Mayer-rokitansky-kuster-hauser syndrome: surgical management of two cases.

The Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome is a rare anomaly characterized by congenital aplasia of the uterus and vagina in women showing normal development of secondary sexual characters and normal 44 XX karyotype. We report our experience in the management of two patients with congenital absence of the vagina due to the MRKH syndrome. The first case was a 24-year-old student, who presented with primary amenorrhea, uterovaginal agenesis, right pelvi-ureteric junction obstruction, and left renal agenesis. The second patient was a 24-year-old housewife, who presented with primary amenorrhea and inability to achieve penetrative sexual intercourse. She had vaginal atresia and a grossly hypoplastic uterus. Both had successful sigmoid colovaginoplasty and are sexually active. Vaginal reconstruction using the sigmoid colon saw an immediate and satisfactory outcome in both patients.

A review of appendicectomy in Sokoto, North-western Nigeria.

BACKGROUND: Acute appendicitis is a common surgical emergency in developed countries. There is a strorng evidence of a rising trend in the developing world. METHODS: We present a retrospective review of appendicectomy as performed at Usmanu Danfodiyo University Teaching Hospital, Sokoto over a six year period (January 1997 to December, 2002) RESULTS: The diagnosis of appendicitis was made in 38.9% of surgical abdominal emergencies. The peak age group was 20 to 29 years with a male to female ratio of 1.4:1. The negative appendicectomy rate was 15.9% There was associated Schistosoma haematobium in 4.44% of cases. Appendicectomy had a morbidity rate of 13.3% and a mortality of 0.9%. CONCLUSIONS: Appendicitis was the commonest surgical emergency in Sokoto. The negative appendicectomy, morbidity and mortality rates were within the range widely quoted in the literature. The need to avoid negative exploration is imperative in this poor community.