West African journal of medicine
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Acute appendicitis is a leading cause of emergency admission into our hospital. A report on 638 surgical abdominal explorations following emergency admissions for suspected acute appendicitis is presented. The study was conducted at the Komfo Anokye Teaching Hospital between January 1998 and December 2004. ⋯ The diagnosis of appendicitis in our environment is clinical and based mainly on the combination of abdominal pains, signs of peritoneal irritation, and a raised total white cell count with neutrophilia. This mode of presentation is similar to that seen in other communities. The treatment of appendicitis in our hospital is appendicectomy. The negative appendicectomy rate of 25.9% falls within the range reported in other studies. More than a third of the appendices were perforated. The considerable morbidity and appreciable mortality from acute appendicitis in our community are due mainly to the late presentation of our patients.
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Comparative Study
Esophageal atresia with tracheoesophageal fistula and early postoperative mortality.
Several recent reports showed that associated anomalies represent the main cause of postoperative mortality in infants born with esophageal atresia (EA) and/ or tracheoesophageal fistula (TEF) Our observations present additional causes of mortality to the above mentioned. The aim of this study is to identify the major causes of early postoperative mortality in cases of EA and/or TEF in our setup. The ongoing preoperative classifications predicting mortality will be also used for comparison. ⋯ Primary sepsis and sepsis due to technical problems were the main causes of mortality in our series. Factors predicting mortality were pneumonia at presentation, sepsis at presentation or that acquired during hospitalization, major or life threatening anomalies, long gaps and major leaks. The Waterston classification was statistically the best applicable in this study.
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Myiasis is the infection of tissue or organ of living humans or animals by the maggot or larval stages of flies. In Africa, the most common fly responsible for cutaneous myiasis is the tumbu fly, Cordylobia anthropophaga. We present two cases of cutaneous myiasis seen on the upper abdominal wall and anterior chest wall. Both were initially diagnosed as furuncle (common boil), but from high index of suspicion of myiasis, followed by application of petroleum jelly and palm oil to occlude the spiracle and the expulsion of larva stage of Cordylobia anthropophaga the diagnoses in both cases were confirmed.