Journal of the West African College of Surgeons最新文献

{"title":"Incidence of Complications and Parental Satisfaction Following Pain Relief Methods in Paediatric Herniotomy: Caudal Block Versus Pre-incisional Field Block and Diclofenac Suppository Approach.","authors":"Precious B Kpalap, Yohanna M Usman, Husseina A Aliyu, Rimamkanati Shaki, Kefas T Malau, Samuel I Nuhu, Henry Y Embu, Erdoo S Isamade","doi":"10.4103/jwas.jwas_188_24","DOIUrl":"10.4103/jwas.jwas_188_24","url":null,"abstract":"<p><strong>Introduction: </strong>Acute post-operative pain is one of the most common adverse effects of surgery experienced by children following herniotomy. Methods of managing this adverse effect include the use of caudal block, pre-incisional field block, and parenteral analgesics. We therefore sought to determine the incidence of complications and parental satisfaction following caudal block versus combination of pre-incisional field block and rectal diclofenac suppository for post-herniotomy analgesia.</p><p><strong>Materials and methods: </strong>This was a randomised single-blind controlled clinical trial carried out in the Modular theatre of the Jos University Teaching Hospital. Fifty-eight children aged 1-6 years scheduled for elective day case open unilateral inguinal herniotomy with an American society of anesthesiologists of I and II were recruited and randomised into groups A and B; 1 mL/kg of 0.25% plain bupivacaine was administered caudally to group A, while 1 mL/kg of 0.25% plain bupivacaine and 1 mg/kg of diclofenac suppository were administered via pre-incisional field block to group B. Presence of complications such as nausea, vomiting, and pain was noted. Parental satisfaction with post-operative analgesia was assessed using a 5-point Likert item. Data collected were analysed using the SPSS.</p><p><strong>Results: </strong>Patients in the two study groups were comparable with respect to the measured parameters. Two (6.9%) patients in the caudal block group experienced vomiting, while three (10.3%) patients in both study groups had hypotension. Twenty-six (89.7%) and 19 (65.5%) parents in the caudal block group and field block with diclofenac suppository group were, respectively, \"very satisfied\" (<i>P</i> = 0.0001). No parent was either dissatisfied or extremely dissatisfied.</p><p><strong>Conclusion: </strong>Both caudal block with plain bupivacaine and pre-incisional field block with plain bupivacaine plus diclofenac suppository showed comparable efficacy in the incidence of minimal complications. No parent was either dissatisfied or extremely dissatisfied with the techniques.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"146-150"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791040","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":"Evaluating the Accuracy of Appendicitis Inflammatory Response and Alvarado Scoring Systems in Predicting Acute Appendicitis.","authors":"Funmilola Olanike Wuraola, Adewale Oluseye Adisa, Olalekan Olasehinde, Christianah Mopelola Asaleye, Oluwole Odujoko, Olusola Akanni Jeje, Oladejo O Lawal","doi":"10.4103/jwas.jwas_19_25","DOIUrl":"10.4103/jwas.jwas_19_25","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of acute appendicitis (AA) is usually clinical, but the high negative appendectomy rates necessitated the development of several scoring systems. This study compares the accuracy of the conventional Alvarado with the newer appendicitis inflammatory response (AIR) scoring systems in the diagnosis of appendicitis.</p><p><strong>Materials and methods: </strong>Patients with AA who had been selected for appendectomy by surgeons were evaluated pre-operatively using the Alvarado and AIR scoring systems with histopathological diagnosis as the benchmark. Both systems classified patients into low-, intermediate-, and high-risk groups.</p><p><strong>Results: </strong>Fifty-two patients with a mean age of 26.1 SD ± 10.1 years were evaluated. The negative appendectomy rate was 15.4%. Both systems had low sensitivity scores, with Alvarado performing slightly better, with a sensitivity of 45% vs. 30% (AIR). However, the two scoring systems showed remarkable specificity and a positive predictive value of 100% but performed poorly in the intermediate group, with all 24 patients classified as intermediate by AIR and 17 of the 18 classified by Alvarado as having histologically confirmed appendicitis. Notably, most patients in the indeterminate group had elevated C-reactive protein (CRP) levels.</p><p><strong>Conclusion: </strong>The two scoring systems show similar strengths in correctly predicting low- and high-risk patients. Patients classified as intermediate by both scoring systems with elevated CRP levels (>10 g/L) should be strongly considered positive. Modification of the clinical parameters of the AIR score may improve its diagnostic accuracy and clinical utility, hence reducing negative appendectomy rates.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 3","pages":"250-254"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13362867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439202","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":"Carcinoma Ex-Pleomorphic Adenoma Arising within a Palatal Minor Salivary Gland: A Case Report and Review of Literature.","authors":"Zainab Ali Adamu, Abdullahi Mohammed","doi":"10.4103/jwas.jwas_196_24","DOIUrl":"10.4103/jwas.jwas_196_24","url":null,"abstract":"<p><p>Carcinoma ex-pleomorphic adenoma (CXPA) is a malignant tumour originating from the epithelial components of a primary or recurrent pleomorphic adenoma (PA). The minor salivary gland of the palate is not a common site of occurrence of this tumour. Approximately 6% of PAs have the potential to transform into CXPA. It is typically a high-grade tumour, and disease-related death is often observed due to distant metastases. A 52-year-old man presented with a seven-year history of a painless palatal mass which started insidiously and progressively increased in size over the years. There was no history of trauma, toothache, and no history of swelling in other body parts. His medical history was not significant for any disease, and there was no history of irradiation or surgery. Examination of the oral cavity revealed a non-ulcerated palatal swelling, measuring 10 × 8 × 5 cm, non-tender, firm, not freely mobile, and adherent to the underlying structures. An ovoid tan brown firm tissue was received which measured 9 × 7 × 5 cm and weighed 140 g. Transections show yellow-white homogeneous to nodular areas. Microscopy showed the co-existence of a PA with an area of transition to a carcinoma. Pathological assessment is the gold standard for making a diagnosis, and the main histopathological finding in CXPA is the co-existence of the benign characteristics of PA with malignant changes in the epithelial components of the tumour.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"212-215"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791412","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":"Transrectal Ultrasound-Guided Prostate Biopsy: Sextant versus 12-Core Protocol.","authors":"Adedeji Lukman Fatuga, Kehinde H Tijani, Rufus W Ojewola, Charles C Annunobi, Adekunle A Adeyomoye, Emmanuel A Jeje, Moses A Ogunjimi","doi":"10.4103/jwas.jwas_15_25","DOIUrl":"10.4103/jwas.jwas_15_25","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In Nigeria, prostate cancer is the most diagnosed cancer in males from middle age. The only definitive way to confirm prostate cancer is through prostate biopsy. Transrectal ultrasound (TRUS)-guided core needle biopsy of the prostate has become the procedure of choice for obtaining high-quality tissue cores for histopathologic assessment in patients with suspected prostate cancer. Successive biopsy protocols have emerged to improve the detection rate of prostate cancer while maintaining its safety and tolerability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to compare cancer detection rates between sextant and extended 12-core biopsy protocols using TRUS-guided needle biopsy amongst patients being evaluated for prostate cancer in Lagos University Teaching Hospital, Lagos.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This study was a prospective comparative hospital-based study involving patients evaluated for prostate cancer. All study participants had thorough clinical evaluation, including digital rectal examination, a serum assay for prostate-specific antigen (PSA), radiologic imaging of the prostate with TRUS and TRUS-guided extended 12-core needle biopsy of the prostate (including six-sextant and six-lateral core biopsies). Samples obtained were sent separately for histological analysis. Data analysis was performed using the Statistical Package for Social Sciences&lt;sup&gt;®&lt;/sup&gt; version 22. The cancer detection rate of sextant and extended 12-core biopsies was compared, and the relationship to the clinical, radiologic, and histologic findings was analysed using Fisher's exact test, Kruskal-Wallis test, and McNemar correlation as appropriate. The significance level (&lt;i&gt;P&lt;/i&gt; value) was set at 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total,138 men (aged 37-89 years) were enrolled in this study and had extended 12-Core TRUS-guided prostate needle biopsy. In total, 78 men (58.2%) tested positive for cancer, 52 men had benign prostatic hyperplasia (BPH), and four men had prostatitis. Of the 78 patients positive for prostate cancer, six-sextant biopsy protocol detected 61 (78.2%), and six-lateral-directed biopsies detected 77 (98.7%), showing an improvement of 17 (20.5%) of six-lateral biopsies over six-sextant biopsy protocol. This was statistically significant (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). The extended 12-core biopsy protocol (combination of the two techniques) shows an overall improvement of 18 (21.8%) in cancer detection over the sextant protocol alone, which was also statistically significant (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). The study showed that the extended 12-core biopsy protocol was significantly superior in detecting cancer of the prostate than the sextant six-core biopsy protocol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study showed that men with prostate cancer were older, had smaller prostates, and had higher PSA range levels. Increasing the number of cores taken on prostate biopsy is associated with an increase in can","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"183-192"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791083","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":"Groin Flap: A Vital Resource for Upper Limb Reconstruction in Low-Resource Settings.","authors":"Yang S Wash, Akintunde J Akintayo, Abdulquadir Idrisu, Atarang Dafong, Akpomushi Egga, Simon J Yiltok","doi":"10.4103/jwas.jwas_185_24","DOIUrl":"10.4103/jwas.jwas_185_24","url":null,"abstract":"<p><strong>Background: </strong>Complex wounds, particularly in the upper limb, can lead to significant functional loss despite seemingly small size. Free flap surgery is often preferred for resurfacing; however, it requires microsurgery, which may not be readily available in resource-poor settings. This study explores the use of groin flaps for soft tissue coverage in managing complex injuries of the upper limbs.</p><p><strong>Materials and methods: </strong>All consecutive patients with upper limb wounds which were not feasible for closure using direct apposition, skin grafting, or local flaps that presented to the Division of Plastic and Reconstructive Surgery, Department of Surgery of Jos University Teaching Hospital between February 2016 and August 2022, were assessed, counselled and consented for groin flaps. Data on clinical presentation, operative procedure and outcomes were retrieved from their case notes and entered into a proforma.</p><p><strong>Results: </strong>Fourteen patients were operated on during the period under review. Their ages ranged from 6 to 64 years with a mean of 27 ± 7 years and a median age of 25 years. All wounds had traumatic aetiology, except one which was from an infection, with road traffic collision accounting for six, assault accounting for five, and one each for fall, occupational injury and infection. Ten (71%) percent of these defects were in the hand with four around the arm and forearm. Of the hand wounds, six were on the dorsum, one on the palm, and three on the fingers. The average area of the wound covered was 60 cm², with a range of 12 cm² to 140 cm².</p><p><strong>Conclusion: </strong>Despite advances in flap surgery, with a free flap in the fore, there is still room for groin flaps to be used in coverage of upper limb wounds, especially in resource-poor countries where expertise and resources for free flap might be unavailable.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790564","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 Outcome of Distal Femur Fracture Fixation in Adults: A Comparative Study Between Dynamic Condylar Screw and Distal Femoral Locked Plate.","authors":"Sulaimon O Olanrewaju, Kehinde A Alatishe, Lukman O Ajiboye, Wahab I Aremu","doi":"10.4103/jwas.jwas_14_25","DOIUrl":"10.4103/jwas.jwas_14_25","url":null,"abstract":"<p><strong>Background: </strong>Distal femoral fractures are difficult to treat due to their proximity to the knee joint, and different modalities have been developed over the years to overcome these challenges. Some studies have shown variable results of different operative modalities. However, there is little evidence to show the superiority of one over the other.</p><p><strong>Objective: </strong>To compare the functional outcome of operative treatment between dynamic condylar screw (DCS) with a side plate and distal femoral locked compression plate (DFLCP) using the Schatzker and Lambert criteria. The mean time to union and complications were secondary outcome measures.</p><p><strong>Materials and methods: </strong>This prospective study was carried out in our hospital between January 2018 and December 2019. Eighty-seven patients with closed distal femur fractures arbeitsgemeinschaft für osteosynthesefragen (AO) typesA, B1, B2, C1, and C2 were consecutively recruited into DCS and DFLCP groups using a simple balloting technique. The outcome measures were compared between the groups at six weeks, six months, and one year durations.</p><p><strong>Results: </strong>A total of 82 patients completed the study. According to the Schatzkers and Lambert criteria at final follow-up, six (15%) patients had excellent results, 24 (60%) had good results, and 10 (25%) had moderate results in the DCS group. In the DFLCP group, eight (19%) had excellent results, 26 (62%) had good results, and eight (19%) had moderate results. There was no significant difference in the functional outcome between the groups (<i>P</i> = 0.385). The mean time to union was 14.3 weeks and 13.9 weeks in the DCS and DFLCP groups, respectively, with no significant difference (<i>P</i> = 0.53). Similar complications, like surgical site infection, limb length discrepancy (LLD), varus deformity, and stiff knee, were observed in both groups.</p><p><strong>Conclusion: </strong>The functional outcome, time to union, and complication rates were similar in both DCS and DFLCP groups. Emphasis should be laid on surgical principles such as soft tissue handling, good reduction, fixation techniques, and early rehabilitation.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"139-145"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791420","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":"Use of Bedside/Office Skin Graft Technique: Exploring Field Sterility and Local Anaesthesia in Resource-Poor Settings.","authors":"Yang S Wash, Akintunde J Akintayo, Akpomushi Egga, Abdulquadri Idrisu, Atarang A Dafong, Simon J Yiltok","doi":"10.4103/jwas.jwas_170_24","DOIUrl":"10.4103/jwas.jwas_170_24","url":null,"abstract":"<p><strong>Background: </strong>Managing tissue loss is challenging for surgeons, especially in extensive areas where direct closure is difficult. Skin grafting can address these complex wounds, but costs often borne by patients in resource-poor settings pose a significant burden. Safe alternatives like field sterilisation and local anaesthesia enable effective bedside procedures, benefiting patients and the healthcare systems. This study shares our experience with skin grafting in such settings.</p><p><strong>Materials and methods: </strong>This is a retrospective study of 46 patients with soft tissue defects presenting to the Plastic surgery Division of the Jos University Teaching Hospital between February 2016 and September 2023. The patients' skin grafting was deemed feasible under local or regional anaesthesia, with an average size of 100 mm² with varying sizes ranging from 3 cm by 1 cm to 14 cm by 14 cm. They were counselled and consented to office/bedside skin grafting.</p><p><strong>Results: </strong>Forty-six patients were operated on during the period under review, with their ages ranging from 5 to 90 years with a mean 37.25 years and a median of 36 years. Most of the patients were men and 13% were women. Seventy percent of the wounds that needed resurfacing using split thickness skin graft were on the lower limbs, 25% were on the upper limbs, and 5% were on other areas, such as the penile shaft, chest, and scalp. The graft take averaged 90% but ranged from 70% to 100%. Three patients had complete graft loss. No patient developed a donor site infection.</p><p><strong>Conclusion: </strong>Results from skin grafting out of a conventional theatre in selected patients using field sterility are comparable to procedures done in a formal operating theatre. This offers a safe, affordable alternative with the generation of less waste.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 1","pages":"43-47"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367533","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":"Post-Surgical Hypoparathyroidism and the Impact of Experience, Timing of Surgery and Seasons - Analysis of Single Surgeon Dataset.","authors":"Constantine Ezeme, Mesfin Senbeto, Saba P Balasubramanian","doi":"10.4103/jwas.jwas_49_25","DOIUrl":"10.4103/jwas.jwas_49_25","url":null,"abstract":"<p><strong>Introduction: </strong>Post-surgical hypoparathyroidism (PoSH) is a complication of thyroidectomy, that is associated with poor quality of life, increased cost of care, and morbidity and mortality. The clinical and biochemical predictors of PoSH have been evaluated in previous studies. This study explores putative factors like the surgeon's experience, timing of surgery, and season's impact on PoSH.</p><p><strong>Materials and methods: </strong>A retrospective cohort study conducted in a high-volume centre. Patients who underwent total or completion thyroidectomy (TT/CT) performed by a single surgeon from January 2010 to December 2022 were included. Key outcomes were postoperative hypocalcaemia (adjusted serum calcium <2.1 mmol/L on the first postoperative day) and long-term PoSH (the need for calcium and/or alfacalcidol at six months after surgery). Demographics, and perioperative and postoperative clinical data relevant to PoSH up to six months were analysed.</p><p><strong>Results: </strong>Of the 668 thyroid operations performed by the surgeon, 632 (94.6%) were included for analysis. The median age was 47.3 (18-87) years. TT was performed in 82.4% and CT in 17.6%. Central neck dissection (CND) was performed in 26.9%. Postoperative hypocalcaemia and long-term PoSH rates were 19.9% and 4.9%, respectively. CND significantly increased the rate of long-term PoSH (3.3% in TT vs. 9.2% in TT + CND; <i>P</i> = 0.02 and 1.7% in CT vs. 8.2% in CT + CND; <i>P</i> = 0.02). Increasing surgical experience, surrogate variables for surgeon fatigue, and seasons did not change the rate of PoSH significantly.</p><p><strong>Conclusion: </strong>The study confirmed CND as a risk factor for long-term PoSH but did not find surgeon experience, fatigue, and seasons to have an impact on the PoSH rate.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"199-206"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791099","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":"Non-Hodgkin's Lymphoma: Atypical Presentation as Upper Limb Compartment Syndrome.","authors":"Mahak Goel, Chitrali Khanna, Azaz Akhtar Siddiqui","doi":"10.4103/jwas.jwas_179_24","DOIUrl":"10.4103/jwas.jwas_179_24","url":null,"abstract":"<p><p>Non-Hodgkin's lymphoma (NHL) most commonly presents with fever, weight loss, night sweats, and generalised lymphadenopathy. It usually arises from lymphoid tissues and few extranodal sites like the gastrointestinal tract, skin, ovaries, kidneys, testis, adrenal glands, and thyroid. Among the extranodal sites, involvement of skeletal muscles has been found to be highly unusual, accounting for only 0.5% of all cases. Thus, we would like to share the case of a 75-year-old male who presented with diffuse swelling in the left upper limb, persisting for a duration of 7 days with a recent history of blunt trauma. On examination, diffuse swelling, tenderness, and erythema were noted in the left upper limb, extending from the hand till the shoulder with skin changes and blister formation. Both ulnar and radial artery pulsations were feeble. Fasciotomy was done in the left forearm and arm in view of the compartment syndrome, and muscle biopsy of a suspicious unhealthy-looking muscle was sent, which was eventually reported as the B-cell lymphoblastic variety of NHL. In conclusion, this rare case of NHL presenting as upper limb compartment syndrome highlights the importance of considering atypical presentations in lymphoma diagnosis.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 2","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791087","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":"Orchidectomy: Analysis of the Indications, Methods, and Outcome of the Procedure in a Nigerian Tertiary Care Health Facility.","authors":"Augustine Obasi Ulebe, Chinonso Odo, Anselm Okwudili Obi, Chike John Okeke, Uchenna Ogbobe, Okechukwu Onyebum, Sunday Omebe, Ugochukwu Balantine Eze, Ahuizechukwu Emmanuel Obiesie, Joseph Abiahu, Dubem Ejikeme Orakwe, Emmanuel Afogu","doi":"10.4103/jwas.jwas_34_24","DOIUrl":"10.4103/jwas.jwas_34_24","url":null,"abstract":"<p><strong>Background: </strong>Orchidectomy is the surgical removal of one or both testes. It is one of the commonly done procedures in urologic practice for various clinical indications.</p><p><strong>Objectives: </strong>We aimed to review the indications, methods, and outcomes of orchidectomy procedures done for various indications in a health care facility in South East Nigeria.</p><p><strong>Materials and methods: </strong>This was a retrospective study of patients who underwent orchidectomy in our tertiary healthcare facility over a 10-year period (2012-2021). The case files of all patients who had orchidectomy within the review period were retrieved, and data were entered into a proforma for the study. Data analysis was done using Statistical Package for Social Science version 20.0.</p><p><strong>Results: </strong>Eighty patients with complete records were analysed. Their mean age was 64.5 ± 17.1 years. The commonest indication for orchidectomy was advanced cancer of prostate (CAP) in 67.0 (83.8%) with the commonest (65.0%) approach used being trans-scrotal. The majority of procedures (56.3%) were done using regional anaesthesia. Out of 147 orchidectomies done, 67 patients (83.8%), seven patients (8.8%), and 6 (7.5%) were offered bilateral, right-sided and left-sided orchidectomy, respectively. Among 67 patients with advanced CAP that had bilateral orchidectomies, 44 patients (65.7%), 19 patients (28.4%), and four patients (6.0%) had bilateral total orchidectomy, bilateral subcapsular orchidectomy, and bilateral sub-epididymal orchidectomy, respectively. Twenty-three patients (28.7%) had procedure-related complications with surgical site infection being the commonest seen in eight patients (10.0%).</p><p><strong>Conclusion: </strong>Orchidectomy is a common procedure for various indications in urologic practice. It is a safe procedure with a good outcome and minimal morbidity.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":"16 1","pages":"23-29"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367477","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}