Perforation of the jejunum-an unusual mechanism

Background: Perforation of the jejunum following blunt abdominal trauma can be as a result of various mechanisms. Its diagnosis oftentimes is challenging. Aim: To report a rare case of blunt abdominal trauma with perforation of the jejunum due to a coffin and discuss the diagnosis and management of this condition. Setting: Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria. Case Report: A 19-year-old female was an unrestrained passenger in a 14-seater bus conveying several passengers and an unrestrained coffin. The bus was involved in a roll-over vehicle crash during which the patient suffered a severe impact to the abdomen from the coffin with perforation of the jejunum. She had a trauma laparotomy with repair of the jejunum and had an uneventful recovery. Conclusion: This case illustrates the inherent risks involved in transporting caskets and corpses in a passenger vehicle. We recommend that these be conveyed in hearses with the appropriate restraints in place. Health education, legislation and enforcement on this issue are imperative in developing countries. Keywords: Casket, Blunt abdominal trauma, Jejunal perforation PHMJ Vol. 2 (2) 2008: pp. 174-17

Modifications hémorheologiques chez les cancéreuses

Several Studies have indicated the existence of thrombo-embolic complications in cancer patients and that this could be associated with changes in heamorheological parameters. Packed cell volume (PCV), heamoglobin (Hb), relative plasma viscosity (RPV) and plasma Fibrinogen concentration (PFC) were measured in 50 healthy control women, 50 age-matched women with breast cancer, and 10 women with histophathologically proven benign breast tumour. There were significant differences between the controls and breast cancer patients in all the parameters measured (p<0.05). However, patients with cancer have significantly higher RPV and PFC (p<0.001) respectively than controls. There was significant mean difference between pre and post mastectomy in fibrinogen concentration (p<0.05) and this was observed over the 5-week study period. Since increased fibrinogen may give rise to increase fibrin formation which has been asserted as an independent cardiovascular risk factor for thromb-oembolic complications, African patients with breast cancer may well be predisposed to thrombotic complications during illness. The rheological assessment may offer valuable benefit for the management and early diagnosis of breast cancer in African women.Beaucoup d&apos;études ont montré l&apos;existence des complications thrombe-embolique chez les cancéreuses et qu&apos;on peut lier ceci aux modifications dans les paramètres hémorheologiques. Le volume globulaire concentré (VGC), l&apos;hémoglobine (Hb), la viscosité du plasma relatif (VPR) et la concentration du fribinogène du plasma (CFP) ont été mesurés chez 50 femmes en bonne santé comme femmes témoin, 50 femmes cancéreuses qui ont été appariées selon l&apos;âge et 10 femmes qui souffraient de la tumeur du sein bénigne qui a été prouvée histopathologiquement. Il y avait des différences importantes entre les témoins et les patientes cancéreuses dans tous les paramètres mesurés (p < 0,05). Toutefois, les patientes cancéreuses ont une VPR considérablement plus élevé et la CFP (p < 0,001) respectivement que les témoins. Il y a une différence moyenne importante entre la pré et la post mastéctomie dans la concentration du fribinogène (p < 0,05) et ceci a été observé au cours des cinq semaines que l&apos;étude a duré. Puisque l&apos;augmentation du fibrinogène peut aboutir a l&apos;augmentation de la formation de la fibrine qui a été acceptée comme un facteur indépendant de risque cardiovasculaire pour des complications thrombe-emboliques. Les patientes cancéreuses africaines pourraient bien être prédisposées à des complications thrombotiques pendant la maladie. L&apos;évaluation rhéologique peut donner des avantages valables pour le traitement et le diagnostique anticipé du cancer du sein chez les femmes africaines