ABSTRACT
Non-obstetric vulvar hematomas are rare and have never been reported in West Cameroon. No guidelines are available to inform the management of cases. Authors herein report the successful management of a post-traumatic vulvar hematoma in a 17 years old gravida 1 para 1001 patient. She was referred to our emergency department ten hours after a fall in a squatting position during a road traffic accident. Prior to the referral she had been managed conservatively by analgesics and a compressive dressing of the vulva in a community clinic. Clinical assessment on admission revealed a good general condition, normal vital signs and a tense and painful hematoma of the right labia. Surgery was done under general anesthesia to drain the hematoma, ligate the bleeding vessels and repair the vulva. Post-operative course was uneventful and the patient was discharge six days later. This case reminds practitioners in remote health facilities that early referral of this rare pathology contributes to its successful surgical management in our semi-urban region.
ABSTRACT
Aims. To study the intra- and interobserver reproducibility of Sydney System amongst pathologists in Cameroon as Sydney System gradation has not gained enough confidence in African pathologists. Methods. We performed a descriptive study including 100 patients who benefited from gastric biopsy by endoscopy. These biopsy specimens were stained with hematein and eosin and modified Giemsa; and read independently using the same microscope by two pathologists with four years experience and no experience with the updated Sydney System. Gastritis was graded according to the updated Sydney System. Levels of intra- and interobserver reproducibility were assessed using the unweighted kappa coefficient. Results. The intraobserver reproducibility of gradation of Helicobacter pylori density; activity; chronic inflammation; atrophy; and intestinal metaplasia showed respective values of kappa: 0.63; 0.34; 0.61; 0.48; and 0.82 for one observer against 0.42; 0.005; 0.41; 0.31; and 0.72 for the other. Interobserver reproducibility kappa values were; respectively; 0.41; 0.18; 0.57; 0.58; and 0.82. Conclusion. Results are encouraging but experience in the updated Sydney System should be improved. The later should be introduced as a means to grade and classify gastritis in Cameroon and African countries
Subject(s)
Biopsy , Gastritis , Helicobacter pylori , Observer VariationABSTRACT
Molar pregnancy is a rare entity and ectopic location of pregnancy in the uterine horn represents the least frequent site of implantation. This paper presents a rare case of molar cornual ectopic pregnancy at advanced gestational age with a particular difficulty in diagnosis and management. A 35-year-old woman; gravida 4 para 3 with a history of 12 weeks amenorrhea; was operated for presumed ruptured ectopic pregnancy. Per-operative findings showed swollen villi in clusters that looked like bunches of grapes; characteristic of a complete hydatiform mole; located at the left horn of the uterus. Histopathologic examination confirmed the diagnosis. Bleeding could not be controlled with suturing and hysterectomy was eventually done. Although rare; molar pregnancy can be ectopic. If it is located at the uterine horn; bleeding may be difficult to control if at a gestational age of 12 weeks or more