Background: There is limited documented literature on the occurrence of tumors of the skin adnexae in the Black African population, and the seeming rarity of these tumors as earlier reported is not unrelated to misdiagnosis with other epidermal tumors, due to their complex, overlapping, and confusing morphological features, and lack of expertise in their diagnosis. Material and Method: A morphological analysis of all diagnosed cases of adnexal tumors of the skin in a Pathology laboratory over a 21-year period (1999-2019) using formalin-fixed paraffin-processed hematoxylin and eosin stained slides and tissue blocks subjected to special stains and immunohistochemical analysis. Results: One hundred and sixty-two adnexal tumors of the skin were diagnosed over the 21-year period. 115 were benign and 47 malignant with an overall male to female distribution of 67: 95. The mean age overall was 40.5 years, while the mean ages for benign and malignant lesions were 35.7 years and 50.9 years, respectively. The most common benign tumors were of eccrine and apocrine differentiation, while sebaceous carcinoma was the most common malignant tumor overall with a male predominance and closely followed by porocarcinoma with a female predisposition. Three (3) patients had recurrent tumors and the diagnosis of 17 cases with generic diagnoses of benign adnexal tumor and malignant adnexal tumors were reviewed based on the 2006 WHO classification of skin tumors. Conclusion: There is an increase in the frequency of tumors of the skin adnexae in our setting due to improved diagnostic capabilities and better health-seeking awareness among patients. These tumors have different biologic potential in terms of aggressiveness and thus require definite diagnosis for further patient management.

Background: Pre-eclampsia is a pregnancy-specific disorder characterized by the onset of hypertension and proteinuria after the 20th week of gestation. It is characterized by an exaggerated maternal inflammatory response with a preponderance of cell-mediated immune response. Tumor necrosis factor-alpha (TNF-α) is a pro-inflammatory cytokine that induces apoptosis and restrains differentiation. Defective trophoblastic invasion is now identified as the key etiology of pre-eclampsia. The objective of this study was to determine the serum levels TNF-α and interleukin 10 (IL-10) in women with pre-eclampsia/eclampsia and the relationship between these cytokines and the severity of the disease. Patients and Method: This was a case-control study carried out in Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Forty-eight patients with a diagnosis of pre-eclampsia/eclampsia were recruited as cases. The diagnosis was according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. For each case, a healthy pregnant control was selected, after matching for age, gestational age, and parity. Blood samples were taken and assayed for TNF-α and IL 10 using enzyme-linked immunosorbent assay. Data were analyzed using SPSS v 20. A P value <0.05 was considered statistically significant. Results: The prevalence of pre-eclampsia/eclampsia in ABUTH Zaria is 5.1%. Nulliparous women constituted 65.9% of the patients. Thirty-five percent of the women were between 20 and 24 years of age. The mean serum levels of TNF-α in women with pre-eclampsia/ eclampsia and controls were 294.8 ± 146 pg/mL and 176 ± 35.5 pg/mL, respectively. The mean serum levels of IL-10 in patients and controls with pre-eclampsia were 13.9 ± 5.7 pg/mL and 33.0 ± 11.0 pg/mL, respectively. The levels of TNF-α correlated positively with the severity of the disease. The serum levels of IL-10 did not correlate with disease severity. Conclusion: The prevalence of pre-eclampsia/eclampsia is high in ABUTH. The disease is characterized by an exaggerated inflammatory response in women in Zaria. Use of anti- TNF-α drugs may possibly have a role in the prevention of pre-eclampsia.

Background: Hirschsprung's disease (HD) was initially treated as a multistage procedure. Subsequently, it has been recognized that surgery can be done as a single-stage at an early age as this approach is safe, cost-effective, and avoids the morbidity associated with stomas. We study the effectiveness and safety of single-stage management of HD using Langer's or Georgeson's techniques, to analyze the outcome of surgery, and its comparison with other similar studies. Patients and Method: The study was retrospectively carried out in our institution from October 2016 to September 2019. They were operated in a single-stage either by Langer's procedure or by laparoscopy-assisted Georgeson's procedure. Inclusion criteria were clinically diagnosed cases of HD with an obvious transition zone. Patients without a funnel (on barium enema films) were excluded. Results were analyzed using IBM SPSS statistics 20.00 software. Result: The present series included 28 patients. The mean age of the patients was 16.24 months. Mean intra operative blood loss for Langer's series was 30 ml and Georgeson's series was 20 ml. The mean operative time for Georgeson's procedure was 150 min and for Langer's, it was 90 min. Postoperative enterocolitis 3 (10.7%), persistent constipation 2 (7.5%), and perianal excoriation 9 (32.14%) were some of the important complications noted. Conclusion: Single-stage surgery for HD is safe and avoids the need for multiple operations including stoma and its related complications.

Ovarian cysts in pregnancy are usually managed conservatively but surgical treatment is done for complicated cases. The diagnosis of complicated ovarian cyst in pregnancy is challenging, management often poses a dilemma to the obstetrician and is a source of anxiety to the patient because it can be associated with adverse pregnancy outcome. Complicated ovarian cysts in pregnancy accounted for 16.7% of all surgically managed ovarian cyst accidents (3/18) in our institution. It was also the most common indication for non-pregnancy-related laparotomy in pregnancy (3/6). The mean age of the patients was 31 ± 5.6 years, 66.7% (2/3) were primigravidae and all had cyst complication in the second trimester. All women presented with abdominal pain but accurate initial preoperative diagnosis was made in only 33.3%. Mean presentation to surgery interval was 46.7 h. All patients received tocolytic argents. The mean size of the cyst was 10.9 cm, commonest complication was torsion, and all cysts were benign. The commonest surgery performed was salpingo-oophorectomy. Surgical intervention was associated with favorable perinatal outcome in most cases with fetal loss seen when cyst was rapidly increasing in size or ≥15 cm in size. Prompt diagnosis and intervention enables preservation of affected adnexa.

Johann Friedrich Meckel was the first to feature the anatomy and embryology of a diverticulum in 1809, as an incomplete obliteration of the omphalomesenteric duct, and named this as Meckel's diverticulum. Since then, lots of facts have been gained about its presentations and treatments. When a surgeon encounters a Meckel's diverticulitis with a normal base instead of an inflamed appendix in a patient with acute pain in the right iliac fossa, diverticulectomy should suffice. We present a patient with clinical features of acute appendicitis but was found to have torsion and gangrene of a Meckels diverticulum. This was successfully managed by laparoscopic diverticulectomy with a hand-sewn technique. Laparoscopy has utility in the treatment of complicated Meckel's diverticulitis.

Trauma surgeons and emergency care physicians in Nigeria would often be required to manage solid organ transplant patients with injuries; this is because of increased transplant activity both locally and from other countries for the citizens.Knowledge of various transplanted organs physiology and anatomy is essential to ensure adequate allograft protection and good outcome. The reported patient had split deceased-donor liver transplantation at infancy 25 years ago for biliary atresia. He presented with blunt abdominal injury following road traffic accident and was evaluated and managed according to the guidelines for managing native solid organ injuries. The injury to the pathologic spleen was managed non-operatively, successfully. Familiarization with transplant process, physiology, and management is recommended for acute care and trauma specialist to enable adequate participation in transplant services establishment, optimal management of transplant patients with emergency conditions for better allograft protection and overall patient outcome.

Tooth impaction is a dental anomaly which is defined as cessation of eruption of tooth. It is caused by a physical barrier in the eruption path or abnormal position of the tooth. Impaction of permanent second molar is not a common condition. Early detection and treatment of impaction reduces the risk of complications associated with this condition. There are several treatment options for impacted tooth which depends on the degree of tooth inclination as well as the required tooth movement. The present case report presents a case of 14-year-old male patient with mesially impacted permanent second molar. The case presents the surgical and orthodontic management with orthodontic extrusion and uprighting of concerned impacted tooth.

Cholecystoenteric fistula is a rare entity, which is seen in cholecystitis complicated with cholangitis. The incidence of such fistula in pediatric patients with the choledochal cyst is extremely rare. Here, we report one such case of choledochal cyst in which cholecystoenteric fistula was detected intraoperatively.