Endoscopic Evaluation of Upper and Lower Gastro‑Intestinal Bleeding

Introduction: A myriad of pathologies lead to gastro‑intestinal bleeding (GIB). The common clinical presentations are hematemesis, melena, and hematochezia. Endoscopy aids localization and treatment of these lesions. Aims: The aim was to study the differential diagnosis of GIB emphasizing the role of endoscopy in diagnosis and treatment of GIB.Patients and Methods: A prospective study of patients with GIB referred to the Endoscopy unit of two health facilities in Port Harcourt Nigeria from February 2012 to August 2014. The variables studied included: Demographics, clinical presentation, risk score, endoscopic findings, therapeutic procedure, and outcome. Data were collated and analyzed using SPSS version 20 software.Results: A total of 159 upper and lower gastro‑intestinal (GI) endoscopies were performed during the study period with 59 cases of GI bleeding. There were 50 males and 9 females with an age range of 13–86 years (mean age 52.4 ± 20.6 years). The primary presentations were hematochezia, hematemesis, and melena in 44 (75%), 9 (15%), and 6 (10%) cases, respectively. Hemorrhoids were the leading cause of lower GIB seen in 15 cases (41%). The majority of pathologies in upper GIB were seen in the stomach (39%): Gastritis and benign gastric ulcer. Injection sclerotherapy was successfully performed in the hemorrhoids and a case of gastric varices. The mortality recorded was 0%.Conclusion: Endoscopy is vital in the diagnosis and treatment of GIB. Gastritis and Haemorrhoid are the most common causes of upper and lower GI bleeding respectively, in our environmentKeywords: Endoscopy, diagnosis and treatment, gastro‑intestinal bleedin

Cutaneous squamous cel carcinome in Port Harcourt, Nigeria

No Abstract

Surgical glove perforations during surgical operations: An ever existing risk in the theatre

No Abstract

Obstructive uropathy in childhood: A review

Background: Obstructive uropathy is any affection of the urinary tract characterized by impairment of urine flow through the tract and which, if left untreated, will cause progressive renal damage. Aim: To present an update on obstructive uropathy in children with emphasis on the situation in Nigeria. Methods: Contemporary information on the management of obstructive uropathy was obtained by searching the Medline and adding information from the authors\' experience. Results: Obstructive uropathy causes renal impairment in all age groups. The causes in children may be congenital or acquired. The congenital causes include pelvi-ureteric junction obstructions, posterior urethral valves (PUV), urethral atresia, phimosis and meatal stenosis. Associated anomalies include imperforate anus and vertebral malformations. Acquired causes include calculi, post-traumatic and post-inflammatory strictures and meatal stenosis. Some specific manifestations are prune-belly syndrome, hydronephrosis and renal failure. Diagnostic investigations include ultrasonography, intravenous urography, cystography and renography. Recent technological advances have impacted on the treatment of the different lesions. These include in utero vesico-amniotic shunt and endoscopic valve ablation for PUV and minimally invasive techniques for urolithiasis. Nephrectomy may be indicated in a unilateral damaged kidney. Not all lesions require treatment. Criteria to select patients for treatment require definition. Occasionally treatment fails because of pretreatment irreversible renal damage. The resulting end-stage renal failure is an indication for renal transplantation. Conclusion: Obstructive uropathy is an important cause of renal impairment. Contemporary advances in the management are yet to become available in developing countries. Compromise treatment options therefore prevail. Adequate treatment is essential to prevent end-stage renal failure. Port Harcourt Medical Journal Vol. 1 (3) 2007: pp. 137-14

Anaesthetic challenges in surgical excision of phaeochromocytoma

Background: Phaeochromocytoma is a rare tumour, which is benign but metabolically active, with a potential for malignancy. This tumour of adrenal or extra adrenal origin usually presents as hypertension, which can be sustained or paroxysmal and with lethal complications. Aim: To present an anaesthetic experience during the surgical resection of a phaeochromocytoma. Method: A 26-year old woman with phaeochromocytoma of the right adrenal gland is presented. The tumour was excised under general anaesthesia. The anaesthesia involved the use of continuous infusion of esmolol (an ultra short-acting intravenous cardioselective beta-antagonist) and propofol. The resected tumour was sent for histopathological examination. Results: The tumour was completely excised under general anaesthesia. The haemodynamic changes that occurred during tumour handling were controlled with fentany1,propofol/esmolol infusion. Histopathological findings confirmed phaeochromocytoma. Conclusion: Although, the anaesthetic and surgical management of a phaeochromocytoma could be an uphill task, it is possible in an environment with limit laboratory and intensive care facilities. Port Harcourt Medical Journal Vol. 1(1) September 2006: 71-7

Post-operative Anaemia and Prevalence of Blood Transfusion In Surgical Patients at The Rivers State University Teaching Hospital

Blood transfusion following surgical procedures may be a life saving venture especially in anaemic patients. Even though there is no universal accepted consensus on blood transfusion in surgical patients there should be clear cut indications prior to blood transfusion. The prevalence varies from centers and regions in the world. To determine post-operative anaemia and prevalence of blood transfusion in surgical patients at the Rivers State University Teaching Hospital (RSUTH). This was a six-month retrospective study of post-operative patients at the Surgery and Obstetrics/Gynaecology department of the Rivers State University Teaching Hospital. Ethical clearance was obtained from ethical committee of the Rivers State Hospital Management Board. The cut- off for anaemia was 33% in line with the World Health Organisation (WHO). Structured profoma was used to extract information from patients case notes and analysed using SPSS version 25. The subjects for the study were 370, comprising of 146 (39.5%) males and 224 (60.5%) females. The mean age was 31 years of which 194 (52%) were obstetrics and gynaecological surgeries while 176 (47.6%) were non-gynaecological surgeries. The commonest indication for surgery was ceasaren section representing 126 (34.1%) of the subjects; 259 (70%) had anaemia, of which 168 (64.8%) were females while 91 (35.2%) were males. Eighty-four (22.7%) of the subjects had blood transfusion. The prevalence of post-operative anaemia and blood transfusion in surgical patients at the RSUTH were 70% and 22.7% respectively. Optimizing surgical patients prior to operative procedures as well as taking measures to reduce blood loss intra-operatively cannot be overemphasized.&nbsp