Aetiological Spectrum of Pancreaticobiliary Diseases in Adult Nigerians on Magnetic Resonance Cholangiopancreatography.

BACKGROUND: Imaging is vital for assessing pancreaticobiliary diseases. AIM: The aim of the study was to investigate the spectrum and pattern of pancreaticobiliary diseases in adult Nigerians using magnetic resonance cholangiopancreatography (MRCP). METHODS: This was a retrospective, descriptive cross-sectional study. The electronic radiological records of 110 adult Nigerians who had undergone MRCP were reviewed. The MRCP images were evaluated for bile duct dilatation, intraluminal filling defects, strictures, calculi, and other abnormalities. RESULTS: There were 45 males (40.9%) and 65 females (59.1%) aged 18-83 years, with a mean age of 51.93 ± 15.22 years. Jaundice (59.1%) and right hypochondrial pain (31.8%) were the most common presenting complaints. Gallstones (32.7%), common bile duct strictures (15.5%), choledocholithiasis (11.8%), pancreatic head carcinoma (10.9%), and gallbladder carcinoma (2.7%) were the most frequent abnormalities. There was biliary obstruction in 56.4% of participants, mostly at the distal and proximal common bile duct. Other findings include hepatomegaly (23.6%), hepatic cysts (6.4%), hepatic steatosis (0.9%), duodenal wall thickening (1.8%), and ascites (5.5%). MRCP was normal in 25 (22.7%) participants. CONCLUSION: Gallstones were the predominant pathology of the various pancreaticobiliary diseases, while Pancreatic head and gallbladder carcinoma were the most common malignant diseases.

ADELOLA ADELOYE: QUINTESSENTIAL NEUROLOGICAL SURGEON, NEUROLOGIST, DISTINGUISHED ACADEMIC, MEDICAL HISTORIAN, AND BIOGRAPHER.

Adelola Adeloye (formerly Rufus Bandele Adelola Adeloye) is the second Nigerian doctor to qualify as a Neurological surgeon in 1967, having trained in Nigeria, United Kingdom and the United States of America. He worked with the College of Medicine, University of Ibadan and the University College Hospital, Ibadan as an academic Neurosurgeon and honorary Consultant Neurosurgeon, respectively from 1968 to 1995. He subsequently took up appointments in Saudi Arabia, Kuwait, and Malawi where he served in various capacities. He garnered panoply of academic and professional qualifications in the course of his career, matched by an equally prolific array of scholarly publications on diverse subjects. The high points of his career would include the landmark description of the Adeloye-Odeku disease in 1971, helping to institutionalise local Neurosurgical training in Nigeria, helping to set up a Surgery department in the then fledgling Medical School in Malawi, his election as an honorary Fellow of the American College of Surgeons and honorary President of the World Federation of Neurosurgical Societies, as well as his appointment as an Emeritus Professor of Neurosurgery by the University of Ibadan. An altruistic and far-sighted man, he ensured that the first Nigerian Neurosurgeon who died prematurely and other Nigerian/African pioneers of Medicine/Neurosurgery are properly immortalised by a painstaking and selfless documentation of their lives and contributions. Biographies of Prof E. Latunde Odeku (Nigeria's first Neurosurgeon and the first Black Neurosurgeon trained on US soil), Dr James Africanus Beale Horton, and other such writings are testament to this.

Correlation of sonographic inferior vena cava and aorta diameter ratio with dehydration in Nigerian children.

BACKGROUND: Accurate assessment of the degree of dehydration is essential in the management and fluid therapy of dehydrated children. The invasiveness of central venous pressure limits its routine clinical use. Fortunately, some studies have suggested that ultrasonographic measurement of inferior vena cava (IVC) diameter: aorta diameter ratio (IADR) is an objective method of assessing intravascular volume. OBJECTIVES: To determine the clinical usefulness of ultrasound measurement of IADR in assessment of children with dehydration. METHODOLOGY: This was a cross-sectional study which compared dehydrated children to age- and sex-matched euvolemic healthy children as controls. The maximum anteroposterior diameter of the abdominal aorta (at peak systole) and maximum IVC diameter (in expiration) were measured. RESULTS: A total of 120 subjects and 120 controls were evaluated. The mean age was 21.73 ± 20.89 months for subjects and 21.19 ± 22.13 months for control. The mean IADR for children with mild, moderate, and severe dehydration was 0.75 ± 0.07, 0.55 ± 0.07, and 0.33 ± 0.05, respectively. The mean IADR for controls was 0.99 ± 0.06. IADR had an inverse relationship with the degree of dehydration in the subjects. A cut-off point of 0.86, with a sensitivity and specificity of 96.7% in predicting dehydration, was derived, with the sensitivity and specificity increasing with increasing level of dehydration. CONCLUSION: IADR is sensitive and specific for assessing moderate and severe dehydration in Nigerian children.

Gall bladder volume and contractility in type 2 diabetes mellitus

The aim of this study was to sonographically evaluate gall bladder changes in type 2 diabetes. One hundred type 2 diabetic subjects (50 with neuropathy and 50 without neuropathy) and 50 healthy controls un-derwent sonographic evaluation of the gall bladder. Fasting and postprandial gall bladder volumes (FGBV and PPGBV) were measured; and the gall bladder contractility index (GBCI) calculated. The presence of gallstones was also noted. It was found that patients with diabetic neuropathy had a significantly higher FGBV and PPGBV; and lower GBCI; compared with diabetic patients without neuropathy; PPGBV and GBCI also differed significantly from non-diabetic controls. Gallstones were present in 22% of diabetic patients with neuropathy; in 10% of those without neuropathy; and in 8% of controls. We conclude that diabetic patients with neuropathy have significant abnormalities of gall bladder function; presumably due to autonomic nerve dysfunction. These patients also have a higher prevalence of gallstones; suggesting that ultrasound screening may be worthwhile

Ultrasound evaluation of obstructive uropathy and its hemodynamic responses in southwest Nigeria.

PURPOSE: To determine the renal arterial hemodynamic changes induced by obstructive uropathy using Doppler ultrasonography. MATERIALS AND METHODS: 60 adult subjects with suspected obstructive uropathy and 60 asymptomatic apparently healthy controls with normal renal ultrasound features were evaluated. B-mode sonography of the kidneys and spectral Doppler examination of the renal interlobar arteries of all the participants were performed. The mean resistive indices (mRI) of both interlobar arteries were obtained and compared to that of the controls. The mRI of bilaterally obstructed kidneys were also compared with the mRI of unilaterally obstructed kidneys. RESULTS: The mRI of the right and left kidneys of subjects were 0.72±0.04 and 0.69±0.06 while those of the controls were 0.64±0.04 and 0.63±0.03 respectively. The mRI for the grades of caliectasis increased from grade I (0.72±0.03) to grade II (0.73±0.03) and grade III (0.73±0.02) but fell within the most severe levels of obstruction (0.69±0.07). There was no statistically significant relationship between the grades of caliectasis and unilateral or bilateral obstruction for both kidneys. The results show a sensitivity and specificity of 86.7% and 90% respectively when mRI≥0.7 was used to determine presence of obstruction. CONCLUSION: Renal duplex sonography is highly sensitive and specific for diagnosis of obstructive uropathy. Increased resistive index of the obstructed kidney may be a useful diagnostic tool in situations where intravenous urography cannot be done or is contraindicated.

Ultrasound evaluation of obstructive uropathy and its hemodynamic responses in southwest Nigeria

To determine the renal arterial hemodynamic changes induced by obstructive uropathy using Doppler ultrasonography.