echem richard | University of Port Harcourt (original) (raw)
Papers by echem richard
International surgery
A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcou... more A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcourt Teaching Hospital (UPTH) in the period 1994-1998 is presented. All the patients were males with an average age of 43.4 years. Most of the patients had a predisposing factor. There was a low incidence of pre-existing medical conditions. The commonest organisms isolated were of the enterobacteria group. All the patients were treated with antibiotics, surgical debridement and frequent wound dressings with hypertonic saline, hydrogen peroxide and Eusol. In 71.4% of the cases, the wounds healed by secondary intention. The mortality was 9.5%. The deaths occurred in the older age group. We recommend surgical debridement of necrotic tissues as they present and suggest that the surgical procedures be minimal as scrotal wounds heal satisfactorily.
American Journal of Health, Medicine and Nursing Practice
Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cro... more Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cross Wound Score (RCWS) is a simple classification system that is thought to fairly assess severity of injury, influence surgical management and a good predictor of outcome in gunshot wounds. This study aims to evaluate the correlation between the Red Cross Wound Score RCWS and initial response to management. Methodology: This was a prospective study recruiting all consenting patients who suffered gunshot wounds to any extremity and presented at the University of Port Harcourt Teaching Hospital (UPTH). The study was conducted over a 12-month period between October 2018 and September 2019. Data on demographics, anatomical region of the body involved, type of gun time between injury and hospital presentation were obtained using a proforma. Analysis of extracted data was done by the aid of SPSS for Windows version 20. Findings: A total of 106 wounds from 82 patients were analyzed; seventy mal...
Nigerian journal of clinical practice, 2007
To determine the relative frequencies of types of operations, age and gender distribution of the ... more To determine the relative frequencies of types of operations, age and gender distribution of the patients and the indications for operation in the Urology Unit over a 10-year period between 1989 and 1998. The Urology Unit of the University of Port Harcourt Teaching Hospital. Retrospective. Patients' demographic data were collected from the Main Theatre registers of the Hospital, the Medical Records Department ward records patients' and case note. Those operations done in the Urology Unit were analysed. Urological operations (total 1875) formed 22.6% of all surgical operations in the hospital during the decade under review. There were 1847 males (98.5%) and 28 females (1.5%). The age distribution showed two peaks in the first decade and in the seventh decade. Frequencies of operations were least in the 4th decade and after the 9th decade. Circumcisions, surgery for prostate disease, procedures for urethral strictures, urological trauma and paediatric reconstruction formed the...
African journal of medicine and medical sciences, 2004
The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the ra... more The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the radiological findings may suggest a malignancy. To report a case of chronic pyonephrosis, which even at exploration appeared to be a malignancy. The case record of the patient as well as the literature were reviewed and reported. A 25 year-old woman presented with a 5-year history of left lumbar pain, urinary frequency and intermittent total haematuria. The intravenous urography showed non-function in the left kidney harbouring a calculus. Treatment was delayed for poor finances. At laparotomy a huge renal mass invading the colonic mesentery and showing neovascularisation was removed. The final diagnosis was chronic pyonephrosis. She recovered from postoperative septicaemia. Neovascularisation is a feature of malignant disease mediated by angiogenesis factors. These factors are probably present in chronic inflammation. It is suggested that for nephrectomy, prophylactic antibiotics should b...
African journal of medicine and medical sciences, 2003
The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted... more The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted for analysis included age, sex, clinical features, indications for nephrectomy, post-operative complications and histological findings. Thirty-four unilateral nephrectomies in 21 males and 13 females were done. The patients were aged between 1.5 to 75 years. The predominant presenting features were abdominal pain (76.5%), abdominal mass (70.6%), haematuria (61.8%) and weight loss (47.1%). Diagnostic investigations were intravenous urography and renal ultrasound scan. The major indications for renal exploration included non-functioning kidney and renal mass suspected to be carcinoma. The histopathological findings included renal malignancy 23 (67.6%), hydronephrosis 6 (17.6%) and renal infections 3 (8.8%). The male/female ratio in nephrectomy for malignancy was 1:1.09. Renal trauma was the indication in only one patient. Non-functioning kidneys on intravenous urography (IVU) occurred in ...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
Renal cell carcinoma occasionally presents in an unusual manner. To report the rare presentation ... more Renal cell carcinoma occasionally presents in an unusual manner. To report the rare presentation of renal cell carcinoma as a scalp swelling. The case record of a patient with renal cell carcinoma and the literature on the disease were reviewed. A 42-year old woman presented with a scalp swelling. Haematuria was missed at the first visit until she volunteered it on a subsequent visit. Investigations suggested renal cell carcinoma. This was confirmed following a right nephrectomy. The scalp lesion was a metastasis extending through the skull into the intracranial compartment. She was not given any systemic drugs because none was available. She survived until she was lost to follow up. Haematuria remains an important symptom of renal cell cancer and should be elicited during systemic enquiry.
Urinary catheterization is often performed in the pediatric age group. The procedure although saf... more Urinary catheterization is often performed in the pediatric age group. The procedure although safe, is not free of complications. Knotting of the urinary catheter is a rare but serious complication. A seven-year-old boy presented with left-sided neuroblastoma and underwent an exploratory laparotomy during which it was found that he had an inoperable tumor. There was a nodule obstructing the left ureter. This was resected and an end-to-end anastomosis of the ureter was carried out. A size 8 French (Fr) feeding tube was introduced through the urethra to monitor the patient's urine output and fluid balance in the absence of a self-retaining pediatric catheter. An attempt at removal 48 h later was unsuccessful. The patient was afterwards, on the sixth postoperative day, anaesthetized and the tube was pulled out. It was noticed that the catheter was knotted. The case is reported with a limited discussion of relevant literature. Spontaneous knotting of a catheter is a rare complication. With availability of appropriate catheters and adequate knowledge and skill, this complication can be reduced to the barest minimum.
International surgery
A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcou... more A review of 21 consecutive cases of Fournier's gangrene seen at the University of Port Harcourt Teaching Hospital (UPTH) in the period 1994-1998 is presented. All the patients were males with an average age of 43.4 years. Most of the patients had a predisposing factor. There was a low incidence of pre-existing medical conditions. The commonest organisms isolated were of the enterobacteria group. All the patients were treated with antibiotics, surgical debridement and frequent wound dressings with hypertonic saline, hydrogen peroxide and Eusol. In 71.4% of the cases, the wounds healed by secondary intention. The mortality was 9.5%. The deaths occurred in the older age group. We recommend surgical debridement of necrotic tissues as they present and suggest that the surgical procedures be minimal as scrotal wounds heal satisfactorily.
American Journal of Health, Medicine and Nursing Practice
Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cro... more Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cross Wound Score (RCWS) is a simple classification system that is thought to fairly assess severity of injury, influence surgical management and a good predictor of outcome in gunshot wounds. This study aims to evaluate the correlation between the Red Cross Wound Score RCWS and initial response to management. Methodology: This was a prospective study recruiting all consenting patients who suffered gunshot wounds to any extremity and presented at the University of Port Harcourt Teaching Hospital (UPTH). The study was conducted over a 12-month period between October 2018 and September 2019. Data on demographics, anatomical region of the body involved, type of gun time between injury and hospital presentation were obtained using a proforma. Analysis of extracted data was done by the aid of SPSS for Windows version 20. Findings: A total of 106 wounds from 82 patients were analyzed; seventy mal...
Nigerian journal of clinical practice, 2007
To determine the relative frequencies of types of operations, age and gender distribution of the ... more To determine the relative frequencies of types of operations, age and gender distribution of the patients and the indications for operation in the Urology Unit over a 10-year period between 1989 and 1998. The Urology Unit of the University of Port Harcourt Teaching Hospital. Retrospective. Patients' demographic data were collected from the Main Theatre registers of the Hospital, the Medical Records Department ward records patients' and case note. Those operations done in the Urology Unit were analysed. Urological operations (total 1875) formed 22.6% of all surgical operations in the hospital during the decade under review. There were 1847 males (98.5%) and 28 females (1.5%). The age distribution showed two peaks in the first decade and in the seventh decade. Frequencies of operations were least in the 4th decade and after the 9th decade. Circumcisions, surgery for prostate disease, procedures for urethral strictures, urological trauma and paediatric reconstruction formed the...
African journal of medicine and medical sciences, 2004
The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the ra... more The spectrum of renal tract infections is wide. When the kidney has been severely damaged, the radiological findings may suggest a malignancy. To report a case of chronic pyonephrosis, which even at exploration appeared to be a malignancy. The case record of the patient as well as the literature were reviewed and reported. A 25 year-old woman presented with a 5-year history of left lumbar pain, urinary frequency and intermittent total haematuria. The intravenous urography showed non-function in the left kidney harbouring a calculus. Treatment was delayed for poor finances. At laparotomy a huge renal mass invading the colonic mesentery and showing neovascularisation was removed. The final diagnosis was chronic pyonephrosis. She recovered from postoperative septicaemia. Neovascularisation is a feature of malignant disease mediated by angiogenesis factors. These factors are probably present in chronic inflammation. It is suggested that for nephrectomy, prophylactic antibiotics should b...
African journal of medicine and medical sciences, 2003
The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted... more The case records of patients who had nephrectomy from 1989 to 1998 were retrieved. Data extracted for analysis included age, sex, clinical features, indications for nephrectomy, post-operative complications and histological findings. Thirty-four unilateral nephrectomies in 21 males and 13 females were done. The patients were aged between 1.5 to 75 years. The predominant presenting features were abdominal pain (76.5%), abdominal mass (70.6%), haematuria (61.8%) and weight loss (47.1%). Diagnostic investigations were intravenous urography and renal ultrasound scan. The major indications for renal exploration included non-functioning kidney and renal mass suspected to be carcinoma. The histopathological findings included renal malignancy 23 (67.6%), hydronephrosis 6 (17.6%) and renal infections 3 (8.8%). The male/female ratio in nephrectomy for malignancy was 1:1.09. Renal trauma was the indication in only one patient. Non-functioning kidneys on intravenous urography (IVU) occurred in ...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria
Renal cell carcinoma occasionally presents in an unusual manner. To report the rare presentation ... more Renal cell carcinoma occasionally presents in an unusual manner. To report the rare presentation of renal cell carcinoma as a scalp swelling. The case record of a patient with renal cell carcinoma and the literature on the disease were reviewed. A 42-year old woman presented with a scalp swelling. Haematuria was missed at the first visit until she volunteered it on a subsequent visit. Investigations suggested renal cell carcinoma. This was confirmed following a right nephrectomy. The scalp lesion was a metastasis extending through the skull into the intracranial compartment. She was not given any systemic drugs because none was available. She survived until she was lost to follow up. Haematuria remains an important symptom of renal cell cancer and should be elicited during systemic enquiry.
Urinary catheterization is often performed in the pediatric age group. The procedure although saf... more Urinary catheterization is often performed in the pediatric age group. The procedure although safe, is not free of complications. Knotting of the urinary catheter is a rare but serious complication. A seven-year-old boy presented with left-sided neuroblastoma and underwent an exploratory laparotomy during which it was found that he had an inoperable tumor. There was a nodule obstructing the left ureter. This was resected and an end-to-end anastomosis of the ureter was carried out. A size 8 French (Fr) feeding tube was introduced through the urethra to monitor the patient's urine output and fluid balance in the absence of a self-retaining pediatric catheter. An attempt at removal 48 h later was unsuccessful. The patient was afterwards, on the sixth postoperative day, anaesthetized and the tube was pulled out. It was noticed that the catheter was knotted. The case is reported with a limited discussion of relevant literature. Spontaneous knotting of a catheter is a rare complication. With availability of appropriate catheters and adequate knowledge and skill, this complication can be reduced to the barest minimum.