Placental Site Trophoblastic Tumour Mimicking Placenta Previa.

ABSTRACT: We present a 42-year-old Nigerian woman who had three previous caesarean sections and is being managed conservatively for placenta previa. She underwent a caesarean hysterectomy on account of uncontrollable bleeding, and histopathology revealed a placental site trophoblastic tumour.

Changing clinicopathological profile of intussusception in Nigeria--a 20-year review.

BACKGROUND/AIMS: Intussuception was a common cause of intestinal obstruction at the University College Hospital, Ibadan. A peculiar type characterized by being ceco-colic, and found most commonly in adults, was the commonest variety found, but over the last few years this type of intussusception appears to have reduced in incidence. The aim of the study is to define the relative incidence of intussusception and the contribution of the various types of the overall incidence as seen at the University College Hospital, Ibadan, Nigeria. METHODOLOGY: Review of case notes and the surgical pathology records of all cases of Intussusception seen at the University College Hospital, Ibadan between 1975 and 1994 was done. RESULTS: There was a 48.1% decline in the absolute number of cases seen during the period of the study, and this decline was more among adult cases than infantile intussusception. The mean age of presentation of infantile intussusception was 8 months, while it was 42 years for adults. The classical triad of vomiting, pain and bloody stool was seen in only 15% of cases. Morbidity and mortality rates were high at 18 and 8.5% respectively and this was related to delayed presentation. CONCLUSIONS: The incidence of intussusception has fallen in the community studied and this decline has affected the adult age group and the ceco-colic type of intussusception more. Late presentation is a feature of most cases and is related to the high mortality and morbidity rates seen.

Carcinoma of the oesophagus in Ibadan.

This was a retrospective analysis of 177 histologically confirmed cases of oesophageal carcinoma seen in the University College Hospital, Ibadan, Nigeria over a period of 30 years. Oesophageal carcinoma constituted 0.6 per cent of all malignant neoplasms and 1.4 cases per 1000 surgical biopsies during the study period. Dysphagia and weight loss were the most common clinical manifestations. Ninety three patients presented within one year of onset of clinical symptoms. The peak age incidence occurred in the seventh decade of life. Sex distribution was equal. The middle third of the oesophagus was the most common location of the neoplasm and the vast majority (94.5%) were squamous cell carcinomas. Achalasia of the cardia and Barrett's oesophagus were not associated with oesophageal carcinoma in this study. Regional lymph nodes and lungs were the most common sites of metastasis. Surgical complications included mediastinitis and bronchopneumonia, both occurring within seven days postoperatively. Late clinical presentation and high postoperative mortality are responsible for the persistently poor prognosis of oesophageal carcinoma despite significant advances in the diagnosis and management of these neoplasms.

The clinicopathological pattern of carcinoma of bronchus and lung in Africa: a 20-year clinical, histopathological, and autopsy study in Ibadan, Nigeria.

The clinicopathological pattern of carcinoma of the bronchus at the University College Hospital, Ibadan over a 20-year period, 1971-1990, was studied. An increased incidence of this disease was observed when compared to the study that was carried out in the sixties in the same environment. The reasons for the increase in incidence and the pattern of clinical presentation are discussed. The findings suggest that increasing industrialization and increased acquisition of modern diagnostic facilities are responsible for the increased incidence. The factors responsible for the poor response to treatment in the series are also discussed.

Congenital malformations: a review of 672 autopsies in Ibadan, Nigeria.

The postmortem findings in 672 Nigerian children with lethal congenital malformations are reviewed. Eighty-six percent of the patients were less than 1 year of age and the male-to-female sex ratio was 1.3:1. The alimentary tract was the most common anatomic site involved (30%), intestinal and biliary atresia being the two lesions most frequently identified in this location. Twenty-six percent of the children had cardiovascular malformations, of which ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot were most important. There was an accentuated male predominance among cases with urogenital malformations due to the high frequency of posterior urethral valve. Hydrocephalus, spina bifida, and anencephaly were the most common lesions observed in the craniospinal axis. One-fifth of the children had complex malformations of multiple organ systems, 20% of which were associated with chromosomal anomalies, rubella, and other malformation syndromes.

Childhood infections in Nigeria: an autopsy study.

Infections are the leading cause of childhood morbidity and mortality in developing countries. Bronchopneumonia, meningitis and gastroenteritis are the commonest fatal infections encountered in Ibadan. Tuberculous lymphadenitis, bronchopneumonia and meningitis are other frequent causes of death. The predominant sequela of measles is respiratory tract infection. Another important cause of childhood mortality is cerebral malaria. In half of the cases of tetanus no obvious portal of entry can be found. It is advocated that the implementation of immunization schedules should be vigorously pursued to curtail childhood mortality resulting from infection.

Tumours of the eye and orbit in Ibadan.

Four hundred and forty ocular and orbital tumours seen in Ibadan over 11-year-period (1980-1990) are reviewed. Three quarters of the 252 patients who had enucleation had malignant neoplasms, of which 55% were retinoblastomas. The mean age of patients with retinoblastomas (3.2 years) was less than that of patients with carcinoma and malignant melanomas (47 years). Malignant melanomas were rare neoplasms in Ibadan. The commonest orbital lymphoma was Burkitt's lymphoma. Only 24% of the enucleated eyes had inflammatory conditions, of which 38% gave a positive history of trauma. Inflammatory lesions were the commonest benign ocular diseases accounting for 33% of these latter cases. Postmeasles keratitis was a significant associated finding in these patients.