Sonographic Diagnosis and Clinical Correlates of Gallbladder Stones in Patients with Sickle Cell Disease in Calabar, Nigeria

BACKGROUND: Sickle Cell Disease (SCD) causes chronic haemolysis which is a risk factor for cholelithiasis. AIM: To determine the prevalence and clinical correlates of cholelithiasis in SCD patients in steady state treated at the University of Calabar Teaching Hospital. METHODS: This was a prospective study that took place at the Haematology and sickle cell disease clinics, University of Calabar Teaching Hospital, Calabar, Nigeria between January and June 2018. The study population were aged between 1.5-5.5 years and confirmed to have SCD through haemoglobin electrophoresis. A brief history was obtained, and all the patients had a physical examination. Ultrasound examination was performed using a B-mode mind-ray ultrasound machine using a 3.5-5.0 MHz probe after an overnight fast. A Calculus is diagnosed when a highly echogenic structure casting a concrete shadow is detected in the lumen of the gallbladder. RESULTS: One hundred and twenty confirmed SCD patients aged between 1.5-55 years were recruited in the study, 69 (57.5%) were males, while 51 (42.5%) were females. The overall prevalence of cholelithiasis was 10%, and it increased with age. The youngest patient with cholelithiasis was 13 years old. All the patients were asymptomatic at the time of examination. At the multivariate level, age, gender, weight and gallbladder volume were associated with gallbladder stones. CONCLUSION: The prevalence of cholelithiasis in patients treated at the Sickle Cell Clinic at the University of Calabar Teaching Hospital, Calabar is fairly high. The patients were largely asymptomatic, and cholelithiasis is more common in females than males. This study showed a weak association between blood transfusion and gallbladder stone. It is recommended that routine abdominal ultrasound scan for gallbladder be done for SCD patients from the second decade of life in our environment

Computed Tomography Scan Findings in Children from a Tropical Region

BACKGROUND: Computed Tomography in the diagnosis of pathologies in children is becoming increasingly popular.AIMS: To document indications and findings of referrals for CT scan in children in a private Radio - diagnostic Center in a developing environment.METHOD: Children aged 6 months to 13 years referred to a private Radio - diagnostic Center, between June 2015 to June 2016 were studied. Patients were examined using GE CT Brivo 385 machine.RESULT: Forty - seven children were referred for CT scan during the period. Of these 45 (95.47%) were referred from the Teaching Hospital located in the same city. A brain scan was most commonly performed (93.6%) while the frequency of abdominal CT was (6.4%). The main indications for the referrals were delayed milestones (61.7%) and seizures (17.0%). The major findings were cerebral atrophy 26 (55.32%), and cerebral infarction 3 (6.38%).CONCLUSION: This study shows a predominance of brain CT scan request in children, delayed milestones and seizures being the most common indications, while cerebral atrophy and cerebral infarction were the common brain findings. In the absence of MRI, CT scan provides a suitable alternative for imaging of the brain and abdominal pathologies in a developing environment like ours