A dissertation of ten surgical conditions

This dissertation of ten common surgical conditions is submitted as part of the requirements for the degree of Master of Medicine (M.Med.) in Surgery awarded by the University of Dar es Salaam. It consists of three main sections which have been arranged in such a way that five conditions constitute General surgery problems, three conditions for urological problems and two conditions in orhtopaedics and trauma. For each condition, a summary of the important features and results of the patients managed are presented in tabular form and a patient is presented in details as a case report and the literature on the subject is reviewed. Emphasis is put on the various modes of therapy including advances and any controversies known comparing with our ways of treatment within the existing facilities. Illustrations are included where necessary and various references are quoted. Endemic non toxicgoitre is a very common surgical and public health problem that needs proper and adequate surgical intervention for the benefit of our people. Acute cholescystitis used to be a common problem in the western world but now it is showing up among our patients. Surgery does wonders especially where the disease is associated with gallstones. Acute intestinal obstruction is a long time problem that needs surgical intervention for definitive cure. Gastric outlet obstruction due to peptic ulcer disease is now becoming a common surgical disease that responds so well to surgery. Rupture of the spleen especially is on the increase and many people have died from intra-abdominal haemorrhage due to severely ruptured spleens. Early recognition of this problem is very essential. Benign prostatic hyperolasia is a very common urological problem that affects males above the age of 40 and since our life expectancy is increasing this problem should be viewed in that perspective . Undescended testes (Cryptorchism) is another urological problem that needs early surgical correction to avoid the nasty sequelae of testicular malignancy and infertility. Urethral strictures in the male are a real problem to patient and the surgeon as a lot of patience is needed in the management of these cases. The surgical outcome may be very rewarding or very distressing to the patient who may end up with a normally functioning urethra or constant life bouginage. Tibial shaft fractures is a very common orthopaedic problem whose management should take into consideration the septic nature of the injury as the majority are compound fractures. Another common orthopaedic problem is posterior dislocation of the hip whose management involves early reduction as an emergency to guard against the unwanted complications that may follow if it is left unreduced.