Rectal prolapse in pregnancy: a case report

Rectal prolapse occurs when a mucosal or full thickness layer of rectal tissue slides through the anal orifice. It is relatively infrequent and occurs commonly in elderly women. This report is to bring to focus the possibility of a rectal prolapse being misdiagnosed as haemorrhoids in pregnancy. A case of a 35-year-old woman, gravida 4, para 3+0, found to have a large rectal prolapse but misdiagnosed as prolapsed haemorrhoids at 34 weeks gestation is reported. Although rectal prolapse is not a common condition during childbearing years, it is instructive for obstetricians and midwives to be vigilant in all cases of pregnant women presenting with rectal protrusion or bleeding

Principles of management of breast cancer and its implications in a developing nation: Invited commentary

No Abstract. Port Harcourt Medical Journal Vol. 1(1) September 2006:

Case Report: Synchronous dehiscence of the abdominal and uterine wounds

Two primigravida patients presented with obstructed labour and intrauterine foetal deaths. Caesarean section was done to deliver the dead fetuses. In each, intrauterine sepsis was noted during the procedure. The uterine wounds were closed in two layers with No.2 chromic catgut. The abdomen was closed in mass with nylon. The abdominal and uterine wounds subsequently dehisced synchronously at about 7 days after the operations. Resuture was done using chromic catgut for the uterine wounds and nylon to the abdominal fascia without tension sutures. One patient developed further wound infection but the deep wounds remained intact at about 3 months review. The importance of deep wounds infection in abdominal wound dehiscence is emphasized by these two cases. A subsequent complication of secondary infertility from pelvic infection will take time to evaluate. Keywords: wound dehiscence, synchronous, abdomen, uterus Mary Slessor Journal of Medicine Vol. 5 (1), 2005: 77-8

The Altemeier repair - a form of repair for complete rectal prolapse

The problem of full-thickness rectal prolapse is formidable. The operations proposed are broadly divided into transabdominal and perineal procedures with no clear choice of superiority. The aim of the study is to report a series of perineal sigmoidectomy (Altemeier's modification) for full thickness rectal prolapse. A retrospective review of all cases of rectal prolapse operated upon over a period of 15 years (1990-2005) by the same surgeon using hospital records. The setting is at the University of Port Harcourt Teaching Hospital. Port Harcourt and Seaside Specialist Surgery, Port Harcourt. Data extracted included: name, age, presenting symptoms, signs, investigations, diagnosis, co-morbidities, procedure, outcome and follow-up. Fifty two adults comprising 40 (76.9%) females and 12(23.1%) males with a mean age of 62.6 years were treated for full thickness rectal prolapse for a period of 15 years. They all presented with rectal prolapse and other associated symptoms. Following the surgery, they were all satisfied as there was no longer visible prolapse and they enjoyed varying improvement of other symptoms. Altemeier's mode of repair of rectal prolapse is safe and can be carried out in elderly patients with multiple co-morbidities.Key Words: Complete rectal prolapse; Altemeier repair; OutcomeNigerian Hospital Practice Vol. 2 (3) 2008: pp. 60-6

Traumatic rupture of the diaphragm

Background and aim: Blunt injury of the chest is the most common form of thoracic trauma. The resulting deceleration injury can cause a life threatening damage to any intra-thoracic structure. We therefore, aimed to highlight the importance of a high index of suspicion while examining patients involved in a road traffic accident or other serious thoracic trauma. Methodology: All the case notes of patients who presented from 1994 to 2004 with blunt injuries to the chest following road traffic accident were reviewed. Those treated for traumatic rupture of the diaphragm were selected and analyzed for age, gender, cause of injury, associated injuries sustained and mode of treatment. They were all treated at the University of Port Harcourt Teaching Hospital and a private clinic in Port Harcourt. Results: 12 patients had traumatic rupture of the diaphragm. All were males and aged between 16 and 46 years (mean 32 years). 10 cases (83.3%) were left sided and 2 (16.7%) were right-sided and there were no bilateral cases. The right-sided cases all died. There were associated injuries in all cases and they involved the spleen, rib fractures, liver and lungs. All the cases were repaired by laparotomy with the exception of the right-sided cases that died from severe haemorrhage. Conclusion: A high index of suspicion combined with repeated and selective radiological evaluation is necessary for early diagnosis and treatment. Keywords: blunt trauma, diaphragmatic rupture Sahel Medical Journal Vol. 8(1) 2005: 9-1

Marjolin's ulcer: report of 4 cases

No Abstract. Nigerian Journal of Medicine Vol. 14(1) 2005: 88-9

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

Ruptured heterotopic pregnancy: A case report and brief review of the literature

No Abstract. Nigerian Journal of Medicine Vol. 14(3) 2005: 315-31

Pregnancy-associated breast cancer; A management dilemma in Nigeria

Pregnancy-associated breast cancer (PABC) is uncommon. Its management is sometimes controversial and may present ethical problems. This paper presents cases treated in the University of Port Harcourt Teaching Hospital from 1990 to 2002. The case records of patients treated for pregnancy-associated breast cancer were retrieved, studied and are presented with a limited review of the literature on the current management of the disease. There were 5 nulliparous young women aged between 26 and 32 years with breast cancer involved in 6 pregnancies. One patient had sequential bilateral mastectomy for carcinoma of the breast in pregnancy at two pregnancies, three had the cancer affecting one breast in pregnancy and one had the mastectomy but while on chemotherapy became pregnant and delivered successfully. One patient with advanced disease, refused biopsy and treatment. The diagnosis in 5 instances was intraductal carcinoma. The disease is uncommon but evokes significant emotion in patients and their doctors. The prognosis appears similar to that in non-pregnant women. The treatment of PABC is similar to that in non-pregnant women except that radiotherapy and chemotherapy may be contraindicated at certain trimesters. KEY WORDS: Breast cancer, Pregnancy, Management dilemma. Sahel Medical Journal Vol.7(2) 2004: 69-7