HighlightsCases of imperforate hymen (IH) that present with hemoperitoneum mimicking acute appendicitis are rare.Diagnosis and management can be a challenge especially in low-resource setting.Surgical management of both acute appendicitis and IH can be successful achieved during the same operative session.

ObjectiveTo estimate the surgical burden of malignant disease in the Eastern Region of Ghana.DesignDescriptive cross-sectional study.SettingRegional hospital in the eastern region of Ghana.ParticipantsPatients treated by the surgery department at Eastern Regional Hospital in Koforidua, Ghana.InterventionsNone.Primary and secondary outcome measuresPrimary outcome was incidence of malignancy and secondary outcome descriptive differences between patients who had a benign indication for surgery compared with those with a malignant indication for surgery.ResultsA total of 1943 inpatient surgical procedures were performed from 2015 to 2017 with 13.4% (261) of all procedures ultimately performed for malignancy. Of all breast procedures performed, 95.2% of procedures resulted in a malignant diagnosis. The remaining subtypes of procedures had rates ranging from <1% to 41.2% of procedures performed for malignant disease. Additionally, this study found over 13% of patients admitted to the surgical service for breast cancer ultimately did not undergo a surgical procedure.ConclusionThis is the first study investigating the burden of malignant disease in the Eastern Region of Ghana. We found a substantial prevalence of malignant disease in the surgical population in this region. This information can be used to aid in future medical resource planning in this region.

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