African Journal of Medicine and Surgery

African Journal of Medicine and Surgery Vol. 1 (4), pp. 028-030, November, 2013. © International Scholars Journals

Case Report

Gastro-intestinal stromal tumours of stomach and small intestine: Report of two cases

Mahesh Gupta, Manoj Gupta and Pooja Gupta

Department of Surgery, Rama Medical College Hospital and Research Centre, Mandhana, Kanpur.

Corresponding author. E-mail: gm982003@yahoo.co.in, Tel.:+7753920881

Accepted 04 October, 2013

Abstract

Gastrointestinal stromal tumors (GIST) are rare gastrointestinal tract (GIT) tumors that originate from the interstitial cells of Cajal. Melena or hematemesis and anemia are the most common presentations and CT scan is the investigation of choice in demonstrating the endoluminal and exophytic extent of tumor. Surgery remains the mainstay of treatment in GIST and chemoradiation has not proved to be very effective. We have encountered two such cases of GISTs in our clinical practice. 62-years and 32-years old males presented with epigastric and paraumblical pain respectively. Clinical examination revealed a well defined epigastric mass of approximate size 12*10 cms in former and a vague paraumblical mass in the later. Contrast Enhanced CT Scan of abdomen and pelvis suggested the origin of masses in each case and exploratory laparotomies performed in both of them revealed a mass in relation to the stomach and ileum respectively. Histopathology and immunohistochemistry confirmed the diagnosis. Histopathology and immunohistochemistry are very useful aids in making a diagnosis of GIST and surgery remains the choice of treatment even in cases of larger GISTs.

Keywords: Gastro-intestinal stromal tumours, stomach, small intestine, interstitial cells of Cajal, c-kit proto-oncogene.

African Journal of Medicine and Surgery Vol. 1 (2), pp. 009-012, September, 2013. © International Scholars Journals

Full Length Research paper

Surgical stress differences between total hip arthroplasty and total knee arthroplasty

Motoki Sonohata*, Kenji Tsunoda, Hajime Kugisaki, Shinsuke Someya, Hidefumi Honke, Mitsunori Komine, Masaru Kitajima, Masaaki Mawatari and Takao Hotokebuchi

Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan.

*Corresponding author. E-mail: epc9719@yahoo.co.jp. Tel.: +81-952-34-2343. Fax: +81-952-34-2059

Accepted 2 September, 2013

Abstract

This study aims to clarify the difference between surgical stress of total hip arthroplasty (THA) and total knee arthroplasty (TKA) under the same conditions through blood transfusion and ischemic extremity. Body temperature, white blood cell (WBC) count, the level of C- reactive protein (CRP), and interleukin-6 (IL-6) were measured for eleven patients undergoing THA and eight patients undergoing TKA. All the patients who underwent THA and TKA received a transfusion of 2 units of autologous blood but no transfusion with homologous blood, and the TKA surgery was performed without an air tourniquet. The first day after the surgery, there was no significant difference between the THA and TKA with respect to body temperature and CRP. However, there was a significant difference between the THA and TKA in WBC count (p < 0.05) and IL- 6 (p < 0.01) on the first day after the surgery. In addition, there was a significant difference between the THA and TKA in IL-6 (p < 0.05) and CRP level (p < 0.05) on the seventh day after the surgery. The surgical stress of TKA was significantly larger than the surgical stress of THA. There may be more potential complications in the patients who underwent TKA than those who underwent THA.

Key words: Cytokine, surgical stress, total hip arthroplasty, total knee arthroplasty.

African Journal of Medicine and Surgery Vol. 1 (1), pp. 001-005, August, 2013. © International Scholars Journals

Full Length Research Paper

Incarcerated external anterior abdominal wall hernias: a 5 year experience in Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State of Nigeria

Dr.  B. G. Fente BMBCH, FWACS, FMCS, FICS¹, and Dr. H. S. Ukoima, MBBS, FMCS².

^1,2Department of Surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria. 

*Corresponding author. Email: bgfente@hotmail.com. Tel. +2348033132866

Accepted 1 June, 2013

Abstract

The aim of this study is to document our first experiences in the surgical management and outcome of incarcerated external anterior wall hernias (EAAWH) in our local environment, outlining the clinical profile, treatment outcome and identify predictors of outcome among these patients. The study design used was a retrospective analysis of data. The study was conducted at the Department of Surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria from January 2008 to December 2012. Records of 29 patients who underwent emergency surgery for incarcerated external anterior abdominal wall hernia in a teaching hospital were analyzed for age, sex, type of hernia, characteristics of clinical presentation, duration of symptoms, past medical history, and significant concomitant diseases, ASA class, type of anesthesia, contents of the hernia sac, surgical procedures, complications, duration of hospital stay and mortality. Twenty-four (82.76%) patients were males and 5 (17.24%) were females. The age of patients ranged from 1 month to 75 years. There were 28 (96.5%) Inguinal hernias, 1 (3.5%) Para-umbilical hernias and none of Incisional and femoral hernias. Gut resection was done in 4 (13.8%) patients. The mortality rate was 3.5%. The mortality was related to septicemia from gangrenous bowel in a one month old child and late presentation. Mortality associated with emergency surgery of incarcerated external anterior abdominal hernias is related to late presentation with subsequent bowel gangrene, very young age, and associated medical illnesses.

Key words: Incarcerated hernia, treatment outcome, predictors, mortality, abdominal wall hernia.