Rupture of an incisional hernia with evisceration of the gut: A case report

Spontaneous rupture of the abdominal wall hernia is very rare and usually occurs in incisional and recurrent groin hernias. Here, we report the case of rupture of a large incisional hernia with the evisceration of small bowel in a 56-year-old female. This surgical emergency was successfully managed using the current standard tension-free prosthetic mesh

Interstitial incisional hernia following open appendectomy: Case report

Open appendectomy is a common surgical procedure but post-appendectomy incisional hernia is uncommon, the actual incidence is probably less than 1%. The common contents of such hernias are small bowel and omentum. Primary repair of this type of hernia has a high failure rate and effective repair can be achieved by using synthetic mesh. We report a case of interstitial incisional hernia in a 70-year-old female who was presented to the hospital. She had a bulge in the the right lower quadrant of the abdomen since last 8 years. The hernia was successfully repaired by tension-free sutured prolene mesh. The follow up showed that there were no signs of reoccurrence

A huge epidermal inclusion cyst of the vulva complicating neonatal female circumcision

Female genital mutilation is the summation of all procedures that involve partial or total removal of the female external genitalia or other injuries to the female genital organs, whether for cultural or other non-therapeutic reasons. Hemorrhage, sepsis and genitourinarydamage are the main early causes of morbidity and occasional mortality associated with this practice. Vulva epidermal inclusioncysts, sexual and birth difficulties occur late and can cause medical, psychological and socioeconomic problems. Here, we presentthe case of a 42-year-old circumcised female, who presented with a huge vulva swelling of 30 years duration that posed somediagnostic challenge because of the presence of other body swellings arising from neurofibromatosis. This was successfully excisedand histology showed it was epidermal inclusion cyst, which we believed was a late complication of her neonatal circumcision

Apparent overuse of antibiotics in the management of watery diarrhoea in children in Abakaliki, Nigeria

Abstract Background Diarrhoea remains an important cause of childhood mortality in Nigeria, with Rotavirus and Cryptosporidium reported to have the highest contribution. However, high use of antibiotics for treatment of paediatric diarrhoea has been observed, although World Health Organization guidelines discourage the use of antibiotics for treating acute diarrhoea. Here we investigated more closely management and treatment practices for acute paediatric diarrhoea, both in home and healthcare settings. Methods Children under 5 years of age (n = 199) presenting at healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea were included in the study. Background information on the children was collected by questionnaire, including home treatments, and clinical information including symptoms and treatment were provided by the healthcare centres. Analysis of faecal samples from the children indicated that over 90% had Rotavirus infection and over 6% Cryptosporidium infection. Data were compiled in a spreadsheet and analysed for associations between variables and use of antibiotics using logistic regression analysis. Results Although most children were treated supportively (oral rehydration solution and intravenous fluids at home and in healthcare settings, respectively) over 15% were given anti-diarrhoea drugs at home and over 85% were also prescribed antibiotics at the healthcare centre, mostly ciproflaxin, but also metronidazole and gentamycin. The only variable positively associated with antibiotic prescription was diarrhoea more than three times per 24 h at admission. Conclusions It is clear that young children presenting with acute watery diarrhoea to healthcare centres in Abakaliki are likely to be prescribed antibiotics, despite there being no obvious reason that this treatment is appropriate. Our study results support the need for institution-based antimicrobial stewardship being implemented in Nigeria

Open mesh repair of a voluminous recurrent inguinal hernia complicated by strangulation and intestinal obstruction

Introduction. Inguinal hernia is a common surgical pathology in Nigeria but a giant (voluminous) recurrent strangulated inguino-scrotal hernia causing intestinal obstruction is very uncommon. Such a hernia, when it is recurrent and becomes complicated with strangulation and dynamic intestinal obstruction, presents many difficulties in management. Aim. To present the successful management of a case of a strangulated and obstructed giant recurrent inguinal hernia. Description of the case. Here we present the case of 47 year old man who had intestinal resection and anastomosis with prolene mesh repair of the posterior wall for a strangulated recurrent large inguinal hernia using the technique of tension free sutured prolene mesh popularized by Lichtenstein Conclusion. The patient recovered, was satisfied with his care and has been symptom free at 18 months of follow up. Giant recurrent hernias complicated by strangulated and intestinal obstruction are uncommon in Nigeria today, despite our resource-poor status. When they occur, tension free repair with sutured onlay prolene mesh after Lichtenstein, can be a useful and the best option with satisfactory results, as in the case reported

Open mesh repair of a voluminous recurrent inguinal hernia complicated by strangulation and intestinal obstruction

Introduction. Inguinal hernia is a common surgical pathology in Nigeria but a giant (voluminous) recurrent strangulated inguino-scrotal hernia causing intestinal obstruction is very uncommon. Such a hernia, when it is recurrent and becomes complicated with strangulation and dynamic intestinal obstruction, presents many difficulties in management. Aim. To present the successful management of a case of a strangulated and obstructed giant recurrent inguinal hernia. Description of the case. Here we present the case of 47 year old man who had intestinal resection and anastomosis with prolene mesh repair of the posterior wall for a strangulated recurrent large inguinal hernia using the technique of tension free sutured prolene mesh popularized by Lichtenstein Conclusion. The patient recovered, was satisfied with his care and has been symptom free at 18 months of follow up. Giant recurrent hernias complicated by strangulated and intestinal obstruction are uncommon in Nigeria today, despite our resource-poor status. When they occur, tension free repair with sutured onlay prolene mesh after Lichtenstein, can be a useful and the best option with satisfactory results, as in the case reported