Delayed Presentation of Posttraumatic Diaphragmatic Hernia Masquerading as Recurrent Acute Asthmatic Attack.

Diaphragmatic hernia following blunt abdominal injury is extremely rare and often diagnosed late. Missed diagnosis is also common with this condition. We herein present a delayed presentation of diaphragmatic hernia following blunt abdominal injury that was initially misdiagnosed as recurrent acute asthmatic attack due to repeated presentation with episodic difficulty in breathing.

Breast-axillary complex in HIV/AIDS patients.

BACKGROUND: HIV/AIDS have not only increased the health care burden especially in developing countries, it equally complicates the presentation of many diseases. Some well known disease entities now occur in fulminant complexities not previously described or known as such. The objective of this article is to report an unusual presentation of HIV/AIDS patients to the surgeon with Axillary and ipsilateral breast swelling. METHOD: This is a report of three cases seen and managed by the authors. RESULTS: Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known retroviral positive on Highly Active Anti-Retroviral Therapy (HAART). Examination revealed axillary abscess and ipsilateral breast oedema in two cases. The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no malignant cells. The other two had incision and drainage of their axillary abscess. CONCLUSION: This shows the ubiquitous presentation of HIV/AIDS in our environment and surgeons should be aware of the breast axillary complex in HIV/AIDS. Medical practitioners should be careful to obtain accurate diagnosis before embarking on treatment especially mutilating surgical procedures.

High-tension Electrical Burns: Report of Two Cases.

High-tension electrical burns are a rare but devastating form of injury. The objective of this case report is to bring to the fore the severity of this rare form of injury and highlight the benefits of active surgical management of such a condition. We report the cases of two patients who were managed for high-tension electrical burns and highlight the main features of their presentation and management. Both patients needed urgent resuscitation and subsequent multiple amputations and disarticulations to save their lives. In high-tension electrical burns early resuscitation and wound exploration coupled with decisive action on the need for amputation would reduce the morbidity and mortality often associated with the ensuing overwhelming sepsis.

Epidemiology of childhood burns in Maiduguri north-eastern Nigeria.

BACKGROUND: Burns is a global problem and has its toll especially in a developing region like ours where poverty and ignorance are still rife. Previous studies in the sub-region have lumped children and adults together. We retrospectively studied the factors that lead to burns in children and the peculiarities in managing them. METHODS: All case notes of burns injury in children managed at the University of Maiduguri Teaching Hospital between 1991-2000 were retrospectively studied. RESULTS: A total of 219 children were studied. Children of age below 5 years were affected more than children above 5 years (168 vs. 51) with toddlers 1-2 years constituting a significant proportion of those below 5 years (71 vs. 168). The male to female ratio was 1.6:1 with a preponderance of male children below 10 years and the females between 11-15 years of age. The commonest cause of burns was scald (64.4%) in the household, which is usually accidental, but 3 were suicide attempts by teenage pregnant females 11-15 years protesting forced marriages, a cultural problem in our environment. Flame burns ranked second (27.4%) and results mainly from careless storage, adulteration and hawking of petroleum products. More than 50% of the patients sustained major burns resulting in high morbidity and mortality rate of 16%. CONCLUSION: Burn is a major public health problem and will require public/school health education campaign on childhood household safety. Appropriate legislation and enforcement on the sale of petroleum products would help to reduce the scourge.