A.L. Babata

Genital self-mutilation.

We present a case report of a 22-year-old Nigerian student who presented to the accident and emergency unit of a Nigerian Teaching Hospital with a history of self-inflicted genital injury following a suicide attempt. He had background history of predisposition to depressive illness, a current diagnosis of a major depressive disorder, and had had two attempted suicidal episodes in the last 3 months prior to this event. The clinical finding shows a patient with sad affect, feeling of hopelessness, and worthlessness; however, the vital signs remained fairly stable. At examination under anesthesia, the testes were exposed and the right already self-castrated. The penis was degloved to the level of the Bucks fascia with intact corpora cavernosa and urethra. He had surgical excision of the hanging self-castrated right testis with debridement and primary closure of the genital laceration. He was promptly reviewed by the psychiatrists who co-managed appropriately.

Vesicocolonic fistula: a sequela of missed blunt abdominal injury.

A case of vesicocolonic fistula secondary to a missed abdominal injury is described. The patient, a 25-year-old male Hausa, Nigerian, was involved in a road traffic accident and sustained head injury with a fractured left femur and a missed blunt abdominal injury. He was referred to us about six months following the injury, on account of failure to micturate, recurrent passage of frequent watery stool, and recurrent fever and weight loss. A suspected diagnosis of intestinovesical fistula was confirmed on micturating cystography. He had a single stage repair of the vesico-colonic fistula. The repair of urethrocutaneous fistula was scheduled for a later date, which he later had. He was discharged but continued with orthopaedic consultation and management.