Foreign bodies in the aerodigestive tract: time for comprehensive preventive measures.

Background: Foreign body (FB) in the aerodigestive tract presents more commonly in children and remains a surgical emergency with potential for fatal complications. Objectives: To describe management and outcomes of aerodigestive FB managed at University of Ilorin Teaching Hospital (UITH) and proffer preventive measures. Methods: A 9-year retrospective review of all patients with foreign body in the aerodigestive tract managed between March 2011 and July 2020. Results: Sixty-six patients were studied. Median age was 9years with M:F ratio =1.6:1. FB was ingested in 38(57.6%) patients, aspiration occurred in 28(42.4%). Denture was most common FB 20(30.3%); plastic whistle/valve placed in dolls or football accounted for 4(6.1%). When ingested, FB was impacted in cervical 17(44.7%), upper thoracic 10(26.3%) and middle thoracic 2(5.3%) oesophagus. Oesophagoscopy was used in 30(8.9%) for retrieval. When aspirated, FB was located in the right bronchus 10(35.7%), left bronchus 7(25.0%), hypopharynx and trachea 2(7.1%) each, and cricopharynx 1(3.5%); no FB was found in 3(10.7%) patients. Direct Laryngoscopy was the method of retrieval in 3(10.1%) patients while others had rigid bronchoscopy. Mortality rate was 1.5%. Conclusion: Children are most vulnerable group. Preventive effort should include public health education and close monitoring of children by parents and care givers during play.

Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria.

BACKGROUND: Pleural effusion (PE) is a primary manifestation or secondary complication of many disorders. This study reviews the pattern and management of PE in a Nigerian hospital. MATERIALS AND METHODS: The medical records of 213 patients with clinical diagnosis of PE over a period of 3 years were reviewed. RESULTS: PE accounted for 0.5% of the total hospital admissions. The most common cause of PE was tuberculosis (TB) (32.9%), followed by malignancy (29.1%) and pneumonia (15.0%). The male to female ratio was 1.3:1. TB was the leading cause of effusion in males, while it was malignancy in females. Pneumonia accounted for 61.9% of PE in preschool age and 66.7% in school age. Breathlessness (50.0%), cough (39.4%), and chest pain (24.9%) were the common presentations. Most (90.1%) of them were exudative effusion and with half in the right lung. Chest radiography (91.6%), pleural fluid for Ziehl-Neelsen stain (74.7%), cytology (59.2%), and tissue biopsy (57.8%) were the common diagnostic investigations. The majority (92.0%) had closed thoracostomy tube drainage, while 9.9% had chemical pleurodesis. The intra-hospital mortality was 10 (4.7%). CONCLUSION: TB, malignancy, and pneumonia are the leading causes of PE. A multidisciplinary approach is needed for optimal management.

Host, vehicular and environmental factors responsible for road traffic crashes in a Nigerian city: identifiable issues for road traffic injury control.

INTRODUCTION: Road traffic injury (RTI) has assumed major public health importance world-wide and the burden is heavier on the health-care infrastructure of countries in Sub-Saharan Africa. In Nigeria, RTI is the leading cause of trauma related morbidity and mortality. While there are some published epidemiological reports on RTI in the region, studies on the mechanism of causation of road traffic crashes (RTC) are not available. METHODS: Over a 9-month period, we prospectively captured the 571 victims of RTC presenting to a single tertiary health care center in Nigeria. Data collected include demographic data, Mechanism of causation of RTC, Injuries sustained and outcomes. RESULTS: Over three-quarters of the victims are young people and half were either traders (27.5%) or students (20%). Pedestrians, motorcycle riders and open truck occupants (people sitting at the rear loading compartment of trucks) often had fatal injuries. Analysis of collision patterns showed that lone crashes were the most frequent though car-to-motorcycle crashes caused a quarter of the deaths. Host factors (over-speeding driver, driver misjudgment, sleeping driver etc.) were responsible for four-fifths of the crashes while vehicular and environmental factors accounted for the remaining. On binary regression analysis, head injured victims had higher odds of dying than the non-head injured (Odds ratio = 6.5). CONCLUSION: This paper elucidates the mechanisms of causation of and types of injuries sustained following RTC in Nigeria and thus provide opportunities for prevention and control of this unacceptable situation.

Bilateral femoral artery aneurysm mimicking soft tissue sarcoma.

Despite the rarity of femoral aneurysm and the plethora of other causes of swelling in and around its anatomic location, the possibility of its existence must always be borne in mind. A rare case of metachronously bilateral femoral aneurysms mimicking soft tissue sarcoma in a young Nigerian man is presented. Caution in the diagnosis of groin masses is hereby re-emphasized.