Colorectal cancer during pregnancy in a Sudanese female

We report a new case of uncommon but not rare condition of colorectal cancer during pregnancy in 33 years old Sudanese female at her 16th weeks of gestation presented with bloody diarrhea and intermittent left side abdominal pain. Initially she was diagnosed as a case of dysentery which was treated by antibiotics. Condition was diagnosed by colonoscopy and histopathology as colonic cancer, located in the sigmoid colon 50 cm from anal verge. A review of literature found that 276 cases of colon cancer associated with pregnancy have been reported. Pregnancy affects the clinical presentation, evaluation, therapy, and prognosis of colon cancer. Patients usually present with misdiagnosed symptoms. Diagnostic delays often lead to the tragic demise of a young woman from a potentially curable disease and of an otherwise viable fetus. This delay in diagnosis is a major contributing factor to the poor prognosis associated with this disease. Synchronous colon cancer during pregnancy presents a diagnostic and therapeutic challenge for clinicians because there are no generally accepted guideline regarding diagnosis or treatment. This article reviews this uncommon condition with a focus on the features of colon cancer in pregnancy to facilitate earlier diagnosis, to modify investigations, to optimize the therapy, and to improve the maternal and fetal outcomes

Splenic lymphoma and schistosomiasis

This is a report of a 42-year old Egyptian with splenic lymphoma associated with in-testinal schistosomiasis. This association is rare and should be looked for in the evaluation of patients

Post operative sepsis due to antibiotic failure in gangrenous or perforated appendicitis

Seventy-two adult patients with peritonitis, caused by gangrenous or perforated appendicitis, received 80 mg of gentamicin and 500 mg of metronidazole, 8 hourly for 5 days. Postoperative wound infection occurred in 16 [22%] of these patients. Changing the antibiotic therapy, after the culture result became available did not influence the clinical outcome. Deep seated infections occurred in 3 patients, 2 of whom had pelvic and one retrocaecal abscess. Escherichia coli was the commonest organism isolated in 9 patients in 6 of whom it was resistant to gentamicin. No signs or symptoms of nephrotoxicity or ototoxicity developed during use of gentamicin. Although the combination of gentamicin and metronidazole is safe in the prevention and treatment of wound infection, the failure rate in appendicectomy for perforated or gangrenous appendicitis is unacceptably high. This data shows that a reconsideration of the antibiotic policy in patients with perforated and gangrenous appendicitis is indicated

Upper gastrointestinal fibreoptic endoscopy in Khartoum teaching hospital [Sudan]: a retrospective study of 5000 cases

The results of 5000 upper gastrointestinal endoscopic examinations carried out in Khartoum Teaching Hospital in the period 1980-1986 are presented. 44% of those endoscoped were normal. Duodenal ulcer was the commonest abnormality detected and occurred in 23% of cases. Although the finding of a gastric ulcer was rare [0.9%], 50% of those detected were malignant. Oesophageal varices were diagnosed in 10% of patients. Endoscopy is a safe and easy procedure and can be used in the study of the pattern of upper gastrointestinal disease in a large country like Sudan