Gallbladder Perforation in a 7 Year Old - A Diagnostic Challenge in a Rare Cause of Acute Abdomen.

Spontaneous perforation of the gall bladder is uncommon. It often presents with symptoms suggestive of peritonitis thereby posing a diagnostic challenge. We report the case of a 7 – year old boy who was admitted with surgical acute abdomen. Preoperative abdominal ultrasonography did not help in diagnosis as it was thought to be a case of typhoid intestinal perforation. The patient under- went an exploratory laparotomy which revealed a perforated gangrenous gall bladder. A cholecystectomy was done and patient recovered without incidence and was discharged home after a few days.

Laboratory request forms-How well do Doctors fill them? A look at the practice at the Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria

BACKGROUND.Laboratory investigations are often required to manage patients in the hospital. Laboratory request forms serve as a medium between the pathologists and the clinician. Improperly filled laboratory forms may result in misdiagnosis and inadvertent mix-up of patient's results. We therefore undertook to document the extent to which Doctors properly fill laboratory request forms at the Niger Delta University Teaching Hospital; Okolobiri.METHODS.One thousand two hundred laboratory request forms which had already been filled out by various Doctors in the hospital between January and June; 2013 were randomly selected and analysed. The forms were evaluated to assess the completeness of information entered by the requesting Clinician.RESULTSThe patients' names and investigations requested were entered on all forms. 3.0% of forms did not state the gender of the patient; while 11.5% did not even give the age of the patient. 9.6% did not specify the patient's location and 34.0% did not have the patient's hospital number. 25.5% of forms also did not have the name of the attending Consultant and 15.5% did not have the name of the requesting Doctor; while 27.1% of all forms were not signed by the requesting Doctor.A working diagnosis was not stated on 16.5% of forms. Also; the date of collection and nature of the specimen were not stated on 21.5% and 11.0% of forms respectively.CONCLUSION.Laboratory request forms are not always properly filled by Clinicians. Only the patients' names and the requested investigations were filled on all forms. There is the need to remind Clinicians of the importance of carefully filling laboratory request forms

Pattern of Adult Surgical Admissions at the Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State-a 2 Year Review

BACKGROUND: It is important to know the pattern of disease in any environment as this information is useful in planning intervention strategies. There is however a paucity of studies on the pattern of surgical diseases in Nigeria. We therefore aim to document the pattern of surgical diseases in adult surgical in- patients at the Niger delta University Teaching Hospital, Okolobiri, Bayelsa State. METHODS: All adult surgical patients admitted into the wards at the Niger delta University teaching hospital between January, 2010 and December, 2012 were retrospectively studied. RESULTS: A total of597 adult surgical in- patients were studied. There were 438 (73.5%) males and 158 (26.5%) females. The mean age of patients was 42.9± 18.2 years. The commonest diagnostic category was trauma 31.7%. This was followed by gastrointestinal conditions 20.6%, external hernias 16.1%, malignancies 8.2%, genitourinary conditions 7.7%, leg ulcers 6.5%, soft tissue infections 3.0% and others 6.2%. We observed a mortality rate of 7.5% which was highest among patients with malignancies at 24.5%. CONCLUSION: Trauma was the commonest cause of surgical admission while the percentage of deaths was highest in patients with malignancies