Blood transfusion, antibiotics use, and surgery outcome in thyroid surgery: Experience from a suburban center in Nigeria

Background: Edo North, which is a known goiter belt in Nigeria, is within the catchment area of this hospital. Although thyroid disease is prevalent in the communities, the fear and cost of surgery have been limiting factors for sufferers who should otherwise seek expert care.Aim: To review all thyroid surgeries at Irrua Specialist Teaching Hospital, to determine pathological diagnosis of goiters, and to evaluate the outcome and necessity or otherwise of antibiotic therapy and routine cross.matching of blood.Results: There were 80 patients in the study, with 75 (93.75%) females and 5 (6.25%) males, giving female.to.male ratio of 15:1. People in the 4th and 5th decade of life constituted a dominant 32.5% and 26.7%, respectively, while the 1st and 2nd decades combined constituted only 7.5% of the study population. Two patients (2.5%) had blood transfusionwhile a similar number had wound infection.Conclusion: Thyroidectomy is a safe surgery with minimal risk of complications. Grouping and cross.matching of blood in elective thyroidectomy is not an essential pre.operative preparation for all patients just as antibiotic therapy/prophylaxis made no difference in patient outcome. Simple multinodular goiter is the commonest histological diagnosis

Appendicitis: A Study of Negative Appendicectomies

This is a fifteen-month prospective study to assess the diagnostic accuracy of appendicitis. One hundred and fifty nine patients were diagnosed on clinical basis as having acute appendicitis and subsequently had appendicectomy. 52.8% were confirmed on histology. The diagnostic error (negative appendicectomy) was 47.2%. the error was lower in males (35%) compared with females. The reason for the high negative appendicectomy in women is pelvic inflammatory diseases, which mimics acute appendicitis. Post-operative complications were noted in 3% of the negative appendicectomy group but in the positive appendicectomy group complications were much more common particularly when the appendix was ruptured. (Key Words: Negative appendicectomy, perforated appendix and postoperative complications.) Sahel Med. J. Vol.6(3) 2003: 72-7

Intra-abdominal gossypiboma: a report of two cases and a review of the literature

A journal article on Intra-Abdominal Gossypiboma surgery.Post operative foreign body in the abdominal cavily, though rare continues to occur in surgical practice. Symptoms may start early with abdominal pain but usually have a varying course, often leading to the formation of gossypiboma. This is usually a great source of embarrassment to the surgeon and the centre, and of serious detrimental effect to the patient. A case report of a 27 year old trader with intra-abdominal foreign body is presented to highlight the similarity in presentation with abdominal lymphoma and the need to explore carefully masses in the abdominal cavity especially in patients who have had surgery in the past. A high index of suspicious is required on the part of the clinician in addition to appropriate radiological and sonologic assessment. Prompt diagnosis and treatment ameliorates the patients suffering and brings them back to life

Surgery of peptic ulcer in Edo State, Nigeria

The introduction of H2-receptor blockers, proton pump inhibitors and eradication of Helicobacter pylori has greatly reduced the need for surgical intervention in the management of peptic ulcer disease. However in communities where these drugs are out of reach or compliance is poor, operations are still carried out. We reviewed the medical records of 68 patients who had surgery for peptic ulcer disease over a 10 year period to determine the indications for surgery, operative procedure performed, and the outcome of surgery. Thirty-eight (56%) were operated on for gastric outlet obstruction while 21 and 9 respectively had perforation and bleeding as the indication for surgery. The operative procedures performed were truncal vagotomy and gastrojejunostomy(38), truncal vagotomy and pyloroplasty (18) and simple closure of perforation(12). Sepsis, consequent upon perforation and recurrent gastrointestinal bleeding were the most common complications leading to death in 10(12%) patients Keywords: peptic ulcer, gastric outlet obstruction, perforation, vagotomy, gastrojejunostomy, pyloroplasty Nigerian Journal of surgical Sciences Vol. 16 (2) 2006: pp. 80-8

Intra-abdominal gossypiboma: a report of two cases and a review of literarture

No Abstrac

Rationale antibiotic usage in appendicectomy

Background: Surgical site infection is of great concern to the surgeon hence preventive measures such as prophylactic antibiotics in widely used for clean contaminated and contaminated surgical procedures. This study seeks to evaluate any advantage gained by administering antibiotic in uncomplicated appendicitis. Method: A prospective randomized trial done on 70 patients admitted with appendicitis without features of peritonitis. Records were taken preoperatively and updated at the point of discharge and first clinic visit. Results: Wound infection occurred in 1 of 34 patients (2.9%) who had no antibiotic appendectomy against 2 of 36 who had metronidazole and ciprofloxacin. Mean age of patients was 22.8 years, and a mean hospital stay of 4.6 days. Conclusion: Routine antibiotic therapy is not necessary for adult Nigerian patients undergoing appendectomy for uncomplicated appendicitis