Gallbladder Perforation with Choledochogastric Fistula Due to Ascaris Infestation, a Case Report.

We present a case of a 35-year-old Ethiopian female patient presented with right upper quadrant abdominal pain. Studies suspected gallbladder disease, for which she operated. Intraoperatively, gallbladder perforation with choledochogastric fistula was identified, with Ascaris lumbricoides (AL) worm in the common bile duct. Cholecystectomy was performed; common bile was repaired with T-tube and gastric repair. Patient was discharged 11 days after. On subsequent follow-up at the surgical referral clinic, the patient had no complaints.

Renal impairment among acute hospital admissions in a rural Ethiopian hospital.

AIM: Acute renal injury (AKI) is a relatively common clinical condition, reported to be associated with high rates of in-hospital mortality. Although here is an extensive literature on the nature and consequence of AKI in the developed World, much less is known in the developing World and more specifically in sub-Saharan Africa, which is addressed directly in this study. METHODS: We describe the prevalence, clinical characteristics and impact of AKI in patients admitted to a single centre in Ethiopia with no dedicated renal services. RESULTS: Renal function tests are not preformed routinely in many Ethiopian hospitals. This occurred in 32% of all patients in this study, falling to 23% on surgical wards. As a consequence no cases of AKI were identified in the context of surgical admissions. AKI was only identified in a cohort of patients on medical wards, with a prevalence of roughly 20% of medical patients in which renal function was measured. The patients with AKI were younger than those at risk of AKI in studies from the developed World but were older than those who did not develop AKI in this study. In the majority of cases AKI could be considered to be pre-renal in its origin. In contrast to studies in the developed World, AKI did not adversely impact on either duration of hospital stay or on patient mortality. Residual renal impairment was, however, common at the point of discharge. CONCLUSION: The data suggest subtle differences in the nature and impact of AKI between those published and mainly derived from the developed world and patients in sub-Saharan Africa.

Giant malignant carotid body tumor in a 40 years old woman: a case report from Gondar University Hospital.

The Carotid Body Tumor (CBT) should be considered in the differential diagnosis of any patient with an anterior lateral neck mass (mass in the region of carotid artery bifurcation) even though it is a rare neoplasm. Physical findings that support the diagnosis include pulsation without expansile palpation and the ability to move the mass from side to side but not vertically. The diagnosis is supported further by radiological procedures that may include US, CT, MRI and arteriography. Once the diagnosis is made, surgery is the principal treatment and the only curative modality but has inherent risks for hemorrhage and stroke for which the patient should be informed. Radiation therapy has been shown to be an alternative to surgery in certain patients and an adjunct to surgery in others. The internal carotid artery may need to be resected in order to remove the tumor. The surgeon needs to be prepared to employ intraoperative stump pressure manometry, to use intravascular shunts and be familiar with the several diagnostic and reconstructive vascular techniques relevant to this area, any of which may be needed to ensure adequate cerebral perfusion thereby reducing the risk of stroke and death that may attend simple ligation of the internal carotid artery. Regional anesthesia has proven benefit in carotid endarterectomy surgery. This technique may have a role in CBT surgery. In this paper we present an encounter with a giant malignant carotid body tumor and a brief review of CBTs in the English literature.