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Compound volvulus is an uncommon cause of acute abdomen and involves the twisting of the loops of ileum around the base of the sigmoid or vice versa. It is a surgical emergency that is often missed pre-operatively. We are reporting this case and reviewing the relevant literature to increase the awareness of this condition. A 37-year-old female presented at the Emergency Unit of our hospital with features thought to be acute peritonitis secondary to typhoid perforation and a differential of rupture appendix. She had laparotomy with the finding of a gangrenous twisted terminal ileum around the base of the sigmoid for which a right hemicolectomy and sigmoidopexy were done. Compound volvulus, though rare, can still be encountered in our environment. Prompt identification, adequate resuscitation and expedient intervention will reduce morbidity and mortality.

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Background: Federal Medical Centre, Gombe is one of the tertiary hospitals located in the northeast of Nigeria. It serves as a referral center to neighboring states and also gives secondary care to the immediate environment. The institution has evolved in providing minimal access surgery services in appendicectomies, cholecystectomies, diagnostic laparoscopy, endourology, etc. We present our experience in laparoscopic appendicectomies.

Aim: This study compares the outcome of laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) in terms of the duration of surgery, the length of hospital stay, the postoperative analgesia, and the postoperative complications, in order to determine the safety of LC in our center. Materials and methods: This is a retrospective study. All patients who had cholecystectomy in Federal Teaching Hospital, Gombe, Nigeria, between January 2012 and December 2016 were studied. Their relevant data were obtained from the records and analyzed using SPSS version 20.0. t test was employed and a p value of <0.05 was considered to be significant. Results: A total of 26 patients had cholecystectomy during the period-four of them were excluded, three had additional procedures while one had incomplete records. The female-to-male ratio was 1.2:1 and the mean age was 39 years. The indications for surgery were symptomatic gallstones in all patients except in one, which was for an acalculous cholecystitis. Fifteen (68%) patients had LC while seven (32%) had OC. The mean age for LC was 38 years and for OC it was 41 years. The mean duration of procedure was 73 (±17.4) minutes for LC and 92 (±28.0) minutes for OC. This was not statistically significant (p value = 0.066). The mean length of hospital stay for LC was 5.8 (±5.5) days and 10 (±8.5) days for OC, and was equally not statistically significant (p value = 0.433). There was no difference in postoperative analgesia, no surgical site infection or mortality recorded. Conclusion: LC is very safe and has a good outcome in our environment despite our challenges. Clinical significance: LC is still nascent and has not been studied in our environment. This study affirms the safety of this procedure, but fails to establish its superiority over OC.