Rs Jamabo

Abdominal scar endometriosis

BackgroundAbdominal scar endometriosis is an uncommon pathology. It can occur in any abdominal scar, most often after a surgical procedure on the uterus.AimThe purpose of this study is to highlight the potential pitfall in the diagnosis of this disease.Patients and methodsThis retrospective study reviewed all cases of proven abdominal scar endometriosis seen in a 5-year period (2002–2006) in our hospital, noting the demographic data of the patients and management. They were all treated by the same surgeon and also had histopathological confirmation of the lesion.ResultsA total of 14 women were treated during this period. They were all pre-menopausal. The mean age was 29.1years (range 20 to 42). Presenting symptoms included painful ‘heaped-up’ scars and cyclical pain related to their menstrual periods. They were referred to the general surgical clinic with various diagnoses such as incisional hernia, granuloma, keloid scar etc. All the patients had history of previous surgical procedures on the uterus for various indications. Treatment was a wide excision of the lesion with apposition of the edges only. Specimens were examined histologically and confirmed to be endometriosis. The follow up periods were rather short as the patients stopped to attend the hospital. During this period, there was no recurrence or wound break-down.ConclusionAlthough scar endometriosis is a rare entity, a good and diligent surgical history and a high index of suspicion are the keys for a pre-operative diagnosis.

Phyllodes tumour in young female adults in Port Harcourt, Nigeria.

Background: Phyllodes tumour of the breast is a rare and potentially aggressive tumour. Little information is available regarding the optimal management of this tumour and rarer still, are data regarding survival. We report our experience in the diagnosis, management and outcome of phyllodes tumour. Patients and Methods: The hospital case notes of adolescent female patients found to have phyllodes tumour from 1997 to 2007 were identified from the medical records department of the hospital. Data extracted included sex, age, presenting symptoms, anatomical site of lesion and clinical evaluation including approximate size of the breast masses. Results of investigations including haemogram, urea and electrolytes, chest xray, ultrasonography, tru-cut and excision biopsy, surgical treatment and outcome of treatment were obtained. The follow up visits to the outpatient clinic were also noted. Results: There were 17 females aged between 25 and 30 years. Five patients had previous excision biopsy of fibrodenoma from the ipsilateral breasts when they were teenagers. The median tumour size was 17.5 cm in diameter. There were no clinical features suggestive of malignancy. The chest radiographs were within normal limits. Histopathological findings showed that ten (58.82%) patients had the benign variety while seven (41.18%) had the borderline variety. All had a wide excision of the tumour but were not offered any adjuvant therapy. Conclusion: Early diagnosis and treatment with adequate surgical margins are essential in the successful management of phyllodes tumour.

The Altemeier repair - a form of repair for complete rectal prolapse

The problem of full-thickness rectal prolapse is formidable. The operations proposed are broadly divided into transabdominal and perineal procedures with no clear choice of superiority. The aim of the study is to report a series of perineal sigmoidectomy (Altemeiers modification) for full thickness rectal prolapse. A retrospective review of all cases of rectal prolapse operated upon over a period of 15 years (1990-2005) by the same surgeon using hospital records. The setting is at the University of Port Harcourt Teaching Hospital. Port Harcourt and Seaside Specialist Surgery, Port Harcourt. Data extracted included: name, age, presenting symptoms, signs, investigations, diagnosis, co-morbidities, procedure, outcome and follow-up. Fifty two adults comprising 40 (76.9%) females and 12(23.1%) males with a mean age of 62.6 years were treated for full thickness rectal prolapse for a period of 15 years. They all presented with rectal prolapse and other associated symptoms. Following the surgery, they were all satisfied as there was no longer visible prolapse and they enjoyed varying improvement of other symptoms. Altemeiers mode of repair of rectal prolapse is safe and can be carried out in elderly patients with multiple co-morbidities. Key Words: Complete rectal prolapse; Altemeier repair; Outcome Nigerian Hospital Practice Vol. 2 (3) 2008: pp. 60-64