366-369"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531502","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":"To Determine the Histomorphological Variants of Kaposi's Sarcoma in HIV-infected Patients in the University of Benin Teaching Hospital.","authors":"Anthony Eitokpah, Akhator Terence Azeke, Dele Eradebamwen Imasogie","doi":"10.4103/jwas.jwas_13_24","DOIUrl":"10.4103/jwas.jwas_13_24","url":null,"abstract":"<p><strong>Introduction: </strong>There are different histopathological variants of Kaposi's sarcoma (KS) aside the typical patch, plaque, and nodular variants. The baseline data of the unfamiliar variants of this lesion have not been determined in our environment. Their determination will bring to the foreclose differential diagnoses that may lead to diagnostic pitfalls.</p><p><strong>Aim and objectives: </strong>To determine the histomorphological variants of KS in the University of Benin Teaching Hospital over a 3-year 2-month period from May 1, 2014, to July 31, 2017.</p><p><strong>Materials and methods: </strong>This was a prospective study. The patients were all adult human immunodeficiency virus-positive highly active antiretroviral therapy users who had symptomatic cutaneous lesions that were histopathologically identified as KS. The histopathological variants of KS were noted. The Statistical Package for Social Sciences, version 16, was used to analyse the data.</p><p><strong>Results: </strong>Fifty patients had KS. The histomorphological variants (stages) of KS, as seen in this study, ranged from the typical progressive lesions of patch (13.2%), plaque (43.4%), and nodules (18.4%) to rarely diagnosed variants that are lymphangioma-like KS (6.6%), lymphangiectatic KS (5.2%), hyperkeratotic KS (1.3%), keloidal KS (9.2%), ecchymotic KS (1.3%), and pyogenic granuloma-like KS (1.3%). The mixed pattern (spindle cells and vascular channels) was the predominant (63%) histologic cellular group in this study.</p><p><strong>Conclusion: </strong>In addition to the common histopathological subtypes of KS, this study also found less common histopathological variants.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"306-312"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531506","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":"Assessing the Accuracy of Ultrasonography and Biopsy Necessity in the Management of Breast Lumps in Women Less than 40 Years.","authors":"Ukamaka Dorothy Itanyi, James Nwabueze Chukwuegbo, Ugochukwu Egbunike Okafor, Samuel Kelechi Richard, King-David Terna Yawe","doi":"10.4103/jwas.jwas_54_24","DOIUrl":"10.4103/jwas.jwas_54_24","url":null,"abstract":"<p><strong>Background: </strong>Following recommended guidelines, palpable breast lumps in young women should be subjected to clinical-radiologic evaluation and tissue diagnosis where necessary. However, in our local practice, most benign breast lumps are also subjected to excision biopsy. Ultrasonography is the modality of choice in the evaluation of palpable breast lumps in young women.</p><p><strong>Aim: </strong>This study aims to determine the accuracy of ultrasonography and the necessity of tissue biopsy in the management of palpable breast lumps in women less than 40 years of age and to determine lesions that can safely be managed conservatively based on histological diagnosis.</p><p><strong>Materials and methods: </strong>This was a prospective cross-sectional study of 87 adult females who had breast US and biopsy for palpable breast lumps in a tertiary healthcare center over a period of 10 months (July 2020-May 2021).</p><p><strong>Results: </strong>The age range of the women was 18-39 years (mean 27.9 ± 7.09 years).Benign lesions were noted in 86.2% of patients. No malignancy was detected in women < 25 years. Ultrasonography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 93.4%, 70.6%, 100%, and 94.3%, respectively, in differentiating benign from malignant breast lumps following tissue diagnosis.</p><p><strong>Conclusion: </strong>Ultrasonography and tissue biopsy are vital in the evaluation of breast lumps in women less than 40 years of age. Most (86.2%) of the lumps were benign, and no malignancy was detected in women < 25 years. The high accuracy of ultrasonography in distinguishing benign from malignant lesions suggests the need for conservative management of benign lumps in young women.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"275-281"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531490","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":"How Much is Too Much? Evaluation of the Clinical Relevance of Routine Preoperative Investigations in American Society of Anaesthesiologist (ASA) Grades I and II Patients Undergoing Minor to Intermediate Elective Surgeries at Tertiary Care Teaching Hospital - Influence on Change in the Surgical Plan and Outcome.","authors":"Dharmendra Kumar Pipal, Shubham Kochar, Umesh Kumar, Umesh Yadav, Bhumika Arora, Vikram Vardhan, Prakash Biswas, Vibha Rani Pipal, Rajendra Kumar Pipal, Seema Yadav, Ravi Shankar Sharma","doi":"10.4103/jwas.jwas_43_24","DOIUrl":"10.4103/jwas.jwas_43_24","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, experts have questioned the necessity of routine preoperative investigations due to their limited influence on perioperative management, higher expenses, postponed surgical procedures, patient anxiety resulting from false-positive results for minor operations and increased workload for laboratories.</p><p><strong>Objective: </strong>Our objective was to systematically evaluate the impact of pre-operative investigations on the treatment of patients opting for elective procedures. The study aimed to evaluate the impact of pre-operative investigations and peri-operative management on elective surgeries of the American Society of Anesthesiologists (ASA) physical status classification grades I and II, identifying common inappropriate investigations and assessing the impact of abnormal results on patient management.</p><p><strong>Materials and methods: </strong>We conducted a prospective, cross-sectional, clinical, observational, single-centre study from February 2020 to March 2021 on 500 cases in the General Surgery Department of Tertiary Care Teaching Hospital. This study assessed the importance of pre-operative investigations in low-risk patients undergoing low-grade elective general surgical procedures. We recruited consecutive patients from the surgery wards of the institute, who fulfilled the inclusion criteria and obtained informed written consent for anaesthesia, surgery and participation in the study. Demographic data, the type of investigation conducted and test results were noted. We followed up with patients who had abnormal test results to record the consequences of the abnormality, such as the postponement of surgery and the requirement for additional investigations. Pre-operative transfusion, change in the management plan and change in the anaesthesia plan were recorded.</p><p><strong>Results: </strong>In the current study, the age of the patients ranged from 20 years to 45 years, and the mean age of the patients was 32.208 ± 9.16. The age group of 20-30 years was the commonest, being 158 (31.6%) patients. Out of 500 patients, 296 (59.2%) patients were males and the remaining 204 (40.8%) were female patients. Out of 500 tests, 44 (8.8%) had abnormal results. Most of the changes in our study were based on abnormal ECG findings. Out of a total of 500 surgical procedures performed, 497 (99.4%) were carried out without any difficulty, with two (0.4%) postponed due to abnormality in the pre-operative investigations and one (0.2%) cancelled. A total of 490 (98%) patients did not have any post-operative complications. Only ten (2%) patients developed post-operative complications, and out of those, only one (0.1%) had some abnormality in the pre-operative investigations.</p><p><strong>Conclusion: </strong>Preoperative laboratory investigations do not significantly influence the surgical outcome of the patients belonging to ASA grades I and II.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"282-290"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531495","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":"Magnesium Sulphate Versus Fentanyl as Adjuncts to Epidural Anaesthesia for Lower Limb Orthopaedic Surgeries: A Comparative Study.","authors":"Oluwole Fiwawola Olatunji, Tinuola A Adigun, Olayinka R Eyelade","doi":"10.4103/jwas.jwas_37_24","DOIUrl":"10.4103/jwas.jwas_37_24","url":null,"abstract":"<p><strong>Introduction: </strong>Pain relief for lower limb orthopaedic surgeries is achievable with epidural anaesthesia. This study compared the analgesic effects of epidural anaesthesia with magnesium sulphate or fentanyl adjuvant in patients scheduled for elective lower limb orthopaedic surgeries.</p><p><strong>Patients and methods: </strong>A double-blind randomisation study was carried out on 96 patients categorised into three groups; M, F, and C. All participants received 18 mL of 0.5% bupivacaine plus 1.5 mL of 75 mg magnesium sulphate in Group M or 50 mg of fentanyl in Group F or normal saline in Group C via the lumbar epidural route. Variables including the onset time of sensory and motor blockade, duration of anaesthesia, and time for postoperative Numerical Rating Scale (NRS) score of 3 were summarised using mean, median, standard deviation, and percentages as appropriate. A <i>P</i> value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>Mean onset time for the sensory blockade at T8 was 23.7 ± 5.3, 20.5 ± 3.4, and 17.9 ± 5.6 min for groups C, F, and M, respectively (<i>P</i> = 0.001). The onset time for the motor blockade (Bromage score 3) was 29.8 ± 4.0, 26.6 ± 3.5, and 24.5 ± 5.3 min in groups C, F, and M, respectively (<i>P</i> = 0.001). The duration of epidural anaesthesia was 121.6 ± 31.5, 145.9 ± 29.6, and 167.0 ± 27.0 min in groups C, F, and M, respectively (<i>P</i> = 0.001). The time to attain an NRS pain score of 3 was 133.2 ± 27.7, 151.8 ± 32.4, and 172.0 ± 30.9 min in groups C, F, and M, respectively (<i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Magnesium sulphate is better as an epidural adjuvant compared to fentanyl in patients undergoing lower limb orthopaedic surgeries.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"291-297"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531498","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":"Perforated Peptic Ulcer in Lagos. Risk Factors and Management Outcome.","authors":"Olanrewaju Samuel Balogun, Michael O Afolayan, AbdulRazzaq Oluwagbemiga Lawal, Adedapo Olumide Osinowo, Thomas Olagboyega Olajide, Ayomide Makanjuola, Adedoyin Adekunle Adesanya, Oluwole Ayoola Atoyebi","doi":"10.4103/jwas.jwas_46_24","DOIUrl":"10.4103/jwas.jwas_46_24","url":null,"abstract":"<p><strong>Background: </strong>Complications of peptic ulcers, such as bleeding, gastric outlet obstruction, and perforation, can be life-threatening and may require surgical intervention. Perforated peptic ulcer (PPU) presents mostly as a surgical emergency and is one of the leading causes of secondary peritonitis with significant morbidity and mortality. The clinical outcome of surgical treatment of peptic ulcers varies due to the varying patterns of presentations and interventions between countries. There are few documented series on PPU in Nigeria. This paper reviews the management outcome of PPU in our institution.</p><p><strong>Materials and methods: </strong>A retrospective review of the available medical records of patients managed for PPU between February 2008 and February 2023 was conducted. All patients had a single anterior peptic ulcer perforation managed by a modified Graham's patch. Data analysis was performed using IBM SPSS for Windows, Version 23 (IBM Corp., Armonk, NY, USA).</p><p><strong>Results: </strong>There were 107 PPU patients comprising 93 males and 14 females. The mean age of all patients was 41 years. The peak prevalence of PPU was found among patients aged 30-39 years. Delayed presentation was recorded in about half of the patients. Ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) was the most common risk factor for PPU. Among the 93 documented cases, perforated gastric ulcers (71 cases) were found in a much higher proportion than duodenal ulcers (22 cases). Large ulcer (10-30 mm) was the main perforation size category found in 47 out of 83 recorded PPU cases. PPU size was not associated with the incidence of complications or mortality. The median duration of hospital stays was 13 (1-19) days. Surgical site infection was the most common complication after surgery.</p><p><strong>Conclusion: </strong>PPU is present in our predominantly male patients in their fourth decade of life. Ingestion of NSAIDs is a major risk factor. Duodenal ulcers were the predominant type seen in our patients. Documented perforated ulcer sizes in our patients are predominantly in the large category. Surgical site infection, systemic sepsis, and superficial wound infection were major complications in our patients.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"258-264"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531499","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":"Successful Management of Traumatic Cervical Spondyloptosis with Incomplete Neurological Deficit in a Child: A Case Report.","authors":"Ousmane Ouattara, Ibrahim Dao, Narcisse Wendpuiré Mike Ouedraogo, Souleymane Ouedraogo","doi":"10.4103/jwas.jwas_53_24","DOIUrl":"10.4103/jwas.jwas_53_24","url":null,"abstract":"<p><strong>Background: </strong>Spondyloptosis is a condition in which one vertebral body is completely displaced over the corpus of the adjacent one. It is more common in the lumbar region of the spine, but it very rarely occurs in the cervical spine. In this study, we report a case of post-traumatic cervical spine spondyloptosis in a child.</p><p><strong>Case report: </strong>We describe a case of a 14-year-old male, who was admitted for cervicalgia with incomplete neurological deficit as a result of falling from a tree. Computed tomography (CT) of the neck revealed a posterior C5-C6 spondyloptosis with anterior spondylolisthesis of C7-T1. Surgical intervention was performed by the anterior approach only. The patient recovered completely after 2 months.</p><p><strong>Conclusion: </strong>Traumatic cervical spondyloptosis is an injury with rare occurrence with varied clinical presentations. Until now, there is no consensus concerning the most effective treatment for spondyloptosis. Satisfactory clinical and good outcomes can be obtained by anterior cervical corpectomy and fusion.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"15 3","pages":"359-361"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12200798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531505","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}