Primary sclerosing cholangitis in a cohort of south african patients with inflammatory bowel disease at charlotte maxeke johannesburg academic hospital

Background: Primary Sclerosing Cholangitis (PSC) is a chronic, progressive cholestatic liver disease of unknown aetiology. Its incidence and prevalence vary considerably in Asian and Western studies.1 The differences in the recorded epidemiological data suggest that the presentation of PSC may vary in different populations. PSC has a strong association with Inflammatory Bowel Disease (IBD). The phenotype in patients with PSC alone can be different to that of patients with both PSC and IBD (PSC-IBD). There is a dearth of information on this topic from African countries in general and more specifically in the Black South African population

Outcomes of surgical treatment of malrotation in children

Background: Urethral mucosal prolapse is rare. This condition may be confused with tumour or sexual abuse in girls. This study aims at reporting the pathology presentation and therapeutic options of urethral prolapse in girls. Materials and Methods: A retrospective study was undertaken from January 2000 to December 2008. Authors analysed the clinical features and the treatment options. Results: There were nine cases of urethral prolapse. The ages ranged from 2.5 to 10 years (mean age: 5.08 years). The main presentation was vaginal bleeding (five cases). Physical examination revealed a soft; non-tender mass that bleeds on touch (six cases); with a length ranging from 0.75 to 1 cm. Urine culture in four patients revealed urinary infection that yielded Escherichia coli in three cases and the Staphylococcus aureus in one case. Six patients had surgical treatment while three had medical treatment. In those who had surgery; one had acute urine retention and one had recurrence that was treated successfully without operation. All the nine girls are cured. Conclusion: Urethral prolapse is a disease of the prepubertal girls of low socio-economic group. Diagnosis is clinical. The treatment of choice is surgical

Non-traumatic Perforation of the Small Bowel

Background: Non-traumatic perforation of the small bowel is an uncommon serious complication associated with high morbidity and mortality. Diseases that cause small bowel perforation vary in different areas of the world. Objective: To highlight difficulties in the diagnosis and management of non-traumatic perforation of small bowel. Material and methods: The medical records of four patients who have presented with non-traumatic perforation of the small bowel and were treated at Al-Ain Hospital during the last 5 years were studied retrospectively. Results: The presenting symptoms of all patients were similar. Erect chest X-ray has shown free air under diaphragm in 3 patients. Leukocytosis was present in only one patient. HIV was confirmed in one patient. Patients were diagnosed to have typhoid; HIV; hook worms and tuberculosis. Only the HIV patient died while the others were discharged home in a good condition. Conclusion: Clinical findings of small bowel perforation are usually non specific and diagnosis is usually reached after surgery. The Histopathological examination of the small bowel ulcer were non conclusive in three patients. We have made our management plan according to the clinical findings. Non traumatic perforation in developing countries can be due to typhoid; HIV; tuberculosis and possibly hook worms

Spontaneous Rupture of an Umbilical Hernia with Evisceration of Small Intestines in a 16-year-old girl

Background : Umbilical hernia is relatively common in African children. Most of these hernias close spontaneously as the children grow older and they are often remarkably free from complications. Aim: To report a case of spontaneous rupture of an umbilical hernia with evisceration of small bowel. Setting : Seaside Specialist Surgery; Port Harcourt. Case report : A 16-year-old girl; who had had an untreated umbilical hernia from birth; developed a severe pain at the site of the swelling. The swelling had quickly enlarged as a result of an obstructed loop of bowel within it. Traditional medicaments applied to it did not relieve the pain. Severe retching and vomiting ensued resulting in a spontaneous rupture of the umbilical skin. Subsequently; there was evisceration of loops of bowel through the defect. At operation; the eviscerated bowel loops were found to be viable and were returned into the peritoneal cavity. The abdomen was closed in layers with repair of the umbilical defect. Post operatively; her condition was satisfactory. Conclusion : Complications associated with umbilical hernia are not common but justify prevention by early repair of umbilical hernias with large defects

Toxicological Effects of Paraquat on the Histology of the Stomach; Small Intestine and Testis of Male Albino Rat (Rattus Norvegicus)

Background: Paraquat is a herbicide; commonly used by farmers in agriculture to prevent weed infestation. The non-target organic toxicity effect of this chemical motivated this study.Methods: Utilizing male albino rats of 0.2 kg average body weight; the LD100(lethal dose that gave 100death) for Paraquat was obtained as 1g/kg body weight Furthermore LD50 (median lethal dose of paraquat; ip) was obtained as 0.45 g/kg body weight using arithmetic method of karber. Six dose levels of paraquat 0; 0.09; 0.18; 0.35; 0.70; 1.00 g/kg body weight were administered intraperitoneally into the various groups of the male rats. Within 24hrs; histopathological examination in the stomach; in the small intestine and testis of the rats were performed.Results: Histopathological examination of the organs studied revealed that the stomach had mild mucosal ulceration; muscular coat atrophy; stromal oedema and tubular hyalinization which were dose- dependent. The small intestine showed mucosal ulceration; loss of villi; luminal and stromal oedema and glandular necrosis which were also dose dependent. Furthermore; the testis had classical central fibrosis; cellular polarization; tubular disorganization; necrosis and lack of mitotic figures (no cell division); oligospermia; azoospermia and hyperchromasia which were dose dependent.Conclusion: Paraquat; a notable herbicide used in agricultural weed control; had deleterious effects on such organs as stomach; small intestine and testes. Need therefore arises for caution in the handling of these chemicals as the danger of impairment of the gastrointestinal tract and indeed the reproductive system in males is a possibility

Small Intestinal Carcinoid Tumour : a Case Report and Review of Relevant Literature

Background : Carcinoid tumours have long been known to be a morphologically distinct class of rare intestinal tumours. The prevalence vary with geographical area; most are clinically silent and are found incidentally at surgery. They may occasionally cause intestinal or vascular obstruction necessitating emergency surgery following which the dia- gnosis is made. We report this first case of intestinal carcinoid seen in this centre in over twenty years. Methods: The case report discussed here is an intestinal carcinoid in- volving the distal ileum. Results:Clinical presentation was recurrent abdominal pain with a tender mass in the periumbilical region extending to the right iliac fossa with noisybowel sounds. Plain abdominal x-ray; barium meal and abdominal Ultrasonography were not diagnostic. A laparatomy on account of intestinal obstruction was performed which revealed a tan yellow tumour extending into the mesentery. Histology revealed carcinoid tumour.Conclusion : Carcinoid tumours should be considered in patients presenting with recurrent abdominal pain or mass or intestinal obstruction. Localization of the tumour is impor- tant since the diagnosis of all carcinoids without systemic features from hormone production depends on the histological structure and staining properties

Un cancer peu frequent : celui de l'intestin grele. A propos de 25 cas diagnostiques a l'Institut Pasteur de Madagascar de 1992 a 2001

"Cancers of the small intestine diagnosed at the Institut Pasteur de Madagascar"":A retrospective survey of cases of cancer of the small intestine observed in the Institut Pasteur de Madagascar (IPM); in the Centre Hospitalier de Soavinandriana (CenHoSoa) and in the Centre Hospitalier Universitaire d'Antananarivo/Hopital Joseph avoahangy Andrianavalona (CHUA/HJRA); has been undertaken with the goal to find out epidemiological and diagnostical particularities; as well as the therapeutic measures and their results. Only 25 cases have been found in 10 years (from 1992 to 2001). They represent 5;4"