Thoracic endometriosis syndrome at University of Ilorin Teaching Hospital.

BACKGROUND: Endometriosis is defined as the presence of endometrial tissue (stroma and functional glands) outside the uterine cavity in women of reproductive age. Ectopic sites are frequently located in the pelvis; extrapelvic sites have been reported in the gastrointestinal tract and thoracic cavity. Thoracic manifestation of endometriosis constitutes thoracic endometriosis syndrome (TES). OBJECTIVES: To examine the presentation pattern and outcome of in the management of TES. METHODS: This study is a retrospective review of medical records of patients diagnosed with endometriosis at the University of Ilorin Teaching Hospital over a 3.5-year period from January 2014 to June 2017. RESULTS: A total of 21 patients presented with endometriosis, of whom 8 (38.1%) presented with TES. The most common variety of TES was catamenial pleural effusion (CPE) accounting for 75%, followed by catamenial chest pain (37.5%). Two patients (25%) each presented with catamenial pneumothorax and catamenial haemoptysis, while 1 (12.5%) had catamenial surgical emphysema. Closed thoracostomy tube drainage plus chemical pleurodesis was the most frequent intervention technique, accounting for 62.5%. CONCLUSION: TES remains an uncommon entity, despite being the most common extrapelvic manifestation of endometriosis. CPE appeared to be the most common variant of TES in our environment. Currently available treatment options need to be improved, and more use made of video-assisted thoracoscopic surgery.

Concealed enterovesical fistula associated with forgotten intra-abdominal haemostat and intravesical towel.

Introduction. Enterovesical fistula is rare and is often caused by bowel inflammatory diseases and tumours in the urinary bladder or the intestine with local infiltration of bowel or bladder, respectively. The fistula usually presents with lower urinary tract symptoms, pneumaturia, and faecaluria or with food particles in the urine. Intra-abdominal retained surgical foreign bodies have also been reported as causes. Case Presentation. A case of atypical presentation in a woman with enterovesical fistula following abdominal hysterectomy. Investigations confirmed the presence of surgical towel in the urinary bladder and a pair of artery forceps in the abdomen. The towel was removed at cystoscopy after which she presented with food particles in the urine. She later had laparatomy to remove the haemostat and to repair the fistula. Discussion. A typical presentation of enterovesical fistula delayed the diagnosis and treatment in this patient. Conclusion. Managing patients with recurrent urinary tract infection after abdominal operation should include appropriate imaging of the abdomen with emphasis on pelvic organs. Also, surgical operation should always be given the best shot the first time and strict operation room standards and guidelines should always be followed.

Urological complications from obstetrics & gynaecological procedures in ilorin, Nigeria - case series.

BACKGROUND: Despite the advances and improvement in science and surgical skills, post-surgical operation complications are oftentimes inevitable, although they could be minimized. Generally, complications occur because of several reasons including patient factors, the disease condition, management option, skills and expertise of the managing team as well as technical factors. Analysis of postoperative complications will help to understand their pathogeneses and identify ways of preventing such complications in the future. AIM & OBJECTIVES: To retrospectively analyse the urological complications arising from obstetrics and gynaecological procedures at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. METHODOLOGY: Retrospective analysis of available records of patients with urological complications following either obstetrics or gynaecological procedures between the year 2010 - 2012 managed by the urology unit of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The patients were identified from the unit and theatre records. From the patients' clinical records, the data retrieved included the biodata, presentation, details of the gynaecological operations (calibre of surgeons, notable events at operations) and the complications that were recorded. The urological interventions and outcomes were also recorded. RESULTS: There were 11 patients with urological complications during the three year period. Their ages ranged from 28 and 65years (mean 43.8 +/-0.05 years), about 60% had hysterectomy for uterine fibroids. Various complications such as urinary fistulae (45.5%), ureteric obstructions (36.5%), retained surgical foreign bodies (9%) and ureteric transection (9%) were recorded. Corrective urological interventions were successful in majority (72.7 %) of them. CONCLUSION: Urological complications associated with gynaecological and obstetrics procedures are sometimes inevitable but their occurrence could be reduced when standard practices are observed.