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Penetrating Abdominal Injuries: Pattern and Outcome of Management in Khartoum

International Journal of Clinical Medicine 2014年第1期5卷 18-22页

作者： Maha Yassin Omer aamir abdullahi hamza Mohammed Toum Musa Department of Surgery College of Medicine & Health Sciences Bahri University Khartoum Sudan Department of Surgery Faculty of Medicine Al Neelain University Khartoum Sudan Department of Surgery Faculty of Medicine Khartoum University Khartoum Sudan

Background: The pattern and presentation of penetrating abdominal trauma vary according to places and the structure of the present health system. As well controversies in management exist ranging from mandatory exploration to selective non-operative management. Objectives: To determine the pattern of penetrating abdominal trauma, current management practiced and outcome in Khartoum. Patients and Methods: The study was prospective, descriptive and hospital-based. It was carried out at the main three hospitals in Khartoum State. It was conducted over a period of one year from 2012 Mar to 2013 Mar. All patients who presented penetrating injury to their abdomen were included. Results: The study included 85 patients with a mean age of 28 years (SD ± 10). The male to female ratio was 11:1. Most of the patients (89.4%) were in the first four decades of their life. Twenty-three patients (27.1%) presented shock. Stab wound is the commonest mode of trauma seen in 83.5% of our patients. The majority of our patients were managed by exploratory laparotomy (81.2%), however 16 (18.8%) underwent conservative measures. Of the operated group, solid organ injuries were found in 22.9%, yet hollow viscous injuries were reported in 86.9% of the patients. Registrars operated on 78.26% of the patients. The rate of negative laparotomy of this study was 8.7%. Complications and mortality were encountered in 25.9% and 4.7% respectively. The mean hospital stay was 8.47 days (SD ± 10.6). Conclusion: This study demonstrates no difference in the pattern of intra-abdominal injuries. The rate of operative treatment is acceptable, but more laparotomies can be avoided if the haemodynamic stable patients without features of peritonitis were given a period of observation. The overall outcome was satisfactory.

关键词： Mandatory Laparotomy Mortality Non-Operative Management Penetrating Abdominal Injuries

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Presentation and Management of Wilm’s Tumour in Sudan (Three Centre Experience from 2014-2016)

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Open Journal of Urology 2021年第10期11卷 358-366页

作者： Ahmed Mohammed Atiaallah Mutaz Ogeal Osman aamir Abdallah hamza Mawadda Farah Omer Alamin Faculty of Medicine Red Sea University Port Sudan Sudan Faculty of Medicine University of Bahri Khartoum Bahri Sudan Sudan Medical Specializations Board Khartoum Sudan National Elribat University Hospital Khartoum Sudan

Background: Wilm’s tumour is a cancer of the kidneys that typically occurs in children younger than fifteen years of age and rarely in adults. With an early diagnosis and proper management of Wilm’s tumour by Multi-modal approach, excellent outcome can be obtained. This study was designed to reflect the clinical presentations and focus on different management modalities with an outcome of Wilm’s tumour in Sudan. Patients and methods: This descriptive, retro-prospective analytic study included all patients of Wilm’s tumour at Soba University Hospital, Gezira national paediatric surgery centre and Khartoum teaching Hospital from January 2014 to January 2016. Results: Thirty patients (pts) were included. Females were predominant in a ratio of 3: 1 to males. The mean age was 3.0 - 5.9 years. Those who came from central and western of Sudan were more affected. Most patients presented with abdominal mass 28 pts (93.3%), followed by abdominal distension in 16 pts (53.3%), while the less frequent presentation was haematuria seen only in 2 pts (6.7%). The multimodal approach: surgery and chemotherapy used in 21 pts (70%) and single modality was used in nine patients: surgery alone in 6 pts (20%), or chemotherapy alone in 3 pts (10%). The patients discharged uneventfully 23 pts (76%). Morbidity was seen in two patients. Deaths were occurred in five patients in the study (16.7%). Conclusion: The finding of this study reflected that Wilm’s tumour has an excellent outcome when patient was managed by multimodal approach.

关键词： Wilm’s Tumour Multi-Modal Approach Nephrectomy Chemotherapy Outcome

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Traumatic Splenic Injuries in Khartoum, Sudan

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Surgical Science 2013年第12期4卷 525-529页

作者： Isameldin O. Ibrahim aamir A. hamza M. E. Ahmed Department of General Surgery Faculty of Medicine Khartoum University Khartoum Sudan Department of Surgery College of Medicine and Health Sciences Bahri University Khartoum Sudan Department of Surgery Omdurman Teaching Hospital Khartoum Sudan

Background: Spleen injuries are most commonly associated with blunt abdominal trauma and represent a potentially life-threatening condition. Objectives: To study the pattern of splenic injuries of the patient, management instituted and its outcome at Khartoum. Patients and Methods: This is a prospective, analytic and hospital-based multicenteric study, conducted at the three main Teaching hospitals at Khartoum. The study was carried over a period from April 2012 to February 2013. It includes all patients, diagnosed as traumatic splenic injury. Excluded were patients with history of splenic disease, iatrogenic injury or spontaneous rupture. Results: The study included 47 patients: their mean age was 26.4 years (SD ± 14.5). Most of them 41 (87.2%) were in the first four decades of life. Males were predominant 41 (87.2%), with a male to female ratio of 6.8:1. The majority of our patients had blunt abdominal trauma 39 (83%), of whom, road traffic accident accounted for 51.1% and none reported cases of gunshot. Isolated splenic injury was found in 23 (48.9%), and Haemodynamic stability was seen in 27 (57.4%) on presentation. The initial haemoglobin assessment revealed <9 gram/dl in 53.2%. CT scan was performed to 24 (51.1%), of whom 66 patients were Grade I and II and none of our patients were diagnosed as Grade V. Blood transfusion was required in 42 (89.4%). Operative treatment was adopted in 66% (61.7% total splenectomy and 4.3% splenorrhaphy), while selective non-operative management was successful in 16 (34%) of the patients. Higher intra-operative grade of splenic injury was found to be significantly associated with blunt abdominal trauma, haemodynamic instability and associated intra-abdominal injuries. 44 patients (93.6%) were discharged home in a general good condition. The morbidity and mortality were seen in 8.5% and 6.4% respectively. Conclusion: Splenic injuries usually follow blunt abdominal trauma, particularly after road traffic accidents. It is common during the first four decades of life with males b

关键词： Blunt Splenic Trauma Nonoperative Management Splenectomy Splenic Injury

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Extensive Quantitative Analysis of Gallstones

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International Journal of Clinical Medicine 2014年第1期5卷 42-50页

作者： Saadeldin A. Idris Kamal Elzaki Elsiddig aamir A. hamza Mohamed M. Hafiz Mohammed H. F. Shalayel Department of Biochemistry National College for Medical and Technical Studies Khartoum Sudan Department of Surgery College of Medicine University of Bahri Khartoum Sudan Department of Surgery Faculty of Medicine Alzaeim Alazhari University Khartoum Sudan Department of Surgery Faculty of Medicine University of Khartoum Khartoum Sudan

Background: The chemical composition of gallstones is essential to study aetiopathogenesis of gallstone disease. Objective: To determine the composition of gallstones in a Sudanese population. Patients and methods: It describes an extensive quantitative analysis of gallstones from patients presented with symptomatic gall stone disease and treated by cholecystectomy after the acceptance of the pre-given informed consent in Khartoum teaching hospital in the period between Jan 2010 and Dec 2010. Using a pretested questionnaire data collected from and analyzed statistically by SPSS computer program version 21. Results: Data are analyzed from 94 patients (six males and 88 females). Cholesterol stones showed a significantly higher cholesterol content than pigment stones (p = 0.0042), though not significantly higher than mixed stones. Their phospholipids content and inorganic phosphates were higher than in the other types of stones and oxalate content was significantly elevated in comparison with mixed stones (p = 0.0402). In mixed stones, the cholesterol, bile acids, and bilirubin were intermediate between cholesterol and pigment stones, whereas triglycerides were significantly more than pigment stones (p = 0.0007). Bilirubin (p = 0.0021) and bile acids (p = 0.0016) were significantly higher than cholesterol stones (p = 0.0001) and (p = 0.0001) respectively. However, they contained the lowest amounts of sodium, potassium, magnesium, and oxalate. In pigment stones, bilirubin was significantly higher (p = 0.0001) than both groups. Conclusion: Collaborations between surgeons, nutritionists, biochemists, and physicians should be stimulated in future studies to define the different types of gall stones in different areas in Sudan and the relevancy of such types with diets’ traditions.

关键词： Cholesterol Stone (CS) Gallstone (GS) Mixed Stone (MS) Pigment Stone (PS)

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