Pulmonary sequestration occurs when a portion of lung tissue receives its blood supply from an anomalous systemic artery. Three main presentations, intralobar, extralobar and communicating bronchopulmonary foregut malformations, have been described. It is the second most common congenital lung anomaly. The intralobar variant is the most common type seen in 75% of cases, especially in late childhood. Imaging of choice for diagnosis are computed tomography scan and magnetic resonance imaging. Management involves surgical resection with ligation of the aberrant blood supply via thoracotomy or thoracoscopy. Endovascular therapy with coil embolization of the aberrant anomalous systemic artery as a standard therapy or as a hybrid therapy is an option. We present our successful surgical management of an infant diagnosed prenatally with congenital lung abnormality and confirmed postnatally as intralobar pulmonary sequestration.
Lipoma is the commonest benign mesenchymal tumor composed of matured adipocytes. A literature search revealed few reported cases of giant scrotal lipoma. This article aims to report a giant scrotal lipoma weighing 1100 g and illustrate our challenges with the diagnostic process in a low-resource setting. A 28-year-old male presented with a huge right scrotal mass. Examination revealed the mass had no cough impulse. It was firm, non-tender and lobulated, with definite edges. Scrotal sonography was suspicious of lipoma. Intraoperatively, there was an encapsulated scrotal wall mass and an incidental inguinoscrotal hernia, content being the omentum. The scrotal mass was excised, hernia sac was ligated, and excised and the posterior wall was repaired. Histology confirmed the scrotal mass as a lipoma. Primary scrotal lipomas are rare but should be considered in the differential diagnosis of unusual scrotal masses. Ultrasonography is a useful diagnostic tool in resource-limited settings.
Introduction
Diaphragmatic injuries may be associated with thoracoabdominal blunt or penetrating traumas. The diagnosis is often delayed, despite the availability of several medical imaging modalities. The surgical management remains controversial, in terms of the choice of surgical approach and the surgical repair technique.
Aim
To evaluate the surgical management experience of traumatic diaphragmatic rupture in our institution over a ten-year period in the local setting of a tertiary hospital in Ghana.
Material and methods
A retrospective review of the medical records of patients who had undergone surgery for traumatic diaphragmatic rupture.
Results
A total of 35 cases of diaphragmatic rupture were seen from thoracoabdominal injuries. There were 29 (82.86%) males. The mean age was 36.25 ±12.98 years with a range of 16–65 years. There were 3 cases of right diaphragmatic rupture and 32 cases of left diaphragmatic rupture. Penetrating chest injury caused 18 (51%) of the ruptures. The leading cause of injury was road traffic accident, which constituted 48.57%, closely followed by stab (25.71%), gunshot injuries (14.29%) and impalement injury (11.48%). Seventeen (49%) patients had their diaphragmatic ruptures repaired via laparotomy and the remaining 18 (51%) via thoracotomy. The commonest herniated organ was the stomach. One patient died in theatre from cardiac arrest after failed intubation.
Conclusions
Surgery is the treatment of choice in traumatic diaphragmatic rupture and it is repaired via laparotomy or thoracotomy based on the presence or absence of concomitant abdominal injury and the presence or absence of a cardiothoracic surgeon.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.