Paediatric Renal Stone Management in Africa: A Scoping Review and Analysis of Current Practices.

Renal stones are solid deposits formed from minerals and salts that develop within the kidneys and urinary tract. While the condition is more common among adults, children and even infants can also be affected. There is an increasing incidence of paediatric renal stones in Africa alongside multiple challenges faced in managing the condition. This scoping review aimed to provide an overview of the management modalities of paediatric renal stones in Africa. This study utilised Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A systematic search was conducted in three electronic databases: PubMed, African Journal Online (AJOL), and Google Scholar, with 1,180 articles curated. After extensive examination, 10 articles satisfied the inclusion criteria. The review found that calcium oxalate stones were the most prevalent type, accounting for 34.03% of cases, followed by whewellite stones and ammonium urate stones. The most frequent location for stones was the kidney, and the most common symptom was pain. Abdominopelvic ultrasound was the most frequently utilised investigation. Of the 886 patients managed for renal stones, 75.4% were managed surgically, 2.9% medically, and 21.7% spontaneously resolved without intervention. This review identifies opportunities for improving the management of paediatric renal stones in Africa, including the need for standardised diagnostic and treatment protocols and the development of evidence-based guidelines tailored to the African context. Overall, this scoping review provides valuable insights into the patterns and management of paediatric renal stones in Africa and highlights the need for further research to improve the management of this condition in the region.

Hydropneumothorax and Pulmonary Embolism in a Patient With Shortness of Breath.

This is a case of hydropneumothorax in an elderly man presenting to the emergency department with worsening respiratory symptoms one month after treatment for a chest infection and pleural effusion. Computerized tomography pulmonary angiogram (CTPA) showed an encysted hydropneumothorax and chronic pulmonary emboli. He was anticoagulated, had a chest drain with a good outcome and was discharged for a multidisciplinary team follow-up. This report highlights hydropneumothorax occurring as a result of therapeutic or diagnostic pleural interventions. It also reiterates the importance of identifying the probable cause of a pleural effusion, with pulmonary embolism as a cause that should be ruled out.