Penetrating abdominal trauma is on the increase in Calabar. The pattern of injury revealed areas which, when effectively contained, will lead to an improvement in the safety of our environment.

Trauma was mainly due to road traffic injuries. Hemodynamic stability and ultrasonography effectively selected patients for NOM. The establishment of trauma systems, provision of ancillary diagnostic and monitoring facilities, well-designed roads and traffic infrastructure, and health education on road safety would reduce injury, morbidity, and mortality.

Background: Cryptococcosis is a global disease problem. Although seen more frequently in the severely immuno-suppressed, it can also be seen in patients without apparent immuno-suppression. Patients with pulmonary Cryptococcosis typically present with cryptococcal pneumonia while brain cryptococcosis present with meningitis. Case presentation: Here we present our experience in the management of a 33-year-old immunocompetent man, diagnosed of invasive pulmonary Cryptococcal disease with spread to the brain. This case is unique because the patient was previously treated for tuberculosis and presented with typical bronchopulmonary (difficulty in breathing and cough), thoracic (diminished breath sounds and dull percussion notes), extra-thoracic (intra-cranial space occupying lesion) as well as Computed Tommography (CT) Scan features attributable to lung cancer. Diagnosis of Cryptococcosis was made by identification of oval thick-walled yeast on histology of lung biopsy specimen.Conclusions: We conclude that invasive Cryptococcosis affecting the lung and brain may present with a clinical picture similar to metastatic lung cancer. We recommend routine fungal stains and fungal culture in suspected cases.

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Indigestible intra-gastric foreign bodies are encountered in the mentally deranged, transporters of illicit drugs or those desiring weight control. They are often complicated by obstruction, migration, or perforation. Pseudobezoars are indigestible objects introduced intentionally into the digestive system. They may be indicated in bariatric practice for control of obesity. We present an 87-year-old man managed for a 2-year history of burning epigastric pain, aggravated by lying down and relieved by antacids. He had associated reflux symptoms for which he adopted lifestyle modifications. He had an upper gastrointestinal endoscopy which showed a stone attached to the anterior wall of the body of the stomach with associated pseudo-pouch formation. Mucosal overgrowth on the stone could be noted. Attempts at endoscopic retrieval failed as the stone could not be dis-impacted from its lodgement in a mucosal pouch. He had a laparotomy and gastrotomy for retrieval. A piece of stone, identified as granite, which measured 2 × 2 × 2.5 cm was retrieved from the stomach with accompanying formation of the mucosal pouch. Mucosal response, which may include overgrowth, could be an initial step in the migration of intra-gastric foreign bodies.

Targeted empirical antibiotic therapy based on local microbiology and antibiotic resistance patterns is essential for the treatment of empyema thoracis. Our retrospective review of 105 pleural empyema culture and sensitivity reports aimed at determining the causative microorganisms and their antimicrobial resistance pattern. Of 105 pleural aspirate samples, 46 (43.8%) were positive on culture. Gram-negative organisms (n = 43) were the predominant isolates, the commonest of which was Klebsiella pneumoniae. It was concluded that empyema thoracis is predominantly caused by Gram-negative organisms in our locality. This should guide protocols on the initiation of empirical therapy.

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BackgroundChest tube drainage, though the primary management method for many pleural effusions has a failure rate of 9.4–48%. In this study, we examined the factors that predict the outcome of management of non-purulent exudative effusions.Study objectivesTo determine the predictors of outcomes of chest tube drainage of pleural effusions.MethodologyConsecutive patients who had a chest tube drainage of non-purulent exudative pleural effusions were followed up till extubation and discharge in a prospective observational cohort study. Data on the management of the patients were recorded, analyzed and compared between groups of patients with good and poor outcomes.ResultsOf the 52 patients studied, 38 had good outcomes while 14 had poor outcomes. The mean age was 39.7±15.9. Multivariate analysis demonstrated that empyema thoracis complicating drainage was an independent predictor of a poor outcome while the duration of drainage ≤14 days and duration of illness before presentation <30 days were predictive of a good outcome.ConclusionOur results show that the development of empyema thoracis during drainage, a long duration of drainage and a prolonged period of illness before presentation are predictive of the outcome of chest tube drainage.