Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

IntroductionSignificant deaths of between 21% and 38% occur from non-trauma surgical conditions in the accident and emergency room. Access to emergency surgical care is limited in many developing countries including Nigeria. We aimed to study the spectrum of non-trauma surgical emergencies, identify challenges in management and evaluate outcomes.MethodsA one year prospective cohort study of all non-trauma emergencies in adults seen at the surgical emergency room of LASUTH from 1st October, 2011 to 30th September, 2012 was conducted. Data was analyzed using SPSS version 15.0.ResultsOf a total of 7536 patients seen, there were 7122 adults. Those with non-trauma conditions were 2065 representing 29% of adult emergencies. Age ranged between 15 and 97 years and male to female ratio was 1.7:1. Acute abdomen (30%), urological problems (18%) and malignancies (10%) were the most common. Among 985 patients requiring admission only 464 (47%) were admitted while the remaining 53% were referred to other centers. Emergency surgical intervention was carried out in 222 patients representing 48% of admitted patients. There were 12 (24%) non-trauma deaths in the emergency room. They were due to acute abdomen and malignancies in half of the cases.ConclusionFacilities for patients needing emergency care were inadequate with more than half of those requiring admission referred. Attention should be paid to the provision of emergency surgical services to the teeming number of patients seen on yearly basis in the Teaching Hospital.

Context:Abnormal abdominal distension in a child is usually a source of great concern and apprehension in both the parents and the pediatric surgeon. Although Wilms’ tumor is the most common malignant abdominal childhood tumor, usually causing abdominal distension, many other less common causes can also result in abdominal distension. Therefore, early diagnosis of Wilms’ tumor and distinguishing it from all these other causes is essential.Aims:We intend to document the pattern of computed tomography (CT) scan findings in patients with Wilms’ tumor and the peculiarity of its radiological presentation in this environment, highlighting its accuracy and advantages over other imaging modalities.Settings and Design:This is a prospective descriptive study conducted between January, 2011 to January 2012, where all infants, 6-96 months of age, who were suspected to have Wilms’ tumor were made to undergo CT scan examination as part of their management work-up. It was carried out in a teaching hospital.Subjects and Methods:The study performed on 12 children age range of 6-96 months old underwent abdominal CT scans as part of their clinical work-up using a GE Hi-speed dual CT scanner®. Pre- and post-contrast images were acquired and assessed by the radiologists. They were operated and their radiological and histopathology results were correlated.Statistical Analysis:All data was entered into a Microsoft word excel spread sheet and analyzed by simple analysis. Percentages and proportions were determined for categorical variables.Results:Of the 12 patients seen, nearly 75% were males, with a male to female ratio of 3:1 and an average age of 37 months. The right sided tumors were slightly more than the left and nearly 25% were bilateral. Approximately 17% showed punctuate calcifications. Heterogeneous contrast enhancement was seen in all the cases, vascular encasement in three and lymphadenopathy in six cases. There was no bony involvement in any of them but 75% of the masses seen, crossed the midline. Histological confirmation of Wilms’ tumor was obtained in all cases.Conclusions:Majority of the tumors seen in this study crossed the midline and a few of them showed calcification. CT scan is relevant and accurate in investigating children with Wilms’ tumor as it reveals concomitant lesions with involvement of the abdominal vessels and lymph nodes.

This study suggests a high incidence and significant underreporting of pedestrian injuries. A reduction in morbidity and mortality is possible (from head and lower limb injuries) by traffic calming techniques in crossing the highway, especially injuries due to being struck by motorcycles, cars, and buses.