From traditional birth attendants to hospital: a maternal near-miss

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Diverticulosis of the colon: A report of two cases

Background: Diverticula are bulging pouch-like herniations in the wall of the hollow organ anywhere in the gastrointestinal tract from the oesophagus to the colon. Diverticula are thought to occur more commonly in the colon than in any other segment of the gastrointestinal tract. It may be asymptomatic or complicated by diverticulitis (diverticular inflammation), bleeding, or perforation with peritonitis. It could be potentially life threatening. It was thought to be rare in this part of the world, but is increasingly diagnosed with the advent of modern imaging techniques and colonoscopy. Two cases of colonic diverticula discovered during colonoscopy were highlighted.Case ReportsCase 1This patient was a 79-year old traditional ruler who presented with 2 months history of progressive left- sided abdominal pain, dull in nature and sometimes colicky but non-radiating. There was no known aggravating or relieving factors. There was associated history of chronic constipation dating back to over 15 years relieved with use of laxatives. There was no diarrhoea, vomiting or haematochezia. He had no history of previous surgeries. Physical examination showed mild tenderness at the left iliac fossa. Digital rectal examination was normal. Plain abdominal x-ray and abdomino-pelvic ultrasound scan showed no abnormalities. Colonoscopy revealed multiple diverticula with diverticulitis at the descending and sigmoid colon 40cm-60 cm from the anal verge.Case 2This patient is a 64-year old retired military officer who presented with constipation of 5 years and rectal bleeding of 10 months. Pre-morbid bowel habit was 1-2 bowel motions per day but now once in 2 days. Constipation was characterized by recurrent passage of hard pellet-like stools. This became associated with passage of fresh blood in the stool 10months ago, and anal pain. Volume of blood was about 5 mls per episode, and this occurred only when stool was hard. The anal pain was sometimes severe enough to prevent the patient from sitting comfortably on both buttocks. There was no weight loss or constipation alternating with diarrhoea. He had no history of any chronic medical illness. Colonoscopy revealed anal fissure, internal haemorrhoids, and multiple diverticula in the sigmoid and descending colon. Both patients are being managed conservatively with dietary advice and antibiotics, and still being followed up in the clinic.Conclusion: Reports of colonic diverticula with diverticulitis in this part of the world are few. This is the first report of colonic diverticulosis from Ilorin.Keywords: Colon, Diverticula, Diverticulitis, Colonscopy, Ilori

Colonoscopic examination of rectal bleeding in children: A report of two cases

Rectal bleeding in children is a frightening and cause of great concern, and of parental anxiety. In this report, we present the value of colonoscopy to unravel the diagnostic conundrum often associated with rectal bleeding in children.Key words: Children, colonoscopy, juvenile polyps, rectal bleedin

Prevalence Of Human Immunodeficiency Virus & Hepatitis B Virus Co-Infection In A Population Of Apparently Healthy Pregnant Women In University Of Ilorin Teaching Hospital, Ilorin

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Case report: From traditional birth attendants to hospital: a maternal near-miss

‘Maternal near-miss’ is defined as a woman who nearly died during pregnancy or following delivery but survived. The story of many women in sub Saharan Africa is that of an escape from death if they do eventually have a safe delivery.1This situation is not unconnected to several factors as it concerns these women, their families, the society and the choices they make