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Biomedical subjects

O A Adebo

Publications and source records attributed to O A Adebo.

53 records · Page 3Linked to original sources
PubMed1980

Management of post-pneumonectomy empyema and bronchopleural fistula in Nigeria.

This report reviews our experience with six patients with post-pneumonectomy empyema and bronchopleural fistula over a ten-year period (1969-1978) at the University College Hospital, Ibadan. The most common indications for pneumonectomy in this environment are TB-destroyed lung and suppurative diseases of the lung complicated by massive hemoptysis. Five of the six patients who developed these complications presented with life threatening hemoptysis due to lung abscess and pulmonary aspergillosis. The sixth patient presented with TB destroyed lung.This study shows that these complications are more common following emergency pulmonary resection for suppurative lung diseases and following the removal of the right lung. We have achieved the best results with initial closed chest tube drainage followed by continuous pleural irrigation and later by Clagett procedure or open tube drainage.

Adolescent↗
PubMed1980

Chronic constrictive pericarditis: hemodynamic changes following pericardiectomy.

Ten patients with chronic constrictive pericarditis underwent pericardiectomy at the University College Hospital, Ibadan, from July 1977 to May 1979. Preoperatively, right heart catheterization and angiocardiography were performed in seven patients. A significant decline in mean right atrial pressure occurred intraoperatively immediately after completion of decortication. Further measurements obtained in the immediate postoperative period identified two patient groups: one group of four patients with normal pressures and no mortality and one group of five patients with abnormal pressures and three deaths.Intraoperative pressure measurement at pericardiectomy is suggested as a useful parameter in identifying those patients with "reversible" myocardial dysfunction at risk from refractory cardiac failure in the postoperative period. Restoration of normal pressure after pericardiectomy is not dependent on the duration of disease.

Adult↗
PubMed1980

Broncho-esophageal fistula presenting as bronchiectasis in a Nigerian child.

A case is presented of a five-year-old girl with history of intermittent episodes of cough and vomiting exacerbated by eating. A diagnosis of broncho-esophageal fistula was made on barium esophagography after she failed to improve on therapy for bronchiectasis and tuberculosis over a one-year period.The diagnostic considerations and management of broncho-esophageal fistula in the Nigerian child with bronchiectasis are described.

Bronchial Fistula↗
PubMed1979

Pneumonectomy in Nigeria: indications and results.

This report reviews the authors' experience with 35 pneumonectomies over a ten-year period at the University College Hospital, Ibadan, Nigeria. The most common indications for pneumonectomy were TB-destroyed lung and life threatening pulmonary hemorrhage due to suppurative lung disease. Malignant tumors of the lung were featured twice as the cause for pneumonectomies in this study.Results show that until 1973, when most pneumonectomies were performed for TB-destroyed lungs, the mortality rate was nine percent, but after 1973, when more pneumonectomies were performed for life threatening hemoptysis, the mortality rose to 29 percent.From this study, it will appear that penumonectomy carries a grave prognosis when performed for suppurative lung disease, when there is active and massive hemorrhage, and when performed under emergency conditions.

Adolescent↗
PubMed1979

Digitalis in pneumonectomy and its implication.

Between 1968 and 1977, 87 patients underwent pneumonectomy at Rhode Island Hospital. Postoperatively, 25 patients developed arrhythmia (29 percent), giving rise to hemodynamic deterioration necessitating aggressive treatment. There were nine hospital deaths (10 percent). The effect of preoperative digitalis was analyzed in 68 patients over age 50 years.In Group 1, digoxin was not used until the onset of arrhythmia. There were 40 patients in this group; 18 developed arrhythmia (45 percent) with four deaths (22 percent).In Group 2, patients were given digitalis preoperatively. There were 28 patients; six developed arrhythmia (21 percent) with no deaths.Thus, the high incidence (45 percent in Group 1 and 21 percent in Group 2), as well as risk of mortality (4/18 patients) from arrhythmia following pneumonectomy, in patients over 50 years of age without digitalization, is a strong indication for preoperative digitalis.

Arrhythmias, Cardiac↗
PubMed1979

Scimitar syndrome with associated Morgagni hernia in a Nigerian infant.

A Nigerian infant with symptoms of moderate respiratory dysfunction since birth is described. The diagnosis of the scimitar syndrome was made intraoperatively. The clinical and roentgenographic features with which the patient presented are outlined together with anatomical observations. The presence of an associated foramen of Morgagni hernia has not been reported previously.The relevant literature is reviewed, with emphasis on the preoperative diagnostic investigations essential in planning and executing appropriate surgical therapy.

Hernia, Diaphragmatic↗
PubMedDate not supplied

Postoperative closed chest drainage without an underwater seal: a preliminary report.

The Aldon's urobag (e.g. simpla S4) which consists of a 2 litre plastic bag with a flutter valve and a drainage tube has been used in 29 consecutive cases as a postoperative pleural drainage system. The age range of patients was between 2 months and 74 years (mean 26.7 years). Indications for pleural drainage included lobectomy (3 cases), decortication (2 cases), lung biopsy (2 cases). Blalock-Taussig shunt (5 cases), patent ductus arteriosus patent ductus arteriosus (PDA) ligation (1 case), closed mitral valvotomy (1 case), oesophageal surgery (13 cases) and chest wall resection (2 cases). The period of pleural drainage ranged from 1 to 8 days (mean 3.75 days). The only operative death was not related to drainage system. No complications were attributable to the drainage system. This alternative chest drainage was found to enhance early ambulation, increase the efficiency of patient nursing and reduced the cost of consumables.

Adolescent↗
PubMedDate not supplied

Transhiatal esophagectomy in children with corrosive esophageal stricture.

Ten children with corrosive esophageal strictures were referred for esophageal replacement. The children whose ages ranged between 2 and 6 years (mean 4.1 +/- 1.4 years) had transhiatal esophagectomy (THE) and immediate posterior mediastinal transposition of their isoperistaltic stomach and cervical esophagogastrostomy. No patient had a gastric drainage procedure. All patients had nasogastric tube and a cervical perianastomotic drain until full oral intake resumed. Anastomotic leakages were managed by trans-oral irrigation (TOI) and postoperative feeding was through jejunostomy. Postoperative elective mechanical ventilation was for between 24 and 60 hours. Pleural entries were the commonest complication and they occurred in 6 patients (60%), unilateral in 2 patients, bilateral in 4 patients. Cervical anastomotic leaks and strictures occurred in 2 patients (20%) and 3 patients (30%), respectively, and the 2 patients (20%) who had anastomotic leaks and stricture had associated hoarseness. Though the incidence of complications was high, these responded well to appropriate treatment. There was no mortality in the series. THE and esophageal replacement with isoperistaltic stomach in the posterior mediastinum is a safe and useful procedure in the management of corrosive esophageal stricture in children.

Anastomosis, Surgical↗
PubMedDate not supplied

Bronchiectasis consequent upon prolonged foreign body retention.

OBJECTIVE: To review our experience with bronchiectasis complicating prolonged endobronchial retention of foreign bodies (FB) among patients with a history of aspiration of FB seen between 1975 and 1998. DESIGN: A retrospective review of clinical data of consecutive patients with a history of aspiration of FB treated during the time of study. SETTING: The Cardiothoracic Unit of the University College Hospital, Ibadan, directly serves a population of about 40 to 60 million in the South Western Nigeria and the community clinics. SUBJECTS: All patients with a history of FB aspiration (or suggestive of FB aspiration) from whom patients with prolonged FB retention were selected. MAIN OUTCOME MEASURES: Patients with a relevant history or chronic respiratory symptoms had their clinical examination findings, plain chest radiographic (or/and bronchographic) findings, treatment modalities and outcome studied. RESULTS: Sixteen patients among 203 patients who had tracheobronchial foreign bodies removed had this complication. The mean age at presentation was 13.0 +/- 17.3 years. Twelve patients (75%) retained inorganic materials and in four patients (25%) it was organic. The period of retention ranged between 4.8 to 108 months (mean 17.0 +/- 22.6 months). Main presenting symptoms were: productive cough, 16 patients; pyrexia, seven patients; combination of chest pain, fever and copious sputum, five patients. In none of the patients was the history of aspiration of FB definitely elicited before commencement of treatment. Symptoms were worst among patients who retained inorganic materials. All of the patients had bronchoscopy but retrieval of FB by this means was successful in one patient (6.3%). Six patients (37.5%) had thoracotomy and bronchotomy; nine patients had bronchotomy and lung resection [seven (77.8%) lobectomies, one (11.1%) pneumonectomy and one (11.1%) segmentectomy] as the definitive treatment. The one patient who had brochoscopic retrieval subsequently had lobectomy to control symptoms of bronchiectasis. Five out of six (83.3%) who had bronchotomy had persistent symptoms of bronchiectasis. All the nine (56.3%) who had lung resection remained asymptomatic at follow up. There was one mortality (6.3%) in the series--a 75 year old who died from poorly controlled Diabetes mellitus. CONCLUSION: Prevention of aspiration of FB is better than cure. In every medically treated child with persistent cough with or without a history of aspirated FB, the possibility of retained FB should be borne in mind.

Adolescent↗
PubMedDate not supplied

Coronary artery bypass grafting in patients with left main coronary artery stenosis. Improved survival in a predominantly Oriental population.

Over the last 10 years, there has been a reduction of surgical mortality in coronary bypass grafting for left main coronary artery disease. Most of the available literature reports are of Caucasian populations. We report our experience of the surgical treatment of this disease in a predominantly Oriental population. From 1 January 1987 to 30 June 1991, 86 consecutive patients had coronary artery bypass surgery for left main stenosis. There were 65 men and 21 women with an age range of 34 to 80 years (mean age: 58 years SD +/- 8.63). There were no operative deaths and 1 hospital death (1.2%) from a non-cardiac cause. The perioperative myocardial infarction rate was 3.5% (3/86). These results are better than some earlier series in which hospital mortality was reported as high as 12.6% and the preoperative myocardial infarction rate 11.8%. In this series where the patients are predominantly Oriental, the results are comparable if not better than in series reported in centres where the population is predominantly Caucasian.

Age Factors↗
PubMedDate not supplied

Congenital diaphragmatic eventration in a Nigerian child.

BACKGROUND: Diaphragmatic eventration is a rare cause of respiratory distress and failure to thrive in children. METHOD/RESULT: A report of a case of diaphragmatic eventration in a four-month-old child is presented with a review of the relevant literature. CONCLUSION: Clinicians should be aware of this diagnosis and avoid misdiagnosing the condition as a diaphragmatic hernia.

Diagnosis, Differential↗
PubMedDate not supplied

Oesophageal atresia and tracheo-oesophageal fistula: review of a 10-year personal experience.

Eleven neonates with oesophageal atresia and distal fistula were managed between July 1977 and January 1987. The male:female ratio was 1.2:1. The patients were aged between 1 to 14 days (median 7 days) and weighed 1.85 to 3.10 kg (mean 2.6 kg) at presentation. Associated anomalies were present in 5, pneumonia in 4 and uraemia (mean serum urea of 88 mg%) in all patients. A primary repair and simultaneous gastrostomy (omitted in 1) was done for all cases. There were 5 operative deaths. Fifteen postoperative complications occurred in 10 patients; including septicaemia in 3, wound infection in 3, anastomotic leak in 1 and tracheal mucus plug in 1. Statistical analysis indicated no difference between survivors and nonsurvivors on the basis of age, weight, degree of uraemia or presence of pneumonia. One of the 6 survivors (now 5 years after surgery) required bouginage after 26 months and has remained asymptomatic; the other 5 are well and without symptoms 3 to 11 months postoperative. The most significant determinants of survival are the effectiveness of pre- and postoperative managements of patients.

Cause of Death↗
PubMedDate not supplied

Catamenial pneumothorax: a case report.

A case of catamenial pneumothorax in a 17-year-old girl is presented. It is the first reported case in a Nigerian. Pleural blebs were found at thoracotomy and good response to dry sponge pleurodesis has been confirmed. The possibility of missed diagnosis of this entity in an environment where spontaneous pneumothorax is not uncommon is discussed.

Adolescent↗
PubMedDate not supplied

Post-operative complications in pulmonary resections.

Eighty consecutive patients undergoing pulmonary resection at the University College Hospital, Ibadan were studied to determine the factors predictive of postoperative morbidity and mortality. The operative mortality was 10% while complications occurred in 66% of the patients. Complications were significantly more frequent (p less than 0.01) in those with benign disease (73%) than with malignant conditions (31%). Benign disease and pneumonectomy were predictors of wound infection (p less than 0.05 & p less than 0.02 respectively); haemoptysis and pneumonectomy, predictors of bronchopleural fistula (p less than 0.02 and p less than 0.05 respectively); benign disease predictor of empyema (p less than 0.02); and age over 50 years predictor of mortality (p less than 0.01). It is concluded that improved care of patients with these predictive factors would result in reduction of morbidity and mortality.

Adolescent↗
PubMedDate not supplied

Ectopia cordis in a Nigerian child.

A female infant is described with a complete ectopia cordis and a single atrium who presented four hours after birth. There was complete deficiency of the sternum with the absence of pericardium over the heart. There was an associated omphalocele containing an enlarged liver. The infant died 45 hours after birth following an attempt to provide tissue covering. Additional intracardiac anomalies included a ventricular septal defect overriding aorta and total anomalous venous drainage.

Abnormalities, Multiple↗