Annals of African Surgery

Successful Retrograde Intrarenal Surgery for a Large Kidney Stone in a Pelvic Ectopic Kidney: A Case Report and Review of Literature

Afdal Afdal, Aditya Akbar Latief, Steven Steven — Fri, 16 Aug 2024 00:00:00 +0000

An ectopic kidney is a condition in which one or both kidneys are located outside of their normal anatomical position, typically lower than usual, and are prone to stone disease. In the past, most patients required open surgical treatment, but nowadays, laparoscopy-assisted percutaneous nephrolithotomy and multisession retrograde intrarenal surgery (RIRS) facilitate minimally invasive approaches. A 42-year- old male presented to the urology clinic with complaints of intermittent lower midabdominal pain near the suprapubic area for a year. A computed tomography scan evaluation of the abdomen without contrast was then performed, showing incomplete staghorn with multiple calyceal stones in the ectopic kidney, with the largest stone measuring 2 × 1.2 cm and mild hydronephrosis. A single-session RIRS was performed which successfully disintegrated the stone. This pelvic kidney, although situated within the retroperitoneum, has the bowels positioned between the front wall of the abdomen and the kidney. The successful navigation of the flexible ureteroscope through the deformed urinary tract made RIRS applicable in the presence of a urinary tract deformity. This case was managed with RIRS, which offers advantages in visualization and is considered a safer option compared to other methods.

Giant Bladder Calculus in a 70-year-old Female—A Case Report

Fri, 16 Aug 2024 00:00:00 +0000

Vesical calculi are unusual in females, and giant calculi (weighing >100 g) are even more uncommon, considering the advances in contemporary diagnostic modalities. The entity is associated with a variety of pestering symptoms—frequency, dysuria, and hematuria, to name a few—causing serious effects on patients’ quality of life. This report cites the case of an elderly female with a giant vesical calculus weighing 1.28 kg (12.5 cm in diameter). Our patient had no past surgical history or symptoms suggestive of bladder outlet obstruction or neurogenic bladder. As per our literature search, a stone as large as that of our patient has not yet been found in females. She underwent an uneventful open suprapubic cystolithotomy. A biopsy from a suspicious lesion during the surgery revealed squamous cell carcinoma. Given that such a large stone was found in an elderly female without any predisposing causative factors, it is worthwhile looking into the etiopathogenesis and management of giant vesical calculi.

Morphological Pattern of Benign Skin Tumors in a Teaching Hospital in Southeast Nigeria

Fri, 16 Aug 2024 00:00:00 +0000

Background: Benign skin tumors are non-malignant neoplasms of skin origin. They are not uncommon and some have the dreaded propensity for malignant transformation. Aim: The aim of this study is to determine the morphological pattern and distribution of benign skin tumors in a tertiary hospital in southeast Nigeria.

Methods: This is a retrospective review of all histologically diagnosed benign skin tumors at a teaching hospital in southeast Nigeria between 2009 and 2019. Information was gathered from the patients’ clinical notes and registers on age, sex, region of body involved, and histological diagnoses.

Results: One hundred and seven benign skin tumors were seen within the 11 years of this study. The mean age of the patients was 36±18 years with a male-to-female ratio of 1:1.14. Benign soft tissue skin tumors (comprised mostly dermatofibromas and keloids) were the commonest benign skin tumors (61.5%) followed by keratinocytic tumors (27.5%), appendageal tumors (7.0%), melanocytic tumors (3.0%), and neural tumors (1.0%). There was no case of hematolymphoid tumors or inherited tumor syndromes. The modal age range of benign skin tumors was 20–29 years.

Conclusion: Benign soft tissue skin tumors (dermatofibromas followed by keloids) were the commonest benign skin tumors. Skin adnexal tumors and keloids were seen mostly on the head and neck region.

Distal Femur MRI Rotational Anatomy in a Black African Population: A Pilot Study

Fri, 16 Aug 2024 00:00:00 +0000

Background: Correct distal femoral rotation, which varies across populations, is one important factor in total knee arthroplasty (TKA) surgical success. This descriptive pilot study aims to present the magnetic resonance imaging (MRI) findings in a black population using recognized measures that have been utilized in different populations and to compare these findings with published data.

Materials and methods: MRI images of 58 knees taken over a 6-month period were retrospectively reviewed to measure the condylar twist angle (CTA), Whiteside-posterior condylar angle (WPC), and Whiteside-epicondylar angle (W-EP). The correlation between the angles and age and gender was assessed.

Results: The mean CTA was 4.4° (4.7° in males and 4.2° in females), while the mean W-PC and W-EP were 87.1° (87.2° in males and 87.1° in females) and 86.5° (86.5° in males and 86.4° in females), respectively. There was no correlation between the rotational measurements and the age or gender of the study subjects.

Conclusion: The mean CTA was 4.4 in this study which differs from published data showing 6° in Indian and 3° in Caucasian populations. A larger study is required to review the distal femoral and proximal tibial anatomy in the black population group to assess whether significant variations exist that may impact the outcomes in TKA using standard implants.

The African Journal Partnership Program’s Guidance on Use of AI in Scholarly Publishing

Fri, 16 Aug 2024 00:00:00 +0000

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