Biomedical subjects
Publications and source records attributed to J U Monu.
Acute urinary retention can result as a complication of gastrointestinal diseases such as diverticulitis and granulomatous enterocolitis. Appendiceal abscess has been reported as a rare cause of acute urinary retention in children but not in adults. A young adult male who had appendiceal abscess and presented in acute urinary retention forms the subject of this report.
Necrotizing fasciitis is a grave complication of ascending omphalitis in the neonate, but because it is rare some of the signs are not well documented. Rapidly progressive anterior abdominal wall edema and cellulitis were noted in 16 patients who were clinically diagnosed with necrotizing fasciitis. Fifteen of these patients died soon after emergence of anterior abdominal wall edema and cellulitis. The appearance of anterior abdominal edema and cellulitis in a patient with ascending omphalitis has serious implications and demands intensive care if the patient is to survive.
We incidentally noted distinctive high signal defects or fissures in the patellar articular cartilage on sagittal T2-weighted magnetic resonance (MR) images in 4 patients. At subsequent arthroscopy all 4 patients were found to have patellar chondromalacia. To determine the reliability of these signs, we retrospectively evaluated, in a blinded manner, sagittal T2-weighted MR images of the knee in 75 patients who were undergoing arthroscopic assessment of their patellar articular cartilage. We identified high signal defects or fissures in the patellar cartilage of 5 patients. Patellar chondromalacia was noted at arthroscopy in all 5 patients. Arthroscopy demonstrated patellar chondromalacia in an additional 21 patients with normal MR images. We conclude that high signal defects or fissures on sagittal T2-weighted images are useful signs of patellar chondromalacia. This single imaging sequence will, however, detect only a small number of the cartilage lesions that may be present.
To identify magnetic resonance (MR) imaging characteristics of normal patellar tendons and those affected by tendinitis, the authors evaluated MR images obtained in 10 healthy volunteers, in 50 patients who underwent MR imaging for evaluation of knee structures other than the patellar tendon, in 11 patients with patellar tendinitis, and in two athletes with patellar tendon injuries. Normal tendons had uniformly low signal intensity on T1-, T2-, and proton-density-weighted images and displayed distinct margins, and the anteroposterior (AP) diameter slightly increased proximally to distally. It was concluded that the AP diameter of a normal tendon, in its proximal portion, should not exceed 7 mm. In patellar tendinitis, the tendon showed increased signal intensity on T1-, T2-, and proton-density-weighted images and increased AP diameter proximally. The margins of affected tendons were indistinct, especially posterior to the thickened segment. In all groups studied, women had thicker proximal tendons than did men.
An unusual case of infarction of the tibia in a neonate who presented with sepsis following poor cord management at birth is reported. He was managed as for necrotizing enterocolitis and had limited debridement of infarcted limb because the parents refused amputation of the limb. This patient was a diagnostic problem. Necrotizing fasciitis and in retrospect purpura fulminans are considered as possible diagnoses and are discussed briefly.
The Hutchinson-Gilford progeria syndrome is a rare, inherited, pediatric condition with features of premature and accelerated aging. The pattern of inheritance is uncertain though both autosomal dominant and autosomal recessive modes have been proposed. The patients usually present after the 1st year of life with progressive skin and skeletal changes that give rise to a characteristic physical appearance. Three siblings seen at the University of Benin Teaching Hospital are described in this report, the third documenting the occurrence of progeria in African black patients. The two older siblings show the classic physical and radiologic changes described in progeria whereas the third, a 2-year-old boy, manifests only the early physical and radiologic changes of the disease. We compare the radiologic features of progeria with those of other progeroid conditions: acrogeria, Werner's and Cockayne's syndromes.
Appendiceal abscess with urinary symptoms may be the cause of acute urinary retention. The authors present the diagnosis and treatment of such a case.
Necrotizing fasciitis is a potentially lethal syndrome which rarely affects Occurrence in the neonatal period is uncommon, although it has been estimated that up to 50% of reported paediatric cases involve the neonate. Two previous reports have associated the syndrome with neonatal omphalitis. Three cases seen in the University of Benin Teaching Hospital are presented, with poor umbilical cord stump hygiene being the immediate predisposing/associated condition. Two of the infants had Fourier's gangrene and the third developed gangrene of the anterior abdominal wall.
A retrospective study was performed to determine the frequency and pattern of urinary stone disease in a black African population. Urolithiasis was found to be a rare condition in the black African occurring with a frequency of 6.3 per 100,000 hospital population, with a male:female ratio of 4:1. Urinary stasis and infection are associated or etiologically related factors in a significant number of patients. Idiopathic stone disease is uncommon (28% of patients). A recurrence rate of 10% is similar to that found in other areas of the world where the disease is more prevalent.
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Suprapubic transabdominal prostatic sonography was performed at two Nigerian centers over the past year. All abnormal glands were found enlarged. Capsular, periprostatic and extra-organ features helped to segregate carcinomas from benign diseases. Gland shape and internal texture were less useful criteria. Prostatic sonography has great promise in developing and fragile economies, where other efficacious and contemporary imaging modalities are unaffordable.
We performed sonographic evaluations on 14 jaundiced patients over a six months period. Medical jaundice was correctly diagnosed in three, as confirmed by the subsequent clinical course. Sonographic features of surgical jaundice were identified in the remaining 11 cases, five of which were confirmed through either percutaneous transhepatic cholangiography, surgery and pathology or both. Sonography is efficacious in the work-up of jaundice; since the technique is affordable and versatile, it is particularly relevant in developing economies where available resources are limited.
The Superior Mesenteric Artery (SMA) syndrome was the underlying cause of severe gastrointestinal symptoms in a patient with recurrent pregnancy loss. Following a surgical transposition of the duodenum, two normal pregnancies were carried to term. This is the first report of the SMA syndrome in pregnancy, to our knowledge.