RESUMO
BACKGROUND: Surgical Obstructive Jaundice can be life-threatening. Management of these patients can be a major diagnostic and therapeutic challenge. OBJECTIVE: The aim of this study is to determine the sociodemographic data of patients with obstructive jaundice, clinical, laboratory and radiological findings as well as surgical procedures done and immediate postoperative outcome in a tertiary health institution. METHODS: Patients who presented in a Nigerian tertiary health institution with surgical obstructive jaundice between. January 1991 and December 2004 were retrospectively studied. Information was extracted from clinical records, operation notes and histopathology records. Data was entered into SPSS version 11.0 for windows to generate frequency table, percentages, proportion, histogram and pie chart. RESULTS: Sixty-four patients with obstructive jaundice were managed during the study period. Majority of the patients were in the 6th decade of life. More than 50% of the patients have had symptoms for more than 4 weeks before presentation. Carcinoma of the head of pancreas was the cause of obstructive jaundice in more than 60% of the patients. About 47% of the patients had cholecystojejunostomy and operative mortality was 15.6%. CONCLUSION: Carcinoma head of pancreas is the commonest cause of obstructive jaundice in Nigeria with many of the patients in the 6th decade. Diagnosis and management continue to be a challenge especially as a result of late presentation and limited radiological facilities. Patients benefited from palliative surgical intervention in form of bili-enteric diversion.
Assuntos
Adenocarcinoma/cirurgia , Colestase/cirurgia , Icterícia Obstrutiva/diagnóstico , Icterícia Obstrutiva/cirurgia , Neoplasias Pancreáticas/cirurgia , Adenocarcinoma/complicações , Adenocarcinoma/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Procedimentos Cirúrgicos do Sistema Biliar , Criança , Colestase/complicações , Colestase/mortalidade , Feminino , Hospitais de Ensino , Humanos , Icterícia Obstrutiva/etiologia , Icterícia Obstrutiva/mortalidade , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/mortalidade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Resultado do Tratamento , Ultrassonografia , Adulto JovemRESUMO
A case of snake bite of the scrotum in a 43-year-old male Fulani farmer cum herdsman is presented. Gangrene of the scrotum developed 4 days after the bite together with an increase in size of the scrotum to about 59cm in circumference. The patient received polyvalent snake anti venom almost 10 hours after the bite. Surgery to excise the gangrenous part, together with multiple longitudinal skin incisions of scrotum and penis were carried out The scrotal size reduced to almost half of the morbid size within 48 hours of surgery.
