An Unusual Cause of Pyogenic Liver Abscess. The Conundrum of Broom Splinter. Report of Two Cases Olanrewaju Samuel Balogun, Emmanuel A. Jeje, Adedeji Lukman Fatuga, Oluwole Ayoola Atoyebi
Pyogenic liver abscess is an uncommon but potentially fatal disease. Very few cases of liver abscess due to foreign bodies have been reported.
We report our experience in two patients who were successfully managed for liver abscess due to impaled broom splinter. Broom splinters
were swallowed unnoticed during consumption of Jute leaves (Corchorus olitorus) (“Ewedu”) soup. Definitive diagnoses in both cases were
made at surgery. This is the first case of broom stick‑induced liver abscess to be reported in the literature.
Monopolar Transurethral Resection of the Prostate Using Water as the Irrigation Fluid: Our Initial Experience Emmanuel A. Jeje, Taiwo O. Alabi, Rufus W. Ojewola, Moses A. Ogunjimi, Kehinde H. Tijani, Gabriel K. Asiyanbi
Background: Monopolar transurethral resection of the prostate (M‑TURP) has been the gold standard of surgical intervention in patients with
benign prostatic hyperplasia with the indication for surgery. This can be achieved using varieties of irrigation fluids. Objectives: To document
our experience with M‑TURP using water as irrigation fluid in 123 consecutive patients. Materials and Methods: A retrospective study
of all patients who had M‑TURP with water as irrigation fluid was performed between January 2017 and July 2019. Information retrieved
from theatre records and case notes includes patient’s socio‑demographic data, indications for surgery, intra‑operative findings, the volume
of resected chips and irrigation fluid used, post‑operative complications and patient’s satisfaction with the outcome of the procedure. These
data were analysed using SPSS version 23. Results: Data from 123 patients were analysed and presented. The age range was 44–96 years
with a mean of 69 years. Prostate volume ranges from 13.9 to 276.00 mls with a mean of 95.69 mls while resected prostate volume ranges
from 2.0 to 158.0 mls with a mean of 56.68 mls. Volume of the sterile water used as irrigation fluid ranged from 5.0 L to 174.0 L with a mean
of 68.7 L. Mean reduction in International Prostate Symptoms Score, improvement in Q‑max and reduction in post‑void residual urine were
22.1, 16.9 and 141.6 mls, respectively. Transfusion rate was 6.5% while the duration of admission ranges from 1 to 6 days, with a mean of
2.5 days. The overall complication rate was 26.0%. Ninety‑six percent were satisfied with the outcome. Conclusion: M‑TURP using water
as irrigation fluid is safe and is as good as using the more rather expensive glycine or normal saline in bipolar TURP.
Endoscopic Management of Ureteric Stones: Our Initial Experience Taiwo Opeyemi Alabi, Emmanuel Ajibola Jeje, Moses Adebisi Ogunjimi, Rufus Wale Ojewola
The aim of this study is to present our initial experience with intracorporeal
pneumatic ureterolithotripsy highlighting the pattern of patients’ clinical presentation,
techniques, and limitation of the procedure. Materials and Methods: This is a
retrospective study of cases of ureteric stones managed over a period of 18 months
in a private hospital. Data obtained include patients’ sociodemography, clinical
presentation, stone burden, procedural technique, complication, and need for a
secondary procedure. Data were analyzed using the Statistical Package for the
Social Sciences version 21. Results: The total number of patients managed was
20 with an age range of 28–75 years and a mean of 48.2 ± 12.4 years. Majority
of them, i.e., 11 (55%) were middle aged. Female gender was more predominant,
11 (55%). Flank pain was the most common mode of presentation. Right‑sided
stone occurred in 9 (45%), left sided in 7 (35%), and bilateral in 4 (20%). Stone
location was in the upper ureter in 4 (16.7%), mid‑ureter in 7 (29.2%), and lower
ureter in 13 (54.2%). The stone size ranged from 6 to 18 mm with a mean of
9.7 ± 2.5 mm. Four patients (20%) required initial bilateral ureteric stenting before
definitive procedure to allow for recovery from sepsis and/or nephropathy. All
patients had double‑J stenting and were discharged 2 days after the procedure.
The procedure was successful in 19 (95%) with 100% stone clearance rate and
complete resolution of symptom without any complication. One patient (5%) had
a very hard upper ureteric stone which retropulsed into the renal pelvis requiring
open nephrolithotomy. Conclusion: Endoscopic treatment of ureteric stone with
intracorporeal pneumatic lithotripsy is a safe and effective treatment modality. It
is, however, limited in the management of hard upper ureteric stone, especially
those that are close to the pelviureteric junction due to the risk of retropulsion of
the stone into the kidney.