Intestinal helminths in some cases of acute appendicitis operated in Bamenda, Cameroon

Background: Acute appendicitis is the most frequent infectious surgical abdominal emergency and previous studies have noted the presence of parasites in the appendicular lumen.Objective: This study was done to determine the involvement of intestinal worms in the etiology of acute appendicitis.Materials and Methods: This was a prospective and descriptive study concerning cases of confirmed and operated acute appendicitis between 15th April, 2013 and 14th April, 2015 at the People’s Clinic, Ngomgham, Bamenda, Cameroon. The appendicular content was macroscopically examined for parasites and formol-ether concentration technique was carried out for ova detection.Results: A total of 112 patients were operated for acute abdominal pain within the study period. There were 74 (60.8%) cases confirmed with acute appendicitis of which 45 (60.1%) were males and 29 (39.2%) were. The most affected age group was the 21 to 40 years (50%). The removed appendices appeared congestive in 30 (40.5%) cases, suppurated in 27 (40.5%) cases and gangrenous in 17 (23.0%) cases.There was no relationship between the appearance of the removed appendix and the gender of participants (P>0.05).Three different helminth ova were identified in the 74 samples. In decreasing prevalence, the parasite trend was 8 (10.8%) Ascaris lumbricoides, 5 (6.8%) Enterobius vermicularis, 3 (6.0%), Ankylostoma duodenale, Adult Ascaris lumbricoides and Enterobius vermicularis were seen in 1 and 3 cases respectively.Conclusion: A small percentage of parasitic worm eggs were found in the appendicular content, though a good portion of patients took medications against parasites before surgery. Intestinal worms could not be incriminated in the causation of the appendicitis; nevertheless, one adult ascaris was found as an evident cause of appendicular lumen obstruction.Keywords: Intestinal Helminthes, Acute appendicitis, Bamend

The management of pelvic pressure ulcers by myocutaneous flaps: a 10 years experience in Yaoundé - Cameroon.

Pressure ulcers or ischaemic necrosis of tissues over bony eminences due to pressure, heal very slowly. Vascularised tissues such as myocutaneous flaps are necessary to cover the ulcer and accelerate healing. This study was done to share our experience with methods of myocutaneous flaps in the treatment of pressure ulcers. We retrospectively reviewed the outcome of 20 myocutaneous flaps used for the surgical coverage of 24 pelvic pressure ulcers in 18 patients from 1997 to 2007 in the Yaoundé University Hospital Centre (CHUY). The mean patient age was 46.06 years (range: 19-86years). The sex ratio was 5 men for 4 women 10 sacral ulcers were treated by gluteus maximus myocutaneous flaps, 10 trochanteric and 4 ischiatic ulcers were covered by tensor fascia lata myocutaneous flaps. The cure rate was 100%. The main complications were: infection (63.5%), serous fluid discharge (21.05%), and flap edge necrosis (31.6%). Of the 18 patients in the study: 8 were lost to follow up, 1 dead after a week from another disease. The average follows up for the remaining 9 live patients was 20.6 months (range, 1-39 months). No recurrence of pressure ulcer was observed. Myocutaneous flap transposition remains a simple, reliable, effective, safe, versatile and useful method for the coverage of large pelvic pressure ulcers.Key words : Pressure ulcer, musculo-cutaneous flap, pelvic ulcer