SAR J Sur | Pages : 48-54
DOI : 10.36346/sarjs.2022.v03i05.001
Background: Polyps are masses projecting into the bowel lumen beyond the surface of the epithelium with or without a pedicle/stalk and it can be taken to mean a protuberant growth which can be either benign or malignant. The objective of the study was to study the pattern of colorectal polyps among Sudanese patients at Soba university hospital. Patients and methods: The study was a prospective, descriptive, cross sectional hospital based study. Conducted at Soba University Hospital department of endoscopy, in a period from Oct 2017 to August 2018.The study was conducted on Patients with colorectal polyps finding in colonoscopy or flexible Sigmoidoscopy. All the patients have been followed for duration not less than 3 months to assess the outcome. The main objective was to study the pattern of colorectal polyps among Sudanese population. Results: A total of (120) patients with colorectal polyps out of (626) patients underwent lower GI endoscopy during the period of the study, with male to female ratio of 1.8:1.0.The age ranged between (4) to (94) years. The incidence of polyp at the study was (19%). Thirty nine patient (32.5%) are smoker, while (6.7%) of the patients were alcohol consumers. NSAIDs consumptions were found in (40%) of the patients. Considering the consumption of fiber diet the study showed most of the patients were using the moderate fiber diet (53%). Schistosomasis found in 4 patients (3.3%) and these patients had polyps showing inflammatory polyps of schistosomasis origin. Presenting complains includes bleeding per rectum, altered bowel habit, mucus per rectum, abdominal pain, weight loss, abdominal distension, anorexia and anaemic symptoms. The most common co-morbidities were DM in (17.5%), IBD in (11.7%), FAP (6.7.4%) and diverticular diseases in (1.7%). The mode of the diagnosis was either through sigmoidoscopy or colonoscopy, and the NBI was used in (7.5%). The most common type was sessile polyps (67.5%) followed by pedunclated polyps (29.2%). Most of the polyps are within the left side, mainly at the rectum, anal canal and sigmoid colon. The size of the polyps lies between (1 mm to 50mm).The most common modes intervention was snare polypectomy (66.7%), followed by excision via biopsy forceps (62.7), while other treatment options are less frequent. Histopathology showed that most of the polyps were benign polyps (74.2%). (10.8%) were of high degree dysplasia and the rest was less frequent. Thirty three patients showed inflammatory polyps (27.5%) followed by tubulovilous adenomatous polyps (20.8% ), tubuloadenomatus polyp (11.7), juvenile polyp (10.8),hyperplastic polyps (9.2%), villous adenomatus polyp (5%), tubularadenomatus polyp (4.2%), schistosomal polyp (3.3%), hamratomatous polyp (2.5%) , fibroepithelial polyp (2.5%), invasive adenocarcinoma (1.7%) and granulomatus polyp (8%). Conclusion: The pattern of Colorectal polyps among Sudanese patients at our study was in line with international pattern in age, gender, common presentation, risk factors, types, shape and histopathology and most of them were of benign nature..
Mamaye Kouyate, Traore L, Diakité A.S, Sangaré S, Magassa M, Kane M, Haidara M
SAR J Sur | Pages : 46-47
DOI : 10.36346/sarjs.2022.v03i04.003
Anal imperforation or anorectal malformations (ARM) are malformations concerning the rectum. ARMs are a spectrum of various birth defects that vary from fairly minor lesions to complex anomalies. There are three types: the high form, the intermediate form and the low form. They are more and more frequent in our undeveloping countries where resources are limited. Their management is expensive and complex, especially the high form. We report a case of anal imperforation with rectovaginal communication which was referred to us from another region of Mali more than 1000 KM, for care.
SAR J Sur | Pages : 42-45
DOI : 10.36346/sarjs.2022.v03i04.002
Introduction: Peritonitis is an acute inflammation of the peritoneum; it is a surgical emergency in children, as in adults. It is still common in underdeveloped countries because of the delay in diagnosis. There are primary and secondary peritonitis. The main symptom is violent and sudden abdominal pain in children. The objectives were to determine the hospital frequency of peritonitis, to describe the clinical and therapeutic aspects, to evaluate the mortality of peritonitis. This was a retrospective study that took place in the pediatric surgery department from January 2019 to December 2021; using patient records. All patients operated for peritonitis from 0 to 15 years old were included in this study. Results: During this study, we performed 650 surgeries, including 23 cases of peritonitis, or 3.53% of the surgeries. The ages were between 4 and 15 years old, the male sex was predominant, i.e. 65.21%: 15 cases. The average consultation time was 7 days. The clinical signs were dominated by abdominal pain in 100% of cases, asthenia and deterioration in general condition. All the patients had benefited from a biological assessment, the widal was positive in 12 cases. Abdominal X-ray without preparation and abdominopelvic ultrasound were performed in all patients. Abdominal X-ray without preparation objectified 6 cases of pneumoperitoneum, water levels in 10 patients. Ultrasound showed 16 cases of appendicular peritonitis, i.e. 69.56%. All patients underwent laparotomy and we found 16 cases of appendicular peritonitis 69.56%, 5 ileal perforations i.e. 21.73%, 1 perforation of the gallbladder i.e. 4.34% and tuberculous peritonitis confirmed by pathology 4.34%. The postoperative course was simple in 65.21%, parietal suppuration was observed in 21.73% of patients. We had recorded 3 cases of death or 13.04%.
Prajwal K, Amarnath P Upasi, Sunil Byadgi, Kirthi Kumar Rai
SAR J Sur | Pages : 31-41
DOI : 10.36346/sarjs.2022.v03i04.001
Surgery is considered to be the primary mode of treatment of head and neck malignancies and the ultimate aim of surgical resection is to obtain a tumor-free margin. No uniform criteria to define a clear surgical margin exist among practicing surgeons. This study intends to find the adequacy of surgical margin marking intraoperatively by Lugol’s iodine solution considering the frozen section method for oral squamous cell carcinoma (OSCC). Intraoperative staining with Lugol’s iodine and Frozen section analysis of margins of the surgical bed was negative in anterior, superior, and inferior specimens in all the cases, except in one case (4.3%), a posterior margin was found to be positive (unstained) for tumor. The chi-square value of the Lugol’s stained margins following resection of the tumor and negative results of frozen section analysis of the same was found to be statistically significant with the P value <0.001. Hence, we conclude that Lugol’s iodine helps in obtaining a clear surgical margin intra-operatively where inter-surgeons bias/judgment errors regarding safe margin can be avoided, especially in cases where the frozen section is not feasible.
Chukwubuike Kevin Emeka, Eze Thaddeus Chikaodili, Anijunsi Livinus Patrick
SAR J Sur | Pages : 27-30
DOI : 10.36346/sarjs.2022.v03i03.003
Background: The surgical removal of the kidney, nephrectomy, is not a minor surgical procedure. It is a major endeavor. Indications for nephrectomy range from benign to malignant pathological conditions. Materials and Methods: This was a retrospective study of children aged 15 years and below who had nephrectomy between January 2016 and December 2020 at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. The information extracted included the age of the patient at presentation, gender, and predominant presenting symptom and the pathology (indication), duration of symptoms before presentation to the hospital, time interval between presentation and nephrectomy, operative procedure performed complications of treatment, duration of hospital stay and outcome of treatment. Results: Eighteen (18) pediatric nephrectomies were performed during the study period. There were 14 (77.8%) males and 4 (22.2%) females. The mean age of the patients was 6 years with a range of 3 years to 9 years. Nephroblastoma was the most common indication (pathology) for nephrectomy. Nephrectomies were performed more on the left side than on the right. Simple nephrectomy was performed in all the patients. However, children with nephroblastoma had nephroureterectomy. Surgical site infection was the most common post-operative complication. About one-quarter of the patients expired due to tumor metastasis. Conclusion: Nephrectomy is the optimal procedure for neoplasm of the kidney or non-functional kidney. Malignant kidney tumour (nephroblastoma) was the most common indication for nephrectomy in the present study.
Dr. Dani Bouchra, Dr. El Messaoudi Lina, Dr. Hamidi Olaya, Pr. Boulaadas Malik, Pr. Leila Essakalli Hossyni
SAR J Sur | Pages : 19-20
DOI : 10.36346/sarjs.2022.v03i03.001
We report a case of a 20-year-old female. The patient presented since the age of 10 years, left anterior purulent rhinorrhea, fetid and recurrent when antibiotic treatment was stopped. This rhinorrhea was associated with chronic ipsilateral nasal obstruction and cacosmia.
Dr. Dani Bouchra, Dr. Oussalem Amine, Dr. Olaya Hamidi, Pr. Boulaadas Malik
SAR J Sur | Pages : 21-26
DOI : 10.36346/sarjs.2022.v03i03.002
Paranasal sinus osteoma is a rare benign tumor that evolves slowly and can be responsible for ophthalmologic, sinus and endocranial complications. Its treatment, when it is necessary, is only surgical. We report two cases of fronto-ethmoidal osteoma with orbital extension operated in our department, using a para-latero-nasal approach with supra-superciliary extension. Through these cases and in the light of the literature, we will discuss the interest of this approach in the management of ethmoidal fronto-orbital osteomas. Also, we will underline the advantages and inconveniences of other approaches.
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