A spectrum of findings on computed tomography in paediatric abdominal and pelvic tumours in a Ghanaian teaching hospital.

Objectives: To review the Computed Tomography( CT )features of pediatric oncological patients with abdominal and pelvic tumours and correlate these findings with their histopathological diagnosis. Design: This was a retrospective cross-sectional facility-based study. Setting: This study was conducted in the Pediatric Oncology Unit and Radiology Department of the Korle Bu Teaching Hospital. Participants: Fifty-six pediatric oncology patients with contrast-enhanced abdominal and pelvic CT scans. Data Collection: The abdominal and pelvic CT scans findings, patient biodata, and histopathology reports of oncology patients over four years were reviewed. Statistical analysis: Simple descriptive statistics using frequency distribution, percentages, means, and standard deviation were used to describe the various variables and presented tables. Results: The four commonest tumours were nephroblastoma, neuroblastoma, lymphoma, and hepatoblastoma. The mean age at diagnosis was 4.8 years, with a slightly higher male predominance. The majority of the tumours were extremely large at presentation. Overall, the CT - histopathology concordance was 79.2%. Conclusion: Abdominal and pelvic CT scans play an important role in the diagnostic workup of pediatric malignancies by ensuring early and accurate diagnosis of these tumours. Funding: None declared.

Aetiology of Obstructive Jaundice in Ghana: A Retrospective Analysis in a Tertiary Hospital.

Background: Obstructive jaundice is a term that describes the clinical entity of yellowness of the skin and mucous membranes due to the inability of bile to flow freely into the duodenum. This is commonly due to mechanical or physiological blockage of either the intrahepatic or extrahepatic bile ducts. Malignancies are responsible for the most cases of obstructive jaundice in our locality. Aim: The study sought to analyse all cases of obstructive jaundice that presented to a tertiary referral centre over a 36-month period, to determine the age at presentation, sex distribution, and aetiological spectrum. Study Design: Retrospective cross-sectional study. Study Setting: Korle-Bu Teaching Hospital, Accra, Ghana. Materials and Methods: This was a hospital-based study of all cases of obstructive jaundice that were seen over a 36-month period from May 2017 to April 2020, at the Hepatobiliary Unit of the Korle-Bu Teaching Hospital. The unit serves as a referral centre for all liver, pancreas, and biliary tract cases, including cases presenting with obstructive jaundice. The demographic data and diagnosis of all cases of obstructive jaundice seen over the study period were retrieved from both out-patient and in-patient records. Results: Three hundred and sixty cases of obstructive jaundice were studied; 141 (39.2%) were males and 219 (60.8%) were females, giving a male-to-female ratio of 1:1.6. The mean age of the patients was 56.8 (SD, 15.9) years. Malignant conditions accounted for 314 (87.2%) cases, whilst 46 (12.8%) were due to benign conditions. The mean age of the patients with benign conditions (40.4 [SD, 15.7] years) was significantly lower than that of those with malignant conditions (59.4 [SD, 14.9] years) (P < 0.0001). There was no significant difference in sex ratios between patients with malignant and benign causes (P = 0.996). Pancreatic head cancer was the commonest malignant cause of obstructive jaundice accounting for 139 (38.61%), followed by gallbladder tumour, 81 (22.5%), whilst choledocholithiasis (23 [6.39%]) was the commonest benign cause of obstructive jaundice. Conclusion: Obstructive jaundice in our setting was more prevalent in females. Malignant aetiologies were more common than benign ones: pancreatic head and gallbladder cancers were the commonest malignancies, whilst choledocholithiasis was the commonest benign cause. Malignant causes occurred in older patients than benign conditions, but there was no difference in sex ratios between the two categories.