No abstract

Acute appendicitis is believed to be one of the commonest causes of the acute abdomen in tropical Africa. Negative appendicectomy rates are usually above 20%, which is now considered unacceptably high because of increased risk to patients and the availability of diagnostic facilities to aid clinical decision-making. Our negative appendicectomy rate over a 4-year retrospective period was 29.7% in males, and 47% in females. These reduced to 11% and 10%, respectively, after the introduction of laparoscopy for doubtful cases of acute abdominal pain.

Objective To evaluate the use and problems of alphaand the effect on symptom scores and residual urine volume determined after one week and 2 months. receptor blockade with prazosin among patients in Nigeria with benign prostatic hyperplasia (BPH) whoResults Prazosin allowed the catheters to be removed, improved the symptoms of prostatism and/or conface a prolonged wait for a prostatectomy. Patients and methods The study comprised 31 patients trolled high blood pressure in seven, five and nine patients in each group, respectively. (mean age 64.4 years, range 55-89) facing a prolonged wait for prostatectomy: in group 1, 14 patients Conclusion The use of this alpha blocker for BPH in the absence of facilities to measure urinary flow rate, presented in acute urinary retention and had an indwelling urethral catheter; in group 2, six patients intravesical pressure and serum prostate specific antigen can be justified for short periods. However, a large had indwelling catheters but removal was deemed necessary to control urinary tract infection; in group default rate among these patients raises additional questions about long-term safety and underlines the 3, 11 patients had troublesome symptoms from BPH but no retention. Some of the patients were also importance of selecting patients carefully. Keywords Benign prostatic hyperplasia, hypertension, hypertensive. After receiving 1 mg of prazosin twice daily, the catheters were removed at various intervals alpha-receptor blockade, alpha blocker prostatectomy was planned were entered into the study.

Surgeons in developing countries see a need to improve diagnosis and decision making in patients with an acute abdomen. Without the benefit of diagnostic aids such as computers and high-resolution ultrasonography, the rate of unnecessary laparotomy is often unacceptably high. The laparoscope is usually available in a developing country and its use easily acquired. Using laparoscopy in doubtful situations the unnecessary laparotomy rate was significantly reduced from 14.0 to 6 per cent (P < 0.05). Laparoscopy achieved a diagnostic accuracy of 86 per cent and prevented unnecessary laparotomy in 57 per cent of those in whom it was used.

Objectives: To evaluate the safety and benefits of antegrade intraoperative colonic irrigation (lavage) and primary anastomosis, after colonic resection, in the treatment of left sided large bowel emergencies. Design: A prospective descriptive study. Setting: Jos University Teaching Hospital, Jos, Nigeria. Participants: Thirty seven patients with an average age of 44.86 ± 16.15 years. Intervention: Sigmoid colectomy was performed in twenty two sigmoid volvulus, five sigmoid cancer, two faecal fistulae and one sigmoid injury. Left hemicolectomy was offered in four descending colon cancer, one descending colon injury, while anterior resection was carried out in two rectal cancers. Primary anastomosis was performed after intraoperative colonic lavage. Results: The operative mortality was 2.7%, anastomotic leakage rate 2.7% and superficial wound infection occurred in 10.81%. The average duration of hospital stay was 22.76 ± 11.26 days. Intraoperative colonic lavage added 35.79 ± 7.25 minutes to the operating time. Conclusion:The results of this study suggest that intraoperative colonic lavage is an effective method enabling the surgeon to perform a primary anastomosis with reasonable safety after emergency resection of selected distal colonic lesions.