MULTIPLE SACCULAR ANEURYSMS OF THE ABDOMINAL AORTA: A CASE REPORT AND SHORT REVIEW OF RISK FACTORS FOR RUPTURE ON CT SCAN.

INTRODUCTION: Saccular abdominal aortic aneurysms (SAAA) are rare types of abdominal aortic aneurysm. It has a higher risk of rupture, hence must be repaired at smaller diameter. Mortality from rupture of an abdominal aortic aneurysm is high and has been reported to be about 90%. CASE PRESENTATION: This is the case of a 37-year-old woman with chronic waist pain and abdominal discomfort. Clinical examinations revealed a pulsating abdominal mass. Doppler ultrasound and abdominopelvic contrast enhanced CT scan showed multiple saccular aneurysms of the infrarenal abdominal aorta. This patient had no identified predisposing factor. She was being worked up for surgery, but eventually died of rupture, the most dreaded complication 3 days prior to surgical repair. CONCLUSION: The risk factors for rupture found in this patient were the size and type (saccular) of the aneurysm, intraluminal thrombus in addition to the multiplicity of the aneurysm as well as their adjacent positions; that probably led to arterial wall stress.

Foramina parietalia permagna in a Nigerian family.

BACKGROUND: Enlarged parietal foramina are defects in the skull and are believed to be benign and familial and caused by variable degree of defective intramembranous ossification of the parietal bones. They are rare and asymptomatic, usually associated with ALX4 or MSX2 gene mutations and transmitted as autosomal dominant. OBJECTIVE: To highlight the importance of plain radiographs in the diagnosis of this condition and need for health education in affected families. METHODS: A four-year-old male presented with a 14-day history of fever, seizures, and loss of consciousness. Full clinical and radiological evaluation was undertaken. RESULTS: Physical examination showed an unconscious boy who was having persistent twitching of the upper limbs. Investigations of skull X-rays which showed bilateral parasagital lucencies in the parietal bones. Ultrasound scan showed a mass in the posterior fourth ventricle. The father admitted to having defects in his skull. The patient's elder brother also had defects in his skull. CONCLUSION: The case illustrates that PFM is usually benign and mostly discovered accidently. In most cases, health education and reassurance are all that are necessary.

Tramadol as a prophylactic analgesic for hysterosalpingography in African women.

Hysterosalpingography (HSG) is a contrast investigation of the female reproductive tract. A major drawback to its use is pain during and after the procedure. This study was designed to evaluate the usefulness of Tramadol in alleviating the pain of the procedure and to assess the influence of tubal pathology on the degree of pain experienced. We studied 84 women; the patients were assigned randomly into two groups, group A and B. The first group, Group A (n=40) had premedication with intravenous Tramadol (100 mg) and IV hyoscine N butylbromide (20 mg), The Group B (n=44) had premedication with IV hyoscine N butylbromide (20 mg) only. The mean numeric rating pain score was 6.25 for the Tramadol group and 6.26 for the control group, P>0.05. This study does not show a significant decrease in pain perception during HSG in African women premedicated with Tramadol.

Typical and atypical presentations of congenital diaphragmatic hernia - a report of 2 cases.

Congenital diaphragmatic hernias occur through embryologic defects in the diaphragm. We present 2 cases of congenital diaphragmatic hernia, the first case was a late presentation in an 11 month old child, and the second case was an early typical presentation in a day old child, both diagnoses were made on chest radiographs. The paper is focused on the key role of the radiologist in a resource poor environment to make early diagnosis of this fatal and rare condition. Early diagnosis of this defect is essential. This will allow timely intervention and appropriate management, therefore, reducing the mortality associated with the condition.

Heterotopic pregnancy: a case report.

A case of 35 year old gravida 4 para 2(+1) woman with heterotopic pregnancy is presented. She had total salpingectomy for the ectopic pregnancy and spontaneous vaginal delivery of a 3.25 kg live female infant of the intrauterine pregnancy. The need to maintain a high index of suspicion and to intervene early to salvage the intrauterine pregnancy, and to prevent material morbidity and mortality associated with the ectopic pregnancy are emphasized.