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Biomedical subjects

S A Adebonojo

Publications and source records attributed to S A Adebonojo.

At least 37 records · Page 2Linked to original sources
PubMed1980

Chronic constrictive pericarditis: hemodynamic changes following pericardiectomy.

Ten patients with chronic constrictive pericarditis underwent pericardiectomy at the University College Hospital, Ibadan, from July 1977 to May 1979. Preoperatively, right heart catheterization and angiocardiography were performed in seven patients. A significant decline in mean right atrial pressure occurred intraoperatively immediately after completion of decortication. Further measurements obtained in the immediate postoperative period identified two patient groups: one group of four patients with normal pressures and no mortality and one group of five patients with abnormal pressures and three deaths.Intraoperative pressure measurement at pericardiectomy is suggested as a useful parameter in identifying those patients with "reversible" myocardial dysfunction at risk from refractory cardiac failure in the postoperative period. Restoration of normal pressure after pericardiectomy is not dependent on the duration of disease.

Adult↗
PubMed1980

Broncho-esophageal fistula presenting as bronchiectasis in a Nigerian child.

A case is presented of a five-year-old girl with history of intermittent episodes of cough and vomiting exacerbated by eating. A diagnosis of broncho-esophageal fistula was made on barium esophagography after she failed to improve on therapy for bronchiectasis and tuberculosis over a one-year period.The diagnostic considerations and management of broncho-esophageal fistula in the Nigerian child with bronchiectasis are described.

Bronchial Fistula↗
PubMed1979

Lung abscess: a review of three-years' experience at the University College Hospital, Ibadan.

The experience with 45 patients with lung abscess over a three-year period at the University College Hospital (UCH), Ibadan, is presented. This study confirms the rarity of this disease among Nigerian children and its prevalence in young adults in the third and fourth decades of life. The most common presenting symptoms were purulent cough, chest pain, fever, and life-threatening hemoptysis which was the sole indication for emergency operation in 14 out of 16 patients who were treated surgically. The predominance of these abscesses in the right lung, especially in the superior segment of the lower lobe, supports the fact that aspiration of infected material, following depressed level of consciousness, esophageal obstruction, foreign bodies, and oral sepsis form the major causative factors in patients with lung abscess. The frequent association of sickle cell disease, bronchiectasis, hypertension, and pulmonary aspergilloma contribute significantly to the morbidity and mortality attendant to this disease in our environment. Twenty-nine patients were treated medically with five deaths and 16 patients were treated surgically with six deaths. The high operative mortality (37.5 percent) in this series was due to the extreme emergency conditions under which these patients were operated.

Adolescent↗
PubMed1979

Management of tuberculous pneumothorax in Nigeria.

Forty-eight patients with tuberculous pneumothorax treated at the University College Hospital in Ibadan, Nigeria, over a 40-month period were reviewed. This represents 90 percent of all patients admitted with nontraumatic "spontaneous" pneumothorax during the period of survey. This finding shows that pulmonary tuberculosis (still endemic in Nigeria) is the most common cause of spontaneous pneumothorax in Ibadan.Because of delay in presentation, over 70 percent of the patients presented with hydropneumothorax or pyopneumothorax, which tend to prolong the length of intubation days and the period of hospitalization. The most significant factors affecting prognosis are nutritional status of the patient, extent of parenchymal damage, severity of the bronchopleural fistula, and presence of empyema.The goal of therapy had been directed toward prompt intercostal tube drainage, complete evacuation of fluid and pus, improvement in the nutritional status of the patient, and effective chemotherapy. With this approach, open thoracotomy was rarely indicated and decortication was only necessary in five patients. Our results with intercostal tube drainage and chemotherapy alone have been very encouraging.

Adolescent↗
PubMed1979

Primary malignant melanoma of the bronchus.

A case is presented of a 55-year-old woman with fever, cough, chest pain, and hemoptysis. A chest x-ray showed a large mass in the right upper lobe of the lung. Bronchoscopy and bronchial biopsies revealed malignant melanoma of the bronchus. Careful search of all common sites for melanoma and the histological examinations of the two skin lesions failed to substantiate the possibility of an extrapulmonary origin and, thus, by deduction it can be assumed with some certainty that this lesion is primary bronchial melanoma.Total pneumonectomy, when there is no evidence of extrapulmonary extension, coupled with adjuvant chemotherapy seem to offer a chance of cure.The patient presented is the first reported case of primary malignant melanoma of the bronchus from the University College Hospital, Ibadan, and perhaps the first reported case in a Nigerian.

Bronchial Neoplasms↗
PubMed1979

Pneumonectomy in Nigeria: indications and results.

This report reviews the authors' experience with 35 pneumonectomies over a ten-year period at the University College Hospital, Ibadan, Nigeria. The most common indications for pneumonectomy were TB-destroyed lung and life threatening pulmonary hemorrhage due to suppurative lung disease. Malignant tumors of the lung were featured twice as the cause for pneumonectomies in this study.Results show that until 1973, when most pneumonectomies were performed for TB-destroyed lungs, the mortality rate was nine percent, but after 1973, when more pneumonectomies were performed for life threatening hemoptysis, the mortality rose to 29 percent.From this study, it will appear that penumonectomy carries a grave prognosis when performed for suppurative lung disease, when there is active and massive hemorrhage, and when performed under emergency conditions.

Adolescent↗
PubMed1979

Experience with bronchiectasis in Nigeria.

Between April 1975 and March 1978, 54 patients were treated for bronchiectasis at the University College Hospital, Ibadan. The sex distribution was equal and ages of the patients ranged from five to 67 years with a peak incidence of the disease in the third and fourth decades of life.One third of the patients had tuberculous bronchiectasis with destroyed left lung syndrome, another third had chronic sinusitis, while nine percent had sickle cell hemoglobinopathy. One case of Kartagener syndrome, pulmonary aspergillosis, poliomyelitis, and aspiration of a foreign body were associated with bronchiectasis.Factors influencing the clinical course and prognosis of this disease in this environment include life threatening hemoptysis, bilateral disease, associated lung abscess or empyema, malnutrition, and chronic anemia.Twenty-six patients were treated conservatively with one death, while 28 patients were treated surgically with three deaths. Twenty percent of the surgical patients developed recurrent bronchiectasis within one to 31/2 years, in lobes which were bronchographically free of disease prior to surgery. These findings suggest that bronchiectasis is a progressive disease and that elective surgery for localized disease probably does not affect its clinical and natural history in this environment.

Adolescent↗
PubMed1979

Scimitar syndrome with associated Morgagni hernia in a Nigerian infant.

A Nigerian infant with symptoms of moderate respiratory dysfunction since birth is described. The diagnosis of the scimitar syndrome was made intraoperatively. The clinical and roentgenographic features with which the patient presented are outlined together with anatomical observations. The presence of an associated foramen of Morgagni hernia has not been reported previously.The relevant literature is reviewed, with emphasis on the preoperative diagnostic investigations essential in planning and executing appropriate surgical therapy.

Hernia, Diaphragmatic↗
PubMed1978

Pattern of thoracic surgical diseases in Nigeria: experience at the University College Hospital, Ibadan.

A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians.

Adolescent↗
PubMed1978

Surgery for congenital heart disease in Ibadan. I: Non-cyanotic heart defects.

Congenital heart disease represents about 5% of all cardiovascular diseases in Nigeria today. Its incidence has increased in the last decade because of improved neonatal care, increased awareness and clinical acumen of physicians, better diagnostic tools and the introduction of newer techniques in cardiac catheterization. It is now possible to make the diagnosis with certainty and to define the extent of the pathology thus making it possible to select the appropriate surgical therapy for these children. This article reviews the commonest types of noncyanotic heart disease, the indications for surgery and the types of surgical procedures available in Nigeria today. The simple extracardiac defects, such as patent ductus arteriosus and coarctation of the aorta can be corrected with little or no mortality, but the more complex intracardiac defects can only be palliated pending the introduction of open heart surgery in Nigeria.

Aortic Coarctation↗