RESUMO
Schistosomiasis remains an important health problem in many tropical countries and is being seen with increasing frequency in immigrant populations and tourists in developed countries. The pattern of organ involvement and clinical presentation of schistosomiasis in 80 patients (male: female, 9:1) during a five-year period (2001-2005) was examined from archival histopathology records. The urinary bladder was the most common organ affected [50 (62.5%)]. Gastrointestinal, male and female genital schistosomiasis were detected in 12 (15%), eight (10%) and five (6.1%) cases, respectively. Hematuria was the most common presenting symptom [34 (42.5%)], and bladder cancer was the only malignancy found to be associated with the infection. A high clinical index of suspicion usually allows for a preoperative diagnosis where indicated and avoidance of radical surgery. While research for the development of an effective vaccine continues, a plea is made for the expansion of multinational control programs in sub-Saharan Africa.
Assuntos
Schistosoma haematobium/isolamento & purificação , Schistosoma mansoni/isolamento & purificação , Esquistossomose/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Feminino , Trato Gastrointestinal/parasitologia , Genitália/parasitologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Patologia Cirúrgica , Prevalência , Esquistossomose/parasitologia , Esquistossomose/cirurgia , Sistema Urinário/parasitologiaRESUMO
BACKGROUND: Pancreatic pseudocyst is an uncommon disorder in Nigeria compared with the Caucasian population. OBJECTIVE: This study was carried out to determine the pattern and outcome of surgical management of the disease in a Nigerian population. METHODS: The authors reviewed the records of 10 consecutive patients with pancreatic pseudocysts who were surgically managed in Aminu Kano Teaching Hospital, Kano, Nigeria, from November 1998 to October 2005. RESULTS: There were four males and six females, with a mean age of 19.2 years. The etiological factors included idiopathic acute pancreatitis in a two-year old child and blunt abdominal trauma in two patients. In seven patients, the cause could not be determined. The most common clinical features included epigastric pain, fever, intra-abdominal mass and vomiting. The duration of symptoms ranged from 15-204 days (mean=102 days). Open cystogastrostomy was done in eight patients, and two patients had cystoduodenostomy. The mean duration of hospital stay after surgery was 9.4 days (range = 7-15 days). There was no recurrence in any of the patients after about 3-9 months of follow-up with ultrasonography, and no death was recorded. CONCLUSION: Open surgical internal drainage is safe and effective with low morbidity and mortality. There is a need for provision of facilities for minimally invasive laparoscopic and endoscopic techniques.