Malignant Diseases of the Stomach in Ibadan, Nigeria: A 19-year appraisal

Background: Malignant lesions of the stomach have a wide geographical variation in prevalence. This study was aimed at determining the pattern of gastric malignancies in Nigeria, a developing country like and compares this to what obtains in the developed countries. Methods: a retrospective study utilizing case-files, histopathology reports and cancer registry data of patients who have been operated on for a pre-operative diagnosis of carcinoma of the stomach in the University College Hospital Ibadan, Nigeria from 1990 to 2008; a period of 19 years. Results: There were 286 patients with a male to female ratio of 1.4: 1. The age range was 24 to 99 years with an average age of 55.35 years. The yearly average was approximately 15 patients annually. There were 18% of the total who were 40 years and below. Majority of the cases were adenocarcinoma (89%) with a few other cases of Carcinoid tumour, Squamous cell carcinoma, Leiomyosarcoma, lymphomas and Gastrointestinal Stromal tumour (GIST). Conclusions: Incidence rates of malignant disease of the stomach in Nigeria affect the 50-70 years age-group, have a slight male predominance and do not seem to be increasing or decreasing. There seems to be no role at present for Helicobacter pylori in the aetiology of gastric carcinoma in Nigeria

Percutaneous laparoscopic trocar drainage of hepatic abscess in a sickle cell disease patient – A case report

Hepatic abscess as a manifestation of sickle cell disease is rare. A 25 year old Nigerian male with sickle cell disease presented with right sided upper abdominal pain, fever, massive hepatomegaly, neutrophilic leucocytosis and mildly deranged liver enzymes. Sonographic findings were a large thin walled right hepatic lobe abscess; with an estimated volume of 2000ml. He had percutaneous laparoscopic trocar drainage of 2250mls of pus with insertion of a drain. The drain was removed after ten days and the patient was discharged home.Keywords: Hepatic abscess, Trocar drainage, Sickle cell diseas

Adult abdominal wall hernia in Ibadan

Background: Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate.Aim: To describe the clinical profile of anterior abdominal wall hernias and our experience in the surgical management of identified herniasMethods: The project was a retrospective study of all patients with abdominal wall hernia presenting into surgical divisions of University College Hospital Ibadan during a 6 year period (January 2008 to December 2013). Relevant information was retrieved from their case notes and analysed.Result: The case records of 1215 (84.7%) patients out of 1435 were retrieved. Elective surgery was done in 981(80.7%) patients while 234 (19.3%) patients had emergency surgery. There were 922 (84.8%) groin hernias and post-operative incisional hernia accounted for 9.1% (111) of the patients. About half (49.1%) of those with incisional hernia were post obstetric and gynaecologic procedure followed by post laparotomy incisional hernias 16 (14%) and others (23.5%). The ratio of inguinal hernia to other types in this study is 3:1. Hollow viscus resection and emergency surgery were predictors of wound infection statistically significant in predicting wound infection (P < 0.001). Peri operative morbidity/mortality at 28 days post operation was documented in 113 patients (12.1%). One year recurrence rate of groin hernia was 2.1%.Conclusion: The pattern of presentation and management of anterior wall hernias are still the same compared with the earlier study in this hospital. New modality of treatment should be adopted as the standard choice of care. Abdominal wall hernias are very common clinical presentation. Modified Bassini repair was the preferred method of repair due to its simplicity. Mesh repair is becoming more common in recent time but high cost and initial non-availability of the mesh limit its use in our centre.Keywords: Hernia, Mesh, Bassini, Ibada

An audit of deaths in the emergency room in the University College Hospital Ibadan

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Dead on arrival in a low-income country: results from a multicenter study in Pakistan

BACKGROUND: This study assessed the characteristics of dead on arrival (DOA) patients in Pakistan. METHODS: Data about the DOA patients were extracted from Pakistan National Emergency Department Surveillance study (Pak-NEDS). This study recruited all ED patients presenting to seven tertiary care hospitals during a four-month period between November 2010 and March 2011. This study included patients who were declared dead-on-arrival by the ED physician. RESULTS: A total of 1,557 DOA patients (7 per 1,000 visits) were included in the Pak-NEDS. Men accounted for two-thirds (64%) of DOA patients. Those aged 20-49 years accounted for about 46% of DOA patients. Nine percent (n = 72) of patients were brought by ambulance, and most patients presented at a public hospital (80%). About 11% of DOA patients had an injury. Factors significantly associated (p \u3c 0.05) with ambulance use were men (adjusted odds ratio [aOR] = 2.72), brought to a private hospital (OR = 2.74), and being injured (aOR = 1.89). Cardiopulmonary resuscitation (CPR) was performed on 6% (n = 42) of patients who received treatment. Those brought to a private hospital were more likely to receive CPR (aOR = 2.81). CONCLUSION: This study noted a higher burden of DOA patients in Pakistan compared to other resourceful settings (about 1 to 2 per 1,000 visits). A large proportion of patients belonging to productive age groups, and the low prevalence of ambulance and CPR use, indicate a need for improving the prehospital care and basic life support training in pakistan

Gastrointestinal stromal tumour in Ibadan, Nigeria: a case report and review of current treatment

Gastrointestinal stromal tumours (GIST), though rare, present to the gastric surgeon not infrequently making a heightened awareness of this condition a pre-requisite of prompt recognition and timely treatment.. We describe the presentation, diagnosis and the limitations of treatment and follow up of a patient with GIST in a developing country. Surgery still remains as the only readily available modality of treatment in developing countries

Gastrointestinal stromal tumour in Ibadan, Nigeria: a case report and review of current treatment

Gastrointestinal stromal tumours (GIST), though rare, present to the gastric surgeon not infrequently making a heightened awareness of this condition a pre-requisite of prompt recognition and timely treatment.. We describe the presentation, diagnosis and the limitations of treatment and follow up of a patient with GIST in a developing country. Surgery still remains as the only readily available modality of treatment in developing countries