Department of Medicine & Surgery
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Item Isolated gallbladder rupture following blunt abdominal trauma(Nigerian Journal of Clinical Practice, 2013-06-14) Gali Bata Mtaku; Ali N; Bakari AA; Suleiman IEThe gallbladder is a relatively well-protected organ; consequently its rupture following blunt abdominal injury is rare and usually associated with other visceral injuries. Isolated gallbladder rupture is extremely rare. We report a healthy Nigerian adult male who sustained isolated gallbladder rupture following blunt abdominal injury from riding a motor cycle (Okada). A high index of suspicion with positive bile aspirate might lead to early diagnosis. Open cholecystectomy is a safe option of treatment in a resource poor centre especially in delayed presentation and has a good outcome.Item Pyomyositis in north - eastern Nigeria(Nigerian Journal of Surgical Research, 2004-02-02) Madziga A G; Na’aya U H; Gali Bata MtakuBackground: Pyomyositis is a suppurative disease of skeletal Muscle and a well-known disease with frequent occurrence in the tropics and subtropics, which continues to cause significant morbidity. Despite several studies of the disease in various regions of the tropics, there has been none from the northeast region of Nigeria, consisting of a largely rural population where the climate is hot and dry with little annual rainfall.Methods: A retrospective study of all patients seen and treated for pyomyositis in the University of Maiduguri Teaching Hospital from April 1990 to April 2000 was undertaken.Results: Fifty four patients with pyomyositis were seen and managed comprising 36 Males and 18 Females (M: F ratio 2:1). Two peak age incidences of 6-10 years and 31-40 years were noted. Most were from a labouring population and presented with a fully evolved disease affecting the large and powerful muscles of the thigh and calf in 59.7% of cases, the glutei in 12.9% and the trunk in 9.7%. The smaller muscles of the arm and forearm and head and neck were rarely affected. 8 patients had multiple lesions. Staphylococcus aureus was cultured in 91.8% of cases sensitive to cloxacillin, augmentin, chloramphenicol and erythromycin in that order.Conclusion: Prompt diagnosis, appropriate supportive therapy, effective antibiotic therapy and early drainage of abscesses have resulted in minimal mortality despite late presentation although hospital stay was prolonged.Item Phaeochromocytoma in a 4-year old girl(Nigerian Journal of Surgical Research, 2004-02-02) Gali Bata Mtaku; Madziga A G; Nggada H A; Hamid A UThis is a report of a 4-year old female Nigerian patient with phaeochromocytoma, a rare surgically correctable cause of hypertension, highlighting the problems in diagnosis and management in our sub region with review of the literature.Item Outcome of surgery for toxic goitres in maiduguri(Nigerian Journal of Clinical Practice, 2012-10-02) Ali N; Madziga AG; Dogo D; Gali Bata Mtaku; Gadzama AABackground: Thyrotoxicosis a common endocrine disorder of the thyroid gland in Nigeria is commonly treated surgically. The outcome of thyroidectomy for toxic goiters in Maiduguri Nigeria is evaluated. Materials and Methods: Over the last 5 years (Jan 2005-July 2010), in a prospective review, the demographic, and clinical data of patients operated for toxic goiters in our department was entered, into a predesigned proforma and analyzed. The objective of the study is to review our experience with subtotal and near-total thyroidectomy as treatment for benign toxic goiters. Results: Seventy-eight patients, 11 males (14.1%) and 67 females (85.9%), with male: female ratio of 1:6.1 and the mean age of 30 ± 10.9 (range, 17-65 years), underwent thyroidectomy for toxic goiters. The mean duration of symptoms was 41.9 (range 3-126 months). There were 53 patients with toxic diffuse goiters (Grave’s disease) with their mean age of 27.6 ± 6.93 (range 17-38 years), 23 with toxic multinodular goiters, the mean age of 43.7 ± 15.68 (range 17-65 years) and two with toxic nodule. There was no case of permanent recurrent laryngeal nerve palsy or permanent hypocalcemia. Transient hypocalcemia occurred in 9 (11.5%) patients and hemorrhage with hematoma, requiring exploration in 4 (5.1%). There were two cases of wound infection and no postoperative mortality. The mean hospital stay was 7.6 ± 2.34 (range 5-15 days). There was no disease recurrence over a mean follow-up of 20.7 (range 2-48) months. Conclusion: Subtotal thyroidectomy is an effective procedure for the treatment of thyrotoxicosis with few postoperative complications and majority of patients being euthyroid after long follow-up.Item A Clinicopathological Pattern Of Tumoral Calcinosis In Maiduguri, North Eastern Nigeria(The Internet Journal of Third World Medicine, 2005-06-28) Gali Bata Mtaku; Nggada H; Mshelia DBackground: Tumoral calcinosis is a rare disease reported mainly among blacks of African descent with paucity literature in Africa. Aims and Objective: This study aims at reviewing the clinicopathological pattern of Tumoral calcinosis in Maiduguri Northeastern Nigeria. Methods: All histologically diagnosed cases of Tumoral calcinosis were retrieved and reviewed at the University of Maiduguri Teaching Hospital between January 1994 and December 2003. Results: There were twelve diagnosed cases of Tumoral calcinosis. All age groups were affected except the pediatrics age group. The age ranges between 15 and 70 years with a mean age of 38.5 years. There was no sex predilection. Multiple sites occurred in three patients with two recurrences. The commonest site is the hip joint and one unusual site, which is the scrotum. Surgical excision was performed on all patients with recurrences. Conclusions: Tumoral calcinosis is a rare benign lesion and most of the lesions are asymptomatic. However, morbidity may be related to the size, location and secondary infection. Early and adequate wide surgical excision is essential to avoid the morbidity and recurrence.Item Tuberculous ileal perforation in a HIV positive patient: a case report and review of literature.(Nigerian Journal of Clinical Practice, 2008-12-02) Dogo D; Bakari AA; Gali Bata Mtaku; Ibrahim AGTuberculosis is prevalent worldwide. Even in developed countries there is a resurgence of tuberculosis mainly due to increasing HIV infection. Tuberculous ileal perforation is uncommon. It is, however, a potentially fatal complication of intestinal tuberculosis especially in HIV/AIDS patient.To highlight tuberculous ileal perforation as an underestimated complication of intestinal tuberculosis in an HIV patient presenting with acute abdomen.A 42-year-old HIV positive long distance truck driver with tuberculous ileal perforation is presented and related literatures reviewed.Intestinal perforation due to abdominal tuberculosis is an aetiological factor in acute HIV abdomen. High index of suspicion remains the key to diagnosis.Item Congenital aganglionic megacolon in Nigerian adults(Nigerian Journal of Clinical Practice, 2011-06-02) Bakari AA; Gali Bata Mtaku; Ibrahim AG; Nggada HA; Ali N; Dogo D; Abubakar AMCongenital aganglionic mega colon (Hirschsprung’s disease) is a motor disorder in the gut, due to a defect in the craniocaudal migration of the neuroblast originating from the neural crest that occurs during the first twelve weeks of gestation, causing a functional intestinal obstruction, with its attendant complications, in infants. Despite modern pediatric practice, with emphasis on early diagnosis, Hirschsprung’s disease is seen in adults in regions where perinatal care is limited. We report two cases of Nigerian adults with longstanding, recurrent constipation, getting relieved by laxatives and herbal enemata, and then presented to our Emergency Department with a history of progressive abdominal distention, colicky pain, occasional vomiting, and weight loss. Per rectal examination revealed a gripping sensation in the rectum, 10cm from the anal verge, with rectal fecal load. Barium enema showed a grossly distended proximal large colon, with high fecal retention, with the transition zone at the middle one-third of the rectum. Due to difficulty in bowel preparation of these patients, emergency laparotomy was done. The first case had a diverting sigmoid colostomy and later had a low anterior resection. The second case had a one-stage procedure. Histology of both the cases showed aganglionosis of the stenotic segment and a normal distal rectum. Both patients had complete resolution of the symptoms, without complications, in a three-year follow-up. The related literatures were reviewed. Hirschsprung’s disease should be considered in adults patient presenting with chronic constipation. Low anterior resection of the rectum would be a surgical option for the treatment of short and zonal segment of adult Hirschsprung’s disease.Item The Trend of Cholecystectomies After the Introduction of Laparoscopic Surgery in a District Hospital in Abuja, North Central Nigeria(Cureus, 2023-06-29) Michael E. Aghahowa; Iliya K. Salu; Rosemary M. Nwokorie; Oku S. Bassey; Sabastine N. Esomonu; Gali Bata MtakuBackground Laparoscopic cholecystectomy is not readily available in secondary care hospitals in Nigeria, even though it is now the gold standard for the treatment of cholelithiasis and other gallbladder diseases worldwide. Thus, many hospitals in Nigeria still offer open cholecystectomies. This retrospective study investigated the trend of cholecystectomies performed in the general surgery unit of a district hospital in Abuja before and after the commencement of laparoscopic surgery services in 2016. Methodology This retrospective study was conducted in Asokoro District Hospital, Abuja, Nigeria The records of all patients who underwent a cholecystectomy from January 2000 to December 2019 were retrieved and analyzed for the number, types, and rate of cholecystectomies performed per year. All open cholecystectomies were performed via a right subcostal incision, whereas all laparoscopic cholecystectomies were performed via the standard four-port incisions approach. Results A total of 96 patients underwent cholecystectomies from January 2000 to December 2019. In total, 50 (52.08%) open cholecystectomies were performed in 20 years with a yearly average of 2.5, and 46 (47.92%) laparoscopic cholecystectomies were performed in four years with a yearly average of 11.5. The trend of open cholecystectomies in four years dropped from three (30%) in 2016 to one (5.26%) in 2019, whereas laparoscopic cholecystectomies increased from seven (70%) to 18 (94.74%) within the same period. Conclusions There is a drop in the trend of open cholecystectomies and an increase in both laparoscopic and total cholecystectomies in our hospital. We recommend adequate capacity and subsidized laparoscopic cholecystectomy for secondary healthcare facilities in Nigeria.