A study of extracranial aneurysms at UNTH in Enugu, Nigeria.

BACKGROUND Previous studies on aneurysms in Nigeria have either been case reports or studies of peripheral aneurysms. No study has comprehensively evaluated all aspects of this disease as an entity among Nigerians. The need therefore arises to re-evaluate this lesion so as to make deductions on incidence, sex ratio, aetiology and management. STUDY DESIGN This is a retrospective descriptive study of arterial aneurysms at the University of Nigeria Teaching Hospital (UNTH), Enugu. Those treated between January 1993 and December 2002 were included for the study. Data were obtained from medical records for all patients admitted with aneurysms over the study period. RESULTS Atotal of 26 patients were admitted during the period, but 24 case notes were analysed. The age range was 10-75 years with male: female ratio of 1.4:1. Traumatic pseudo aneurysms accounted for 16 cases (67.0%) while true aneurysms comprised the remaining. Of all the aneurysms, femoral artery with most of the pseudo aneurysms had 8 out of 24 (33.0%). This is followed by the infra-renal abdominal aorta (5/24, 21.0%) and other sites (11/24, 46.0%). Diagnoses were made clinically in most cases and by abdominal ultrasonography in abdominal aortic aneurysms. Twenty-one patients had surgical intervention with 9.5% operative mortality. CONCLUSION The incidence of aneurysm is low in our locality (2.6/year) based on the rate of diagnosis. Abdominal aorta harbours most of the true aneurysms with diameter ranging from 8.0-15.0 cm without rupture. Untreated, all will eventually rupture with catastrophic consequences. Treatment involved excision with graft interposition. This is not only expensive but the graft is often not readily available. As a solution, grafts should be stocked with drug revolving fund.