Presentation, distribution pattern, and management of diverticular disease in a Nigerian tertiary hospital

Background: Colonic diverticular disease is one of the most common and costly gastrointestinal disorders among industrialized societies, which have recently been described among Africans. Presentations and distribution pattern of the disease among Africans appeared to be different from that described among the Western population. We embark on this study aimed at evaluating the presentation, distribution pattern, and the management of diverticulosis in our tertiary health facility.Materials and Methods: A prospective descriptive study of the cases of diverticular disease seen between January 2007 and December 2011 at Obafemi Awolowo University Teaching Hospitals Complex, Ile.Ife, Osun State, Nigeria.Results: During the 5.year study period, 40 cases were seen. The patients were aged 41.85 years with a median age of 64 years. There were 29 (72.5%) male and 11 (27.5%) female with an average male to female ratio of 3:1. The most common presentation was bleeding per rectum in 28 (70%) patients, which mostly needed transfusion. Ten (25%) patients presented with recurring abdominal pain, whereas one (2.5%) patient presented with abdominal mass and features of intestinal obstruction. Thirty patients were diagnosed on colonoscopy, eight on barium enema, and two on computerized tomography scan. Thirty.four (85%) patients had a pancolonic disease. All the patients were placed on high fiber diet and antibiotics namely ciprofloxacin and metronidazole. Five patients had recurrence within 6 months of follow up, of which one had emergency colectomy.Conclusion: Diverticular disease is no longer a rare disease in Nigeria. It is a common cause of lower gastrointestinal bleeding in elderly patients. High index of suspicion for diverticular disease of the colon and its  complications should increase in the country.Key words: Distribution pattern, diverticular disease, management, Nigeria, presentatio

Evaluation of renal volume by ultrasonography in patients with essential hypertension in Ile-Ife, south western Nigeria

Background and aims: To determine renal volume in adult patients with essential hypertension and correlate it with age, sex, body mass index (BMI), body surface area (BSA) and duration of hypertension. Patients and methods: A total of 150 patients (75 males, 75 females) with essential hypertension and normal renal status were evaluated sonographically in this prospective study. Fifty healthy individuals (25 males, 25 females) without hypertension were also evaluated as control. Renal volume was then calculated from the kidney’s length, width and anterio-posterior diameter using the formula L*W*AP*0.523. Results: The range of renal volume obtained was 51.65-205.02 cm3, with a mean of 114.06±29.78 cm3 for the left kidney and 47.37-177.50 cm3 with a mean of 106.14±25.42 cm3 for the right kidney. The mean volumes of the right and left kidneys in males (112.98±25.56 cm3 and 123.11±32.49 cm3, respectively), were significantly higher than in females (99.31±23.07 cm3 and 105.01±23.77 cm3, respectively). Renal volume correlated significantly with BSA and BMI, but decreased with age. The renal volume showed no correlation with duration of hypertension. Conclusion: Renal volume is higher in the left than the right kidney in hypertensive patients of both sexes and female hypertensive patients have smaller kidney size compared to males. The study also shows that volume of both kidneys decreases with age and positive correlation between renal volume, BSA and BMI. However, there is no correlation between renal size and duration of hypertension.Keywords: essential hypertension; renal volume; ultrasonograph

The contribution of alcohol to chronic liver disease in patients from South-West Nigeria

Objective: This study aimed at determining the level and type of alcohol consumed by patients diagnosed with chronic liver disease (CLD) and, hence, the extent to which alcohol may have contributed to the development of the condition.Study Design: Patients with diagnosis ofCLDwere consecutively recruited and a structured questionnaire was administered on each of them. Diagnosis of CLD was made based on liver histology and/or typical clinical and laboratory features.Alcohol consumption was considered significant if a patient took 50g/day for 10 years.Results: A total of 145 patients were studied consisting of 102 males and 43 females. Their ages ranged from 20- 80 years with a mean of 46.8 ± 15.7 years. Fifty-one (35.2%) patients, all males, drank significant alcoholwhile consumption was not significant in 43 (29.6%) patients. Alcohol was not consumed at all by 51 (35.2%) patients made up of 18 males (35.3%) and 33 females (64.7%). Beer was the commonest form of alcohol consumed (70.2%) followed by palm wine (50%) and locally-brewed gin (20.2%).The diagnoses made were liver cirrhosis [LC] (60, 41.38%), chronic hepatitis [CH] (54, 37.20%), hepatocellular carcinoma [HCC] (23, 15.86%), alcoholic liver disease [ALD] (6, 4.14%) and non-alcoholicfatty liver disease [NAFLD] (2, 1.38%). The liver disease spectrum did not differ between the patients who drank significant alcohol and those who did not. However, the proportion of LC/HCC cases increased relativetoCHwith increasing age and consumption of alcohol.Conclusions: The proportion of CLD directly attributable to alcohol (i.e. ALD) is low among the patients studied. However, the burden of LC andHCCis directly related to age and the amount of alcohol consumed andthe determinants of alcohol abuse are gender and affluence

The appearances of benign breast diseases on ultrasound

No Abstract. Nigerian Journal of Medicine Vol. 15 (4) October-December 2006: 421-42

Unilateral Congenital Multicystic Dysplastic Kidney Mimicking Cystic Renal Cell Carcinoma in an Adult Nigerian

No Abstract Available African Journal of Urology Vol.10(4) 2004: 289-29

Severe pentasomide Armillifer armillatus infestation complicated by hepatic encephalopathy

Background: Diagnosis of Armillifer armillatus infestation is usually incidental, commonly via autopsy or radiography. Affected individual are usually asymptomatic. The case presented here, however, had severe thoracic and abdominal involvement with clinical manifestations.Aim: To report a case of heavy A. armillatus infestation in an adult female Nigerian rural dweller complicated by hepatic parenchyma damage.Setting: Case report from semi-urban southern Nigeria, using clinical records and imaging findings.Materials and Methods: Clinical case records, including laboratory results and radiographic /computed tomography images.Conclusion: Parenchymal damage with organ dysfunction can be seen with severe A. armillatus infestation. Thus, there is a need for regular health education regarding the risk of A. armillatus infestation for individuals who consume snake meat

Successful Separation Of Two Pairs Of Conjoined Twins In Ile Ife, Nigeria: Case Reports

Conjoined twins are rare phenomena occurring in one in 1 in 50,000 live births. Successful surgical separation of conjoined twins is a major undertaking requiring careful planning by a multidisciplinary team. Reports of seperation of joined twins in developing countries like Nigeria are rare. Ten cases of conjoined twins were separated between 1936 and January 2003 (including the authors two new cases). There were five omphalopagus, two pygopagus, two heterpagus and one ishiopagus twins. Three underwent emergency separation with 83.3% mortality while seven underwent elective seperation with 64.3% survival. The overall mortality rate was 50%. Despite the absence of advanced technological resource selected group of conjoined twins can be successfully separated in a developing country like Nigeria. An improvement in facilities and availability of trained personnel in likely to be associated with improved outcome. East African Medical Journal Vol.82(1) 2005: 50-5