Impacted Urethral Calculus in Children Abraham T Oladimeji, Olukayode A Oseni, Emmanuel A Jeje, Adewole Z Adebobola
Background: Urolithiasis is a disease affecting all age groups. Albeit the incidence of urinary tract calculi in children is lower
than in adults, and urethral calculi, especially, are not common. The location of urethral calculi can bring about different clinical
manifestations.
Case Report: An 8-year-old boy who was referred to our facility with 12-hours history urinary retention and failed urethral
catheterization. The referring hospital was said to have decompressed the urinary bladder by suprapubic tap. Clinical examination
revealed a young male in painful distress and a calculus impacted at the stenosed external urethral meatus. He had emergency
meatoplasty and extraction of the meatal calculus. The post-operative period of the patient was uneventful. He was discharged home
second post-operative day.
Conclusion: This demonstrates that while rare, urethral calculi do occur in pediatric age group and should be entertained in children
presenting with urinary retention and failed urethral catheterization. Also, to highlight treatment options for impacted urethral calculi
in children.
Download file: Impacted Urethral Calculus in Children Abraham T Oladimeji, Olukayode A Oseni, Emmanuel A Jeje, Adewole Z Adebobola
COMPARATIVE STUDY OF TRANSRECTAL AND SUPRAPUBIC ULTRASONOGRAPHY IN THE ESTIMATION OF PROSTATE VOLUME: INITIAL EXPERIENCE OZOEMENA S OBOKE, EMMANUEL A JEJE, ABRAHAM T OLADIMEJI, ADEWOLE ADEBOBOLA
Background: Prostate volume (PV) is a principal parameter used by clinicians to better manage patients with lower urinary tract symptoms (LUTS) due to prostate or prostate cancer. PV can be measured by digital rectal examination, transrectal or suprapubic ultrasonography, computed tomography, magnetic resonance imaging and in prostatic specimens after prostatectomy. This study aims at determining the correlation of PV measured by suprapubic ultrasound scan (SPUS) and transrectal ultrasound scan (TRUS). Materials and Methods: This prospective study involved patients that underwent evaluation for lower urinary tract symptoms. Participants had suprapubic ultrasound scan and transrectal ultrasound scan done by the same radiologist. Data was analyzed using Statistical Package for the Social Sciences Version 22.0. Pearson’s correlation coefficient with the P <0.05 considered as significant was used. Results: A total of one hundred and seven patients were studied with age range of 24 – 84years and a mean age of 63.82±9.72years. The mean PV of all patients estimated by suprapubic sonography was 59.10±40.00 (cm3)/gram while mean PV measurement estimated by transrectal sonography was 70.60±45.40(cm3)/gram with positive correlation (r = 0.861 p-value = 0.0001). Conclusion: There is significant positive correlation between the suprapubic measured PV and transrectal measured PV. Therefore, SPUS can be a good substitute for TRUS where the latter cannot be done.
Haemoperitoneum due to Spontaneous Bleeding from Uterine Leiomyoma Abraham Tunde Oladimeji, Edokpolor Osazuwa Ede, Emmanuel Ajibola Jeje, Olukayode Azeez Oseni
Background: Uterine leiomyoma is the most common pelvic tumor in women. Grave complications from this benign tumor are infrequent
though can be life‑threatening. This report is of a rare case of haemoperitoneum secondary to spontaneous bleeding from a uterine leiomyoma.
Case Report: A 36‑year‑old single female presented with generalized acute abdominal pain and weakness. Clinical examination revealed a
distended abdomen with initially stable vital signs. Few hours on admission, her vital signs became unstable. After assiduous resuscitation,
abdominopelvic ultrasound scan (USS) and computed tomography imaging of the abdomen showed an intraperitoneal fluid collection
and multiple large pedunculated subserosal uterine leiomyomata. Emergency laparotomy was performed, and the bleeding blood vessel
overlying the anterior surface of the largest pedunculated subserosal leiomyoma was identified and ligated. The uterine myomas were excised
completely and histology corroborated the diagnosis of benign leiomyomata. The postoperative period of the patient was uneventful. She
was discharged from the hospital without complications on the seventh day of admission. Conclusion: Haemoperitoneum secondary to
spontaneous bleeding of uterine leiomyoma is rare. Surgeons should consider the probability of this complication in women with acute
abdominal pain and a history of uterine leiomyoma.
Predictive Value of Transrectal Ultrasonic Doppler and Elastographic Features in Prostate Cancer Detection in Lagos University Teaching Hospital Abraham T Oladimeji, Emmanuel A Jeje, Rufus W Ojewola, Adekunle A Adeyomoye, Ozoemena S Oboke, Moses A Ogunjimi, Kehinde H Tijani
Introduction: This study aimed at determining the predictive value (PV) of transrectal ultrasonic
Doppler and elastographic features in prostate cancer (PCa) detection among patients in Lagos
University Teaching Hospital. Materials and Methods: This prospective study involved patients that
underwent evaluation for PCa. Participants had digital rectal examination (DRE), prostate-specific
antigen (PSA) assay, and transrectal ultrasound-guided prostate biopsy using colour Doppler
(CD) and elastography. All cores were sent for histopathology. Data were analysed using Statistical
Package for the Social Sciences Version 22.0. CD and elastography PV in PCa detection and their
relationships to the Gleason score (GS) were analysed (P < 0.05). Results: Seventy men (aged
between 45 and 87 years) were enrolled. Forty-three (61.4%) patients had PCa with a mean age of
69.37 ± 8.22years. The sensitivity, specificity, positive PV (PPV), negative PV (NPV) and accuracy of
CD were 8.50%, 97.44%, 64.10%, 66.42% and 66.31%, respectively. The sensitivity, specificity, PPV,
NPV and accuracy of elastography were 84.21%, 94.59%, 88.89%, 92.11% and 91.07%, respectively.
Conclusion: There is a significant association between decreased elasticity (elastography) and PCa
detection but a weak association between increased vascularity (CD) and PCa detection. A positive
correlation exists between extent of prostatic stiffness and GS.
Emergency resuscitation and repair of ruptured abdominal aortic aneurysm in a low resource setting: a case report Olugbemi A, Sanusi M, Mgbajah O Tristate, Reddington Hospital, Lagos, and Babcock University Teaching Hospital, Ilisan Remo, Ogun State Jeje E, Ogunleye E Lagos University Teaching Hospital, Ikeja, Lagos, Nigeria. Sanni S Federal Medical Center, Abeokuta, Ogun State, Nigeria.
Background: Abdominal aortic aneurysm (AAA) occurs when the diameter of the abdominal aorta grows or
enlarges to more than 50% of its original size. This can rupture and becomes a life-threatening condition with
a mortality rate approaching 90%.
Case Presentation: The patient was a 57-year-old hypertensive man who presented with a one-day history of
sudden severe abdominal pains, with no preceding history of trauma. He had significant smoking history (35
pack years). His vital signs were normal except his blood pressure (BP) which was 217/130mmHg and
Respiratory rate, 24cpm. Abdominal findings - tender pulsatile mass in the right lower quadrant. He became
unconscious, was resuscitated, intubated, ventilated mechanically, sedated, and commenced on 3 inotropes. He
also developed acute kidney failure. He had an emergency Abdominal USS done which suggested a ruptured
AAA. He was reviewed by a Vascular surgeon. Emergency contrast abdominal CT scan showed a ruptured
infrarenal abdominal aortic aneurysm - 9.5cm its maximum transverse diameter. He had repair of ruptured
abdominal aortic aneurysm via a midline abdominal incision and a right groin incision, using a PFTE trouser
graft. Post-operative recovery was good and renal impairmentresolved.
Conclusion: Ruptured AAA is a clinical condition whose diagnosis can be sinister and requires a thorough
history and physical examination. Emergency USS of the abdomen is essential and contrast CT of the Abdomen,
diagnostic. The successful management of these patients also depends on prompt review by a Vascular surgeon,
availability of trouser graft and immediate repair of the ruptured AAA and availability of ICU facility.