Publications by authors named "Jay Lodhia"

21 Publications

  • Page 1 of 1

Ileal Atresia in a 10-day-old male baby: A case report.

SAGE Open Med Case Rep 2021 25;9:2050313X211042983. Epub 2021 Aug 25.

Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Ileal Atresia is noted to be the commonest cause of intestinal obstruction in neonates worldwide but still under diagnosed in Sub-Saharan countries with scarce data reported on its occurrence. It is likely under diagnosed due to low index of suspicion. Advancement in foetal ultrasound during prenatal period will increase index of suspicion and hence early diagnosis and correction. This is the first case report in our setup highlighting this condition. We present a case of a 10-day-old male baby referred to us due to vomiting since birth. Clinically was in distress with a palpable supraumbilical mass that was firm and non-tender. Abdominal ultrasound scan showed poor peristalsis and minimal dilation of bowels suggestive of partial intestinal obstruction. Abdominal X-ray showed dilated bowels with multiple air-fluid levels, empty rectum with features suggestive of intestinal obstruction. Patient was successfully operated but unfortunately on day 3 post-surgery succumbed.
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http://dx.doi.org/10.1177/2050313X211042983DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392812PMC
August 2021

Metastatic malignant melanoma of unknown primary site to the brain: A case report.

Int J Surg Case Rep 2021 Sep 16;86:106311. Epub 2021 Aug 16.

Faculty of Medicine, Kilimanjaro Christian Medical University College, P O Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania.

Introduction And Importance: The natural history of metastatic melanoma in the absence of a known primary site has been poorly defined. The disease usually presents a significant cause of morbidity and mortality. Around 90% of melanomas have cutaneous origin, but still there are melanomas that could be found in visceral organs or lymph nodes with unknown primary site. Spontaneous regression of the primary site could be an explanation. The disease is frequently diagnosed after treatment for known extracranial metastases and has a poor outcome despite various local and systemic therapeutic approaches.

Case Presentation: Herein, we present a case of a 43-year old female presented with history of headaches and enlarged a left inguinal lymph node. Notably, no cutaneous lesions could be identified by history or on physical examination. CT-scan of the brain revealed a space occupying lesion and the inguinal lymph node biopsy confirmed the diagnosis of metastatic malignant melanoma. The patient succumbed shortly after establishment of diagnosis.

Clinical Discussion: Most patients with brain metastases from malignant melanoma are diagnosed after treatment for known extracranial metastases and have a poor outcome despite various local and systemic therapeutic approaches.

Conclusion: Metastatic melanomas of brain with unknown primary present a significant morbidity and mortality and confer a poor prognosis. Delay in diagnosis and treatment is of serious concern when it comes to improve the prognosis of patients with this disease. The optimal treatment depends on the objective situation, often surgery, radiosurgery, whole brain radiotherapy and chemotherapy can be used in combination to obtain longer remissions and optimal symptom relieve.
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http://dx.doi.org/10.1016/j.ijscr.2021.106311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377529PMC
September 2021

An incidental finding of duodenal GIST in a patient with penetrating abdominal trauma: A case report.

Int J Surg Case Rep 2021 Aug 3;85:106263. Epub 2021 Aug 3.

Department of Pathology, Kilimanjaro Christian Medical Centre, P.O.BOX 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O, BOX 2240, Moshi, Tanzania. Electronic address:

Introduction And Importance: Duodenal Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the digestive tract. The tumors are derived from interstitial cells of Cajal and usually they present as gastrointestinal bleeding or non-specific abdominal pain, but they can also be asymptomatic even when they have reached considerable size.

Case Presentation: We report a case of a 40-year-old male presented to our emergency department after sustaining a stab wound on the abdomen. Abdominal imaging tests weren't done; instead an emergency laparotomy was undertaken upfront in an attempt to catch up with a "golden hour". Intra-operatively, an incidental solid mass measuring 4 × 5 cm was noted on the third/fourth portion of the interior duodenal flexure. Histopathologically, the lesion demonstrated spindled shaped cells which were immunopositive for positive CD117. The patient fared well postoperatively and during subsequent follow up visits.

Clinical Discussion: High-risk GISTs have malignant potential. In some cases, GIST is diagnosed as incidentally finding, mostly during surgical procedure, upper endoscopy or radiological studies related to GI tract. Surgical resection is recommended curative option and its extension depends on different factors. Tyrosine kinase inhibitors are of the utmost importance in high-risk and metastatic disease.

Conclusion: Even considerably large duodenal GISTs can be asymptomatic, thus incidentally found during an abdomino-pelvic imaging tests. Histopathological evaluation of the operative specimen plays a key role in assessing the need of adjuvant therapy, with a significant impact on the patients' survival.
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http://dx.doi.org/10.1016/j.ijscr.2021.106263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350535PMC
August 2021

Necrotizing fasciitis in a 5-week-old infant: An unusual presentation.

SAGE Open Med Case Rep 2021 29;9:2050313X211037121. Epub 2021 Jul 29.

Department of Pediatrics and Child Health, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Necrotizing fasciitis is a rare and life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the fascial planes and surrounding tissue. These children should be managed promptly with broad-spectrum antibiotics and possible surgical debridement. Here, we present a 5-week-old female infant who presented with fever and ulcer on right lower jaw. She had a sudden onset of darkening of the right lower jaw, which progressed to reddish discoloration, and then an ulcer developed in the middle of this area of discoloration. She had a tender swelling extending from the right pre-auricular area to the right upper neck, crossing the right jaw and extending toward the right cheek and maxillary area. Swelling had areas of hyperpigmentation with an ulcer measuring 2 by 3 cm at the center of the lesion, oozing purulent fluid, and was cultured. The surgeons conducted incision and debridement in theater after suspecting necrotizing fasciitis of the jaw and the baby was kept on intravenous antibiotics, antiretroviral therapy and was dressed daily. The child fared well thereafter.
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http://dx.doi.org/10.1177/2050313X211037121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327223PMC
July 2021

Perforated Meckel's diverticulum in omphalocele in a newborn: A case report of an uncommon presentation from northern Tanzania.

Int J Surg Case Rep 2021 Aug 27;85:106246. Epub 2021 Jul 27.

Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania; Department of Pediatrics, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania.

Introduction And Importance: The concurrent existence of Omphalocele and Meckel's diverticulum is not unheard of but is relatively uncommon. A few cases of their coexistence have been reported. Due to the uncommon dual presentation, it is easy to delay or even miss the diagnosis, delaying management. Meckel's diverticulum should be considered if there is a bowel opening on an omphalocele.

Case Presentation: Herein we present a newborn male baby who was referred to us presenting with an omphalocele that was leaking faeces. The baby also had a cleft lip and palate. He was born at term to a 30-year-old mother whose pregnancy was otherwise normal. The fistulated omphalocele was surgically repaired, and the child continued to do well.

Clinical Discussion: Omphalocele and Meckel's diverticulum are both relatively rare congenital malformations that are uncommonly present together. Other congenital malformations can be associated; hence thorough investigations should be carried out when resources are available. The search for associated malformation should not delay the management of the pathology as it can have serious consequences on the health and outcome of the child.

Conclusion: Fistulation of Meckel's diverticulum on an Omphalocele is rare. Treatment involves surgical resection and repair. Though other co-morbidities should be investigated, investigation for cause and other co-morbidities should not delay surgery.
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http://dx.doi.org/10.1016/j.ijscr.2021.106246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339332PMC
August 2021

Bilateral Subdural Hematoma following Ventriculoperitoneal Shunt Insertion in a Ten-month Old Tanzanian Female with Congenital Hydrocephalus: An Uncommon Presentation.

East Afr Health Res J 2021 11;5(1):17-19. Epub 2021 Jun 11.

Department of General Surgery, Kilimanjaro Christian Medical Center, Moshi-Tanzania.

There is an unmet need for the treatment of hydrocephalus in Tanzania. Thousands of newborns each year in the region are affected by this condition and access to care remains a challenge. While treatment options like cerebrospinal fluid diversion through ventriculo-peritoneal shunting are within the skill set of general surgeons, the potential complications represent an additional challenge. We present a 10-month-old Tanzanian female who developed bilateral-subdural hematomas after insertion of a ventriculoperitoneal shunt.
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http://dx.doi.org/10.24248/eahrj.v5i1.646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8291209PMC
June 2021

Concealed gallbladder perforation: a rare case report.

J Surg Case Rep 2021 Jun 22;2021(6):rjab245. Epub 2021 Jun 22.

Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Acute acalculous cholecystitis remains an elusive clinical diagnosis possibly due to complex clinical setting in which this entity develops, lack of large prospective controlled trials that evaluate various diagnostic modalities, thus dependence on a small database for clinical decision making. Concealed gallbladder perforation is rare. Herein, we report an 82-year-old female who presented with a right upper quadrant pain and features of local peritonitis. Abdominal ultrasound was suggestive of cholecystitis while computed tomography (CT) scan reported a perforated gallbladder with pericholecystic fluid collection. The patient underwent successful cholecystectomy; and intra-operatively, similar findings as those reported on imaging were seen. Unfortunately, she succumbed shortly post-operatively due to pulmonary embolism. Our report highlights the importance CT scan in patients with vague abdominal symptoms followed by sudden resolution. It also reminds the importance of considering the diagnosis of concealed gallbladder perforation as a differential in patients with peritonitis, as it may be missed by routine radiological investigations.
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http://dx.doi.org/10.1093/jscr/rjab245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219397PMC
June 2021

Modified gastrostomy feeding tubes in patients with oesophageal cancer: our experience from Northern Tanzania.

J Surg Case Rep 2021 May 27;2021(5):rjab221. Epub 2021 May 27.

Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Surgeons in resource-limited settings have adapted to overcome the challenges of the limitations of resources using different available methods and inventions from the local environment. We report four cases of oesophageal cancer palliatively treated with improvised gastrostomy feeding tubes by using 24Fr urinary catheters, to optimize their nutritional status to withstand chemotherapy/radiotherapy. Two patients managed to begin chemo and radiotherapy, but only one out of the four survived. The aim of this report is to appraise the methods used by surgeons to overcome the challenges they face in clinical practice.
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http://dx.doi.org/10.1093/jscr/rjab221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159268PMC
May 2021

Ectopia cordis: A case report of pre-surgical care in resource-limited setting.

Int J Surg Case Rep 2021 Jun 12;83:105965. Epub 2021 May 12.

Kilimanjaro Christian Medical University College, Faculty of Medicine, P O Box 2240, Moshi, Tanzania; Department of Pediatrics, Kilimanjaro Christian Medical Center, P O Box 3010, Moshi, Tanzania.

Introduction And Importance: Ectopia cordis is a rare congenital malformation of thoracic midline fusion that presents as location of the heart outside the open chest cavity. This presents as a surgical emergency and demands early and specialized intervention. Particularly in resource-limited settings, where prenatal ultrasonography screening is not done, these children are often born in facilities without the capability of managing such conditions definitively, necessitating them to be referred to a specialized centre. At lower health facilities, the challenge is in ensuring that the child is kept stable and protected from infection until they can reach a centre with the facilities required for care. This report describes the management give to such a child until they were successfully handed over to a cardiac institute.

Case Presentation: We present a newborn male baby delivered at term to a mother from a low socio-economic background with his heart and abdominal viscera outside the thoracic and abdominal cavity. Despite presenting at a centre without cardiac surgery facilities or cardiologists, they were sustained until referral.

Clinical Discussion: Ectopia cordis is a rare congenital anomaly characterized by defect in the fusion of the anterior chest wall resulting in the abnormal extra-thoracic location of the heart. Five types exist; cervical type with worst prognosis, attempts can be made to re-locate the heart and close the thoracic defect surgically.

Conclusion: Even with limited resources, it is possible to provide the basic care necessary to sustain a child with this complex anomaly until definitive management can be provided.
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http://dx.doi.org/10.1016/j.ijscr.2021.105965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141755PMC
June 2021

A giant choledochal cyst: A case reported from Tanzania.

Int J Surg Case Rep 2021 Apr 27;81:105829. Epub 2021 Mar 27.

Department of General Surgery, Kilimanjaro Christian Medical Center, P O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, P O Box 2240, Moshi, Tanzania. Electronic address:

Introduction: Choledochal cyst is a rare common bile duct malformation that usually presents in the pediatric group with abdominal pain, distension, and jaundice. The pathophysiology remains unclear for the cause, and surgery aims to restore biliary enteric drainage.

Case Presentation: We present a six-year-old female who presented with gradual abdominal distention associated with jaundice. Abdominal ultrasound was suggestive of choledochal cyst, and CT-scan confirmed the diagnosis. She was operated on successfully and fared well.

Conclusion: Choledochal cysts are a rare entity of common bile duct malformations and should be considered as a differential diagnosis in the pediatric age group. Diagnosis can be easily made by non-invasive and in-expensive radiologic modalities like ultrasonography in resource-limited settings.
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http://dx.doi.org/10.1016/j.ijscr.2021.105829DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050714PMC
April 2021

Immature teratoma of the ovary in a 1 year and 9-month-old child: a case report and review of the literature.

J Surg Case Rep 2021 Jan 30;2021(1):rjaa609. Epub 2021 Jan 30.

Department of General Surgery, Kilimanjaro Christian Medical Center, Moshi, Tanzania.

Immature teratoma of the ovary is a rare malignant germ cell tumor whose etiology is unknown. Preoperative diagnosis and treatment of this tumor can be challenging for clinicians. We present a 1-year and 9-month female child who presented with a 1- month history of progressive nontender abdominal distension. Computed tomography scan of the abdomen revealed a huge well-defined heterogenous mass arising from the peritoneal cavity. Surgical resection was performed. Histopathology coupled with immunohistochemical analysis of the specimen confirmed it to be an ovarian immature teratoma, grade one. The child recovered well postoperatively. Surgery alone is curative for most children and adolescents with resectable ovarian immature teratoma thus avoiding the long-term effects of chemotherapy in most children with this disease.
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http://dx.doi.org/10.1093/jscr/rjaa609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849942PMC
January 2021

Carpenter syndrome in a patient from Tanzania.

Am J Med Genet A 2021 03 24;185(3):986-989. Epub 2020 Dec 24.

Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Carpenter syndrome (acrocephalopolysyndactyly type II) is a rare autosomal recessive disorder. It was clinically diagnosed in a female baby with polysyndactyly and craniosynostosis in a referral clinic in Northern Tanzania. In the RAB23 gene, a previously described homozygous variant c.82C>T p.(Arg28*) was detected that results in a premature stop codon. Both parents were demonstrated to be heterozygous carriers of this variant. Herewith, its pathogenicity is proved. A literature search suggests this is the first molecularly confirmed case of Carpenter syndrome in continental Africa.
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http://dx.doi.org/10.1002/ajmg.a.62015DOI Listing
March 2021

A Report of a Large Axillary Cystic Hygroma (a.k.a Lymphangioma) in a Newborn from a Tertiary Hospital in Northern Tanzania.

Case Rep Surg 2020 17;2020:5624019. Epub 2020 Nov 17.

Department of General Surgery, Kilimanjaro Christian Medical Center, P O Box 3010, Moshi, Tanzania.

Introduction: Cystic hygroma is a rare condition of the lymphatic system that occurs mainly in children. They are found around the neck, axilla, inguinal, or thoracic regions. . A newborn female baby with a right-sided axillary mass since birth was admitted to our center. She was otherwise a healthy baby with noncontributory prenatal history. The mass was 12 cm in diameter and cystic. Wide excision of the mass was done, and histology confirmed cystic hygroma. Postoperatively, the baby did well clinically and was discharged.

Conclusion: Due to its rare incidence, reports and literature on management of cystic hygroma are few. A multidisciplinary approach is vital to yield the best prognosis for this rare condition.
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http://dx.doi.org/10.1155/2020/5624019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685843PMC
November 2020

Neonatal Polycystic Kidney Disease in a One-Day-Old Baby: A Case Report.

Pediatric Health Med Ther 2020 29;11:445-448. Epub 2020 Oct 29.

Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Background: Polycystic kidney disease in neonates is a rare genetic disease which can be either autosomal dominant or autosomal recessive with each presenting at a certain period in life. They can both be diagnosed before or after birth using fetal ultrasound. This is a case of a five-hour-old baby with suspected polycystic kidney disease in a tertiary hospital in northern Tanzania.

Case Presentation: We present a case of a five-hour-old female baby referred to us with a complaint of non-progressive abdominal distension since birth. The birth weight was 2.4 kilograms with a good APGAR score. Clinically, the baby had palpable kidneys bilaterally, widened anterior fontanelle communicating with the posterior as well as rocker bottom feet. Her abdominal ultrasound showed bilaterally enlarged echogenic kidneys with loss of cortico-medullary differentiation and multiple tiny cystic spaces. An echocardiogram showed patent ductus arteriosus and moderate tricuspid regurgitation with mild pulmonary regurgitation. The patient was started on medication but unfortunately on day two post admission the baby succumbed.

Conclusion: Neonatal polycystic kidney disease is associated with high morbidity and mortality rates. It may not be as rare as previously reported. Minimal to no awareness exists on the condition or its effects in our setup due to underdiagnosis and neither availability of neonatal screening nor availability of genetic analysis. It is likely underdiagnosed due to a lack of skills in fetal ultrasounds and no neonatal ICU to care for these babies. Increased awareness will increase the index of suspicion. This is the first case report in our setup highlighting this condition.
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http://dx.doi.org/10.2147/PHMT.S271209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605961PMC
October 2020

Giant isolated hydatid lung cyst: two case reports.

J Med Case Rep 2020 Oct 24;14(1):200. Epub 2020 Oct 24.

Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi, Tanzania.

Background: Echinococcosis is a parasitic disease caused by Echinococcus granulosus and causes cystic lesions in the liver and lungs commonly. It is endemic in many parts of the world, and though humans are incidental hosts of the parasite, the disease can have severe consequences.

Case Presentation: We present two patients from pastoralist (Maasai) communities in rural Tanzania with long-standing chest pain accompanied by hemoptysis. Both were managed surgically after diagnosis, but one patient died of the complications following rapture of the cyst during surgery. Histopathological evaluation of the specimens confirmed the diagnosis of giant hydatid cysts.

Conclusion: Animal-keeping communities such as the Maasai are at risk of echinococcosis because of their close proximity to animals. The diagnosis can be made on the basis of history and radiological as well as laboratory findings. Surgery is a recommended mode of treatment, though it carries a high risk, especially when the cyst ruptures. Primary preventive measures are thus necessary in order to avoid the secondary and tertiary complications of the management of giant hydatid cysts, which is difficult in resource-limited endemic areas.
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http://dx.doi.org/10.1186/s13256-020-02524-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585214PMC
October 2020

Gastric perforation resulting into pneumoperitoneum in a neonate: a case report.

J Surg Case Rep 2020 Aug 26;2020(8):rjaa298. Epub 2020 Aug 26.

Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.

Gastric perforation in a neonate is a rare surgical emergency in routine practice. The causes and predisposing factors for gastric perforation in a neonate vary from traumatic to benign conditions like inflammatory processes. Early detection, intensive care, stabilization and prompt surgery yield positive outcome. Early diagnosis is important for better prognosis. Simple investigation such as plain abdominal X-ray can adequately lead to the diagnosis by showing pneumoperinoneum. We present a 3-day-old neonate; born at term who presented with abdominal distension and vomiting. Plain abdominal X-ray revealed pneumoperitoneum. Emergency laparotomy was performed where a gastric perforation was found measuring 0.5 by 0.5 cm located on the anterior aspect of the stomach body near the pylorus. The baby underwent successful surgical intervention and recovered well.
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http://dx.doi.org/10.1093/jscr/rjaa298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449603PMC
August 2020

Schistosomiasis and cancer: Experience from a zonal hospital in Tanzania and opportunities for prevention.

J Surg Case Rep 2020 May 1;2020(5):rjaa144. Epub 2020 Jun 1.

Department of General Surgery, Kilimanjaro Christian Medical Center, Moshi, Tanzania.

Schistosomiasis infection is endemic in many parts of Tanzania. The morbidity due to Schistosomiasis and its association with cancer remains to be of great concern and poses greater challenge that needs to be assessed. Cancer is an increasing public health problem in most sub-Saharan African countries, and yet, cancer control programs and the provision of early detection and treatment services are limited despite this increasing burden. This article aims to discuss case series of patients diagnosed with urinary bladder, prostate and colorectal cancer together with Schistosoma infection. We further highlight the opportunities for combating new Schistosomiasis infection, a potential to reduce its oncological complications particularly in low-resource setting.
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http://dx.doi.org/10.1093/jscr/rjaa144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263752PMC
May 2020

Juvenile Polyposis Syndrome in a Young Girl from Northern Tanzania.

Case Rep Surg 2020 3;2020:1536090. Epub 2020 Mar 3.

Department of General Surgery, Kilimanjaro Christian Medical Center, PO Box, 3010 Moshi, Tanzania.

. Juvenile polyposis syndrome is a rare autosomal dominant disorder in children characterized by multiple polyps in the gastrointestinal tract. A variety of clinical features manifest, including prolapse of a polyp or entire rectum, gastrointestinal bleeding, anaemia, and intussusception. This condition if left unmanaged promptly leads to fatal complications including the development of cancer of the bowel. . A 13-year-old girl with a history of mass protrusion per anus associated with bloody diarrhea. Colonoscopy showed multiple polyps in her large bowel. She underwent total colectomy with ileorectal anastomosis and did clinically well post surgery with no complications. . Juvenile polyposis syndrome is an inherited condition with significant morbidity and a high risk of colon malignancy. It is important for early screening and diagnosis and hence management in its early stages as there are no specific standard guidelines for children.
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http://dx.doi.org/10.1155/2020/1536090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073492PMC
March 2020

Isolated Pulmonary Hydatid Cyst: A Rare Presentation in a Young Maasai Boy from Northern Tanzania.

Case Rep Surg 2019 1;2019:5024724. Epub 2019 Oct 1.

Department of General Surgery, Kilimanjaro Christian Medical Center, PO Box 3010, Moshi, Tanzania.

Introduction: Hydatidosis is a parasitic manifestation caused by It is characterized by cystic lesions in the liver and lungs. Diagnosis is based on typical history and radiological measures.

Case Presentation: A four-year-old boy presented with a one-year history of dry cough and difficulty in breathing which was of gradual progression. Computed tomography of the chest revealed a large 11.7 cm × 8.6 cm × 11.0 cm cyst in the right hemithorax. The patient underwent thoracotomy and recovered well post procedure.

Conclusion: This case report highlights that large hydatid cysts can be surgically removed with good outcome and the importance of realizing that the disease is a burden to the public health and is much neglected.
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http://dx.doi.org/10.1155/2019/5024724DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791237PMC
October 2019

Tubular Duplication of the Midgut Presenting with Acute Abdomen and Hematochezia: A Case Report from Northern Tanzania.

Case Rep Surg 2018 24;2018:2858723. Epub 2018 Jan 24.

Department of Pediatrics, Kilimanjaro Christian Medical Center, P.O. Box 3010, Moshi, Tanzania.

Enteric duplication is one of the rare malformations affecting the small intestine more than the other parts of the gastrointestinal tract. It poses a challenge in diagnosis due to nonspecific symptoms that may mimic other pathologies. Furthermore, the management options including total resection, mucosal striping, and internal drainage of the duplicate depend on the presentation of the patient, site, and length of the involved bowel. We present the first documented case of enteric duplication in Tanzania, a 3-year-old male, who was found to have a 90 cm long jejunoileal duplicate. We discuss the presentation and management offered.
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http://dx.doi.org/10.1155/2018/2858723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833192PMC
January 2018

Colorectal cancer in a patient with intestinal schistosomiasis: a case report from Kilimanjaro Christian Medical Center Northern Zone Tanzania.

World J Surg Oncol 2017 Aug 2;15(1):146. Epub 2017 Aug 2.

Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010, Moshi, Tanzania.

Background: Colorectal cancer associated with chronic intestinal schistosomiasis has been linked with the chronic inflammation as a result of schistosomal ova deposition in the submucosal layer of the intestine. Among all species Schistosoma japonicum has been more linked to development of colorectal cancer as compared to Schistosoma mansoni due to absence of population-based studies to support the association. Despite the weak evidence, some cases have been reported associating S. mansoni with development of colorectal cancer.

Case Presentation: We report a patient who presented to us as a case of intestinal obstruction and found to have a constrictive lesion at the sigmoid colon at laparotomy, then later found to have colorectal cancer with deposited S. mansoni ova at histology.

Conclusion: Given the known late complications of schistosomiasis, and as S. mansoni is endemic in some parts of Tanzania, epidemiological studies are recommended to shed more light on its association with colorectal cancer.
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http://dx.doi.org/10.1186/s12957-017-1217-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541651PMC
August 2017
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