Background: Obstructive jaundice is a term that describes the clinical entity of yellowness of the skin and mucous membranes due to the inability of bile to flow freely into the duodenum. This is commonly due to mechanical or physiological blockage of either the intrahepatic or extrahepatic bile ducts. Malignancies are responsible for the most cases of obstructive jaundice in our locality. Aim: The study sought to analyse all cases of obstructive jaundice that presented to a tertiary referral centre over a 36-month period, to determine the age at presentation, sex distribution, and aetiological spectrum. Study Design: Retrospective cross-sectional study. Study Setting: Korle-Bu Teaching Hospital, Accra, Ghana. Materials and Methods: This was a hospital-based study of all cases of obstructive jaundice that were seen over a 36-month period from May 2017 to April 2020, at the Hepatobiliary Unit of the Korle-Bu Teaching Hospital. The unit serves as a referral centre for all liver, pancreas, and biliary tract cases, including cases presenting with obstructive jaundice. The demographic data and diagnosis of all cases of obstructive jaundice seen over the study period were retrieved from both out-patient and in-patient records. Results: Three hundred and sixty cases of obstructive jaundice were studied; 141 (39.2%) were males and 219 (60.8%) were females, giving a male-to-female ratio of 1:1.6. The mean age of the patients was 56.8 (SD, 15.9) years. Malignant conditions accounted for 314 (87.2%) cases, whilst 46 (12.8%) were due to benign conditions. The mean age of the patients with benign conditions (40.4 [SD, 15.7] years) was significantly lower than that of those with malignant conditions (59.4 [SD, 14.9] years) ( P < 0.0001). There was no significant difference in sex ratios between patients with malignant and benign causes ( P = 0.996). Pancreatic head cancer was the commonest malignant cause of obstructive jaundice accounting for 139 (38.61%), followed by gallbladder tumour, 81 (22.5%), whilst choledocholithiasis (23 [6.39%]) was the commonest benign cause of obstructive jaundice. Conclusion: Obstructive jaundice in our setting was more prevalent in females. Malignant aetiologies were more common than benign ones: pancreatic head and gallbladder cancers were the commonest malignancies, whilst choledocholithiasis was the commonest benign cause. Malignant causes occurred in older patients than benign conditions, but there was no difference in sex ratios between the two categories.
Objectives: To review the Computed Tomography( CT )features of pediatric oncological patients with abdominal and pelvic tumours and correlate these findings with their histopathological diagnosisDesign: This was a retrospective cross-sectional facility-based study.Setting: This study was conducted in the Pediatric Oncology Unit and Radiology Department of the Korle Bu Teaching HospitalParticipants: Fifty-six pediatric oncology patients with contrast-enhanced abdominal and pelvic CT scans.Data Collection: The abdominal and pelvic CT scans findings, patient biodata, and histopathology reports of oncology patients over four years were reviewedStatistical analysis: Simple descriptive statistics using frequency distribution, percentages, means, and standard deviation were used to describe the various variables and presented tables. Results: The four commonest tumours were nephroblastoma, neuroblastoma, lymphoma, and hepatoblastoma. The mean age at diagnosis was 4.8 years, with a slightly higher male predominance. The majority of the tumours were extremely large at presentation. Overall, the CT – histopathology concordance was 79.2%. Conclusion: Abdominal and pelvic CT scans play an important role in the diagnostic workup of pediatric malignancies by ensuring early and accurate diagnosis of these tumours
Leiomyomatosis peritonealis disseminata (LPD), a rare and unusual condition affecting mainly women of reproductive age, causes peritoneal and subperitoneal nodules formed by smooth muscle. Very few cases have been diagnosed since the disease was first described. We present a 42year old female who was managed for infertility and uterine myomata at a Municipal hospital in Ghana. Following a pelvic ultrasound diagnosis of multiple uterine myomata the patient was booked for myomectomy. At surgery to remove her myomata, the patient was found to have several peritoneal nodules some of which were attached to peritoneum, omentum and the surface of bowel loops in addition to a uterine myoma. The disease has since recurred twice after two laparotomies. The diagnosis was made by histopathology of ultrasound-guided biopsy of the nodules, and she has since been on GnRH analogue treatment. LPD simulates peritoneal carcinomatosis; thus, a good history, clinical evaluation, radiological imaging, and histopathologic analysis must be accurately diagnosed. Surgeons’ and Radiologists’ knowledge of the condition is fundamental to ensuring correct diagnosis and appropriate treatment and to minimising the probability of malignant transformation.
Background: Breast cancer patients experience bone loss from treatment-induced menopause, as well as from the direct effect of cancer. The use of computed tomography (CT) attenuation values of the lumbar spine to estimate bone mineral density has been validated by several studies. Materials and Methods: This was a retrospective study conducted at Sweden Ghana Medical Centre and Korle Bu Teaching Hospital between June 2016 and August 2019. Measurement of Hounsfield unit (HU) of lumbar vertebrae was achieved by drawing an elliptical region of interest (ROI) on an axial image of the vertebra about 2–3 mm from the spinal cortical bone. The mean HU of the ROI was measured on bone window for each of the vertebral bodies, and the values were documented and analyzed. Results: The mean bone densities of the vertebrae were generally higher for the noncancer patients compared to the breast cancer patients for all the age groups. The measured bone densities showed a normal distribution curve. The range of bone density for osteopenia and osteoporosis was between 174.4 and 236.4 HU and <174.4 HU, respectively. A Pearson's correlation analysis between patient age and bone density for both groups showed a negative statistically significant relationship. Conclusion: Using CT attenuation values of lumbar vertebra to estimate bone density established that the bone densities follow a normal distribution, the mean bone density for breast cancer patients were slightly lower than for noncancer patients, and age correlated better with lumbar bone density in noncancer patients than in breast cancer patients.
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