Tumours of the Vulva in Port Harcourt; Nigeria. A 13-Year Clinico Pathological Study

The aim is to ascertain the pattern and frequency of vulval tumours as seen at the University of Port Harcourt Teaching Hospital. Forty (40) vulval tumours were used for the study. Twenty nine (72.5) were benign and eleven (27.5) were malignant. Patients of age 50 years and above were most affected 24(60). The most common clinical presentation was elevated and ulcerated plaques9 (22.5). Condyloma accummatum was the most common benign tumour while squamous cell carcinoma was the most common malignant tumour. It is concluded that vulval tumours are rare in this environment and that the malignant variants present at advanced stage of the disease in later ages. They constitute a remarkable morbidity and mortality especially in the obese and chronically ill menopausal women

Life Threatening Vaginal Haemorrhage from Coital Laceration in a Post-Menopausal Woman

Background: Life threatening coital laceration from consensual intercourse in the postmenopausal period is unusual without any predisposing factors(s). The usual site of occurrence is the right side of the posterior fornix. Aim: To report a case of haemorrhagic shock from coital laceration. Design: Case report : A 55-year-old woman who presented as an emergency with haemorrhagic shock following vaginal bleeding from consensual coitus is presented. She was resuscitated with intravenous fluids and blood transfusions. The vaginal laceration of about 5 cm on the right side of the posterior fornix was sutured following examination under anaesthesia. Conclusion: Coital laceration should be considered a differential diagnosis in any postmenopausal vaginal bleeding while prompt recognition and treatment are important to avoid morbidity and even mortality

Uterine Sarcomas in Port Harcourt; Nigeria a 12-Year Clinico-Pathologic Study

Background : Uterine sarcomas are rare gyneacologic malignancies with a high mortality.There is the need to determine its frequency; clinical presentation and histologic variants.This may form the basis for further research and management inorder to reduce the morbidity and mortality associated with it. Design : A 12-year hospital based retros- pective clinico-pathological study. Setting : University of Port HarcourtTeaching Hospital (UPTH); Port Harcourt; Nigeria. Subject: Women with histologically diagnosed uterine sarcomas. Method : Previously prepared histologic slides were retrieved and reviewed to confirm the diagnosis and to ascertain the histological type of the uterine sarcoma. Clinical data such as the age and the mode of presentation were extracted from the case notes; histology request forms and reports. Results:Eleven histological reports satisfied the criteria for the study which accounted for 0.5and 4of total malignancies and gynaecologic malignancies respectively in UPTH during the period under review. Malignant mixed mesodermal tumors was the most common (36.4).The highest frequency of the tumors occurred in the age group 50-59 years (45.5) and abnormal vaginal bleeding was the most common clinical presentation (36.4). Conclusion : Uterine Sarcomas are rare world wide; most common above the age of 50 years; with variable clinical presentations and associated with high morbidity and mortality rate

Ruptured Heterotopic Pregnancy and Subsequent Vaginal Delivery at Term

Background: Heterotopic pregnancy is the co- existence of intrauterine and extrauterine gestation at the same time. The condition is life threatening when the ectopic pregnancy ruptures and it is unrecognized.Objective: To report the first successfully managed case of heterotopic pregnancy in a woman without obvious risk factors in our centre.Result: A multiparous 30 - year old lady who had heterotopic pregnancy with natural conception and salpingectomy for the ruptured ectopic component delivered a live baby at term . Management of the ectopic pregnancy with viable intrauterine pregnancy delivered at termConclusion: Heterotopic pregnancy though rare; is possible in our women without known risk factors. Medical practitioners should have a high index of suspicion when a parous woman presents with lower abdominal pain in the first trimester of pregnancy

Human Bite and Human Immune Defiency Cirus (HIV) Transmission

Background: The concentration of human immune deficiency virus (HIV) in the saliva of a carrier is low. As a result; human bite is not considered the traditional route of HIV infection transmission.Aim: To report a case of HIV sero-positivity following a human bite. Setting: University of Port Harcourt Teaching Hospital; Port Harcourt.Case report: A 30-year-old HIV sero-negative woman who became sero-positive following a bite by a known HIV infected commercial sex worker is presented. Both were engaged in a physical fight over a disagreement.Conclusion: This case highlights the possibility of HIV infection through human bite