Background: Abdominal stab injury is a type of penetrating abdominal injury. The management may be operative or non-operative. Objectives: To determine the pattern, treatment options and outcome in abdominal stab injuries. Methods: This was a retrospective study carried out over 4 years between January 2014 and December 2017, at the University of Benin Teaching Hospital, Benin City, Nigeria. Patients aged 18 years and above formed the study population. The case files of the patients were retrieved from the medical record. The information obtained included age, gender, injury to arrival time (IAT), type of weapon, the abdominal injury sustained, clinical symptoms and signs, surgical intervention time (SIT), type of surgery carried out, operative findings and complications. Results: Overall, there were 34 patients made up of 30 (88.2%) males and 4 (11.8%) females with a male to female ratio of 7.5:1. The mean age of the patients was 30±8.9 years with the age range of 17-50 years. The mean injury to arrival time (IAT) was 2.0±1.6 hours; surgery intervention time (SIT) was 5.9±5.6 hours. Twenty (58.8%) patients had laparotomy while 14 (41.2%) were successfully managed non-operatively. Post-operative complications included surgical site infection (SSI), entrance wound infection, intra-peritoneal abscess and intestinal obstruction. There was no mortality. Conclusion: Abdominal stab injury was predominant among males and can be managed by the operative method or non-operative method in the absence of significant visceral injury. Selective non-operative management was effective in avoiding unnecessary laparotomy in more than one-third of the cases.

Perineal injury in children is uncommon. Injuries range from minor perineal skin laceration to severe injury to the genitourinary tract, anorectal region and the pelvic bone. The mechanisms of injury are usually attributed to blunt trauma, penetrating injuries like impalement injury, or sexual abuse. Perineal injury resulting from explosive blast in children is rare. The management depends on the time and mode of presentation and examination findings. Early presentation (a few hours after injury) with 1st or 2nd-degree perineal injury may benefit from debridement with primary repair of soft tissues and/or sphincters. Late presentation (days after injury) with 3rd or 4th-degree injury will require diverting colostomy or urinary diversion and wound drainage. This is a report of an unusual case of severe perineal injury in a child following explosive blast sustained while squatting close to packed explosives that got detonated. The perineal injury was initially managed with colostomy and wound drainage. The colostomy was closed after the wound had healed with good faecal continence achieved and without perineal soft tissue or anal sphincteric repair. It is concluded that severe isolated paediatric explosive blast perineal injury is rare but is amenable to surgical care.

Fibroadenomas are benign tumours of the breast. They are usually single, firm, rubbery masses, slow-growing and well encapsulated. Giant fibroadenomas are fibroadenomas at least 5cm in size or at least 500g in weight. The peculiarities of the index case include the massive size and weight of the breast, causing asymmetry and tissue distortion with little or no normal breast tissue on ultrasound scan. Also, such massive weight has not been reported in the literature as suggested by extensive search on databases such as Pubmed and Google Scholar. The main concern of the patient was the rapid growth over a year, with the attendant risk of malignancy. The mass was firm, lobulated, with a solitary axillary lymph node. An initial clinical diagnosis of phyllodes tumour was made. However, pre-operative Tru-cut biopsy histology suggested fibroadenoma and was confirmed using the excised post-operative specimen. Simple mastectomy with axillary lymph node excision was carried out. In conclusion, a large breast tumour may not be malignant. However, mastectomy may be a treatment option despite the benign nature of the tumour.