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Biomedical subjects

O Osinowo

Publications and source records attributed to O Osinowo.

41 records · Page 3Linked to original sources

Oesophageal reconstruction using the stomach.

Between January 1975 and December 1989, the Cardiothoracic Unit of the University College Hospital, Ibadan (U.C.H.) carried out 47 oesophageal replacement procedures using the stomach. The ages of the patients ranged from 3 to 75 years (mean = 53.2 +/- 19.3 years). There were 24 males and 23 females. The indications for oesophageal replacement were as follows: Carcinoma of the oesophagus--34 patients (73.9%), Corrosive stricture--9 patients (17.4%), peptic stricture--1 patient (2.2%), granulomatous oesophageal lesion--1 patient (2.2%), submucous cysts--1 patient (2.2%), oesophageal perforation--1 (2.2%). Twenty patients (58.8%) with oesophageal carcinoma died between 9 and 33 days after operation. The patients with oesophageal perforation, granulomatous lesion and submucous cysts died from sepsis 8, 13 and 6 days respectively after operation due to anastomotic leak. Three patients with corrosive stricture (24%) died 10, 13 and 15 days respectively after operation. All the other 21 (54.7%) patients survived with good results as judged by the absence of dysphagia. Eight of the fourteen surviving patients with carcinoma are lost to follow-up and are presumed dead. There were two intra-operative deaths (4.3%). The operative approaches used were: Transthoracic (21 patients; 9 deaths), Transhiatal oesophagectomy (14 patients; 9 deaths) and retrosternal route (12 patients; 8 deaths). In terms of morbidity, more complications were observed with the transhiatal oesophagectomy (Orringer's technique). It is concluded that whereas oesophagoplasty with the stomach offers good results in patients with benign strictures, the results with carcinoma of the oesophagus in our environment is poor.

Adolescent↗

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↗

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↗

Congenital aneurysm of the pulmonary artery: a case report.

A case of congenital aneurysm of the left pulmonary artery in a 52-year-old Nigerian woman is presented. She presented with a transient history of cough and epigastric pains. A chest radiograph revealed a rounded left hilar mass just superior to the left main bronchus, and pulmonary angiography confirmed the presence of fusiform aneurysm of the left pulmonary artery. At cardiac catheterization, there was pulmonary hypertension (80 mmHg). There was no associated congenital cardiac malformation. The electrocardiograph showed right ventricular hypertrophy. The patient remains asymptomatic to date. This is the fourth known report of pulmonary aneurysm in an African. The rarity of pulmonary artery aneurysms is stressed.

Aneurysm↗

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↗