Drainage of splenic abscess: a case report.

BACKGROUND: Splenic abscesses are uncommon manifestation of an acute abdomen. We reported a case of splenic abscess managed by tube drainage. METHOD: A case report using the case note records of the patient and review of the relevant literature on splenic abscess. RESULT: A forty five year old Nigerian who presented with features of splenic abscess and was managed by tube drainage. His post operative recovery was uneventful. CONCLUSION: Tube drainage of the splenic abscess is encouraged if there is easy access to the abscess and there is evidence of residual splenic tissue in the critically ill patient.

Giant inguino-scrotal hernias seen at the University of Port Harcourt Teaching Hospital.

BACKGROUND: Inguino-scrotal hernias are a common surgical problem especially in our rural areas. The aim of this study is to review six patients seen with giant inguinoscrotal hernias at the University of Port Harcourt Teaching Hospital. METHODS: A retrospective review of patients seen between 1985 and 1995 at the University of Port Harcourt Teaching Hospital with giant inguino-scrotal hernias was carried out. RESULTS: The duration of the hernias ranged from twelve to thirty years. All the patients were above fifty-five years of age and eighty percent of them worked as farmers. Ninety percent of the patients developed cardio-respiratory difficulties when reduction was attempted during the operation. One patient had his operation converted to a bowel resection in order to allow for easy reduction. All developed severe scrotal haematoma and sepsis, one a full blown scrotal gangrene and another faecal fistula that resulted in death. CONCLUSION: In view of the intensive care required following surgery and the complications of surgery, we are advocating a policy of wait and see till features of intestinal obstruction present for surgery to be contemplated.

Thoracic empyema: a study of 56 patients.

Fifty seven children with thoracic empyema (37 boys and 20 girls) aged less than 12 years were seen at the University of Port Harcourt Teaching Hospital between January 1989 and December 1991. Staphylococcus aureus was the most common organism isolated from the pus of these patients (36 (63%) patients). Pseudomonas aeruginosa, the next most common organism, was isolated in 10 (18%) patients. The most common symptoms at presentation were acute illness with fever and cough (51 (89%) patients). All the patients were treated with closed intercostal tube drainage and appropriate antibiotics. Decortication was resorted to in only one patient. There were two deaths and the overall survival rate was 97%.

Spectral enhancement of proteins: biological incorporation and fluorescence characterization of 5-hydroxytryptophan in bacteriophage lambda cI repressor.

We have used a tryptophan-requiring Escherichia coli auxotroph to replace the three tryptophan residues of lambda cI repressor with 5-hydroxy-L-tryptophan (5-OHTrp). By using a nonleaky promoter, we have achieved > 95% replacement of tryptophan in the repressor. We show that the absorbance and fluorescence properties of 5-OHTrp-lambda cI are clearly distinct from lambda cI repressor and that the fluorescence of 5-OHTrp-lambda cI repressor can be observed selectively in the presence of exogenous tryptophan. We also show that the 5-OHTrp-lambda cI repressor functional properties, as assessed by measurement of binding constants for self-association and for association to operator DNA, and structural properties, as assessed by fluorescence, are indistinguishable from the native repressor. Based on these results, we anticipate that the availability of spectrally enhanced proteins will significantly enhance the utility of both fluorescence and phosphorescence spectroscopies to study protein structure and function in complex interacting systems.

Modern concepts in the management of flail chest.

Seven patients with varying degrees of paradoxical chest wall movement (flail chest) were managed conservatively at the University of Port Harcourt Teaching Hospital with frusemide, methylprednisolone, non administration of crystalloid fluids and limitation of fluid intake. Patients showed considerable improvement within the first 24-48 hours which was sustained throughout the period of management. All seven survived and showed no signs of respiratory distress in the resting state or while performing simple exercise. One patient however had slight to moderate chestwall deformity.