Aerodigestive foreign bodies (FBs) aspiration is a common problem in children; however, simultaneous aerodigestive localisation is rare. Ingestion of multiple magnetic FBs can lead to serious complications, especially tr...Aerodigestive foreign bodies (FBs) aspiration is a common problem in children; however, simultaneous aerodigestive localisation is rare. Ingestion of multiple magnetic FBs can lead to serious complications, especially tracheo-oesophageal fistula and recurrent chest infections. These depend on the duration of foreign-body ingestion/aspiration, prompt intervention and adequate technique for foreign-body retrieval. A 1.8-year-old female child was found to have two magnetic FBs lodged simultaneously in the oesophagus and trachea. The magnetic FBs in the aerodigestive tract in children were removed in the same session using flexible endoscopes.
A large number of congenital anomalies often involve the umbilicus. This is a report of two such anomalies together in an infant. The child had a mass protruding from the umbilicus since birth. The urachus was noted to b...A large number of congenital anomalies often involve the umbilicus. This is a report of two such anomalies together in an infant. The child had a mass protruding from the umbilicus since birth. The urachus was noted to be patent on voiding cystourethrogram. On exploration, a patent vitellointestinal duct was also noted. Resection and anastomosis was done for the vitellointestinal duct, and the urachus was excised close to the dome of the bladder. Histopathological examination confirmed a tube lined by intestinal epithelium and the urachal remnant showing a dense fibrous tube-like structure. The omphalo-mesenteric vessels are located between the urachus and the patent vitellointestinal duct, and care should be taken while incising or dissecting in this region to prevent bleeding.
BACKGROUND: Although congenital ureteropelvic junction (UPJ) obstruction is the most common cause of neonatal hydronephrosis, aetiopathogenesis is still inconclusive. Recently, the paucity of interstitial cells of Cajal...BACKGROUND: Although congenital ureteropelvic junction (UPJ) obstruction is the most common cause of neonatal hydronephrosis, aetiopathogenesis is still inconclusive. Recently, the paucity of interstitial cells of Cajal (ICC) at the narrow adynamic part of UPJ has been implicated as a causative factor. MATERIALS AND METHODS: This prospective study was conducted between October 2019 and March 2022 to find out the density of ICC by the immunohistochemical method using CD117 (c-kit) antibody, in resected segments of UPJ in obstruction patients and in renal tumour patients as control. ICC/high power field (hpf) was also studied from the margins of the resected segment in the obstruction group. The pre-operative and post-operative sonographic and renal scintigraphic features were compared. RESULTS: The median age of patients in the study group (n = 25) was 36 months and in the control group was 39 months. The mean ICC/hpf at the stenotic part of UPJ in the study group was 3.56 ± 1.26 and in the control group was 12.56 ± 1.89 (P = 0.0001). ICC density from the proximal and distal margins of the resected segment was 11.12 ± 2.12 and 11.68 ± 1.62, respectively (P < 0.001). The post-operative antero-posterior diameter of the renal pelvis and differential renal function showed significant improvement in comparison to the pre-operative value (P = 0.0045 and 0.0005, respectively). CONCLUSIONS: The significant decrease in the density of ICC at the stenotic part of UPJ compared to controls suggests a pacemaker role of these cells in ureteral peristalsis and the aetiopathogenesis of UPJ obstruction. Histopathological analysis of ICC should not only be limited to the stenotic part of UPJ but also should focus on the anastomosed ends of the ureter, which reflects post-pyeloplasty outcome.
Tumours of the adrenal cortex are most commonly seen in adults but rare in children. The clinical manifestations depend on the age and sex of patients; about two-thirds of the cases virilisation is the predominant presen...Tumours of the adrenal cortex are most commonly seen in adults but rare in children. The clinical manifestations depend on the age and sex of patients; about two-thirds of the cases virilisation is the predominant presentation, whereas many presents with both virilisation and cushingoid features. Diagnosis is confirmed by hormonal evaluation and radiological investigations. Surgical removal is the mainstay of treatment. Usually, there is a good prognosis in paediatric patients, whereas the high mortality rate reported in older literature may have been due to big tumour size, post-operative complications and inadequate steroid replacement. Here, we are presenting a series of three cases during childhood with virilising features due to adrenocortical tumours. All of them presented predominantly with features suggestive of virilisation. All patients underwent surgery and had a good outcome despite big tumour size in one of the patients. Histology revealed a benign lesion in the form of adrenal adenoma. Most virilisation and cushingoid features disappeared in the follow-up (median - 1 year). Although these tumours are rare, a high index of suspicion should be kept in children with cushingoid features, virilisation or a combination of both of them. Even if the tumour size is big, adequate steroid replacement and supportive management postoperatively have led to good prognosis in our patients.
BACKGROUND: Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidenc...BACKGROUND: Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing. AIM: The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India. MATERIALS AND METHODS: This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre-hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed. RESULTS: Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%). CONCLUSION: The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country-made gun was the most common firearm causing injury in children.
AIM: The aim of this study is to report our experience in the treatment of congenital buried penis using a simplified technique of retrograde progression of inner preputial skin for reconstruction and overcome skin short...AIM: The aim of this study is to report our experience in the treatment of congenital buried penis using a simplified technique of retrograde progression of inner preputial skin for reconstruction and overcome skin shortage. METHODS: This is a retrospective multi-institutional study conducted in the Department of Pediatric Surgery, I Q City Medical College and Hospital, Durgapur, West Bengal, India, and the Department of Paediatric Surgery, Rajiv Gandhi Super Specialty Hospital/Raichur Institute of Medical Sciences, Raichur, Karnataka, India, over a period of 3 years (from March 2019 to February 2022). A total of 14 cases of primary congenital buried penis were operated in the specified period. Age of the patients ranged between 8 months and 9 years. Retrograde progression of the inner preputial skin to provide coverage to the dorsal aspect of penile shaft and ventral transposition of the dorsal penile skin to cover the ventral penile shaft was used as a standard procedure for skin coverage. RESULTS: All patients had good-to-excellent outcomes with uniformly improved visualisation of penile shaft post-operatively. There were no significant post-operative complications apart from mild oedema which subsided over a period of 3 weeks. Genital hygiene had significantly improved in all the patients as a result of uninterrupted urinary stream. CONCLUSION: Retrograde progression of the inner preputial skin may be used as an effective technique to provide skin coverage to the penile shaft for reconstruction of congenital buried penis. It provides good functional and cosmetic results with adequate parental and patient satisfaction with minimal complications.
Scrotoschisis (extracorporeal testicular ectopia) is a rare congenital defect of the scrotal sac associated with the extrusion of one or both testicles. The exact mechanism causing the anomaly is largely unknown. This is...Scrotoschisis (extracorporeal testicular ectopia) is a rare congenital defect of the scrotal sac associated with the extrusion of one or both testicles. The exact mechanism causing the anomaly is largely unknown. This is a report of two infants aged 3 and 4 days, respectively, presented with infected unilateral extracorporeal testicular ectopia. Both infants had orchidopexy and repair of the scrotal defect following debridement of the infected defects and administration of broad-spectrum parenteral antibiotics. The infants have remained well at 3 years of follow-up. The isolated unilateral disease was described by several authors. Delayed presentation in scrotoschisis results in superimposed infection which complicates surgical management resulting in a prolonged hospital stay.
INTRODUCTION: Adduction and medial rotation shoulder contracture are prevalent in unresolved neonatal brachial plexus palsy (NBPP). Various surgical options exist, including open anterior subscapularis release, to addres...INTRODUCTION: Adduction and medial rotation shoulder contracture are prevalent in unresolved neonatal brachial plexus palsy (NBPP). Various surgical options exist, including open anterior subscapularis release, to address this condition. This study assessed the outcomes of this procedure. MATERIALS AND METHODS: This cross-sectional, observational study focused on a cohort of children aged over 12 months who underwent open anterior subscapularis release to remedy residual shoulder contracture from upper or global NBPP over 11 years. The Mallet score was utilised to appraise deficits in shoulder function. RESULTS: The study included 32 patients. The sex ratio was 0.78. The median age at surgery was 36 months (25; 56). The right side was affected in 75% of cases. The median improvement in the Mallet score after subscapularis release was 4 (2; 6). This enhancement was statistically significant (P < 0.001), with a median follow-up duration of 78 months (72; 82). There was a substantial increase in shoulder abduction (P < 0.001) and lateral rotation (P < 0.001). Hand-to-mouth (P < 0.001) and hand-to-head (P < 0.001) manoeuvres exhibited significant enhancement. The hand-to-spine manoeuvre did not show a substantial alteration. A significant correlation was found between the injury severity and the enhancement of the Mallet score post-surgery (P = 0.009). CONCLUSION: Open anterior subscapularis release yielded significant mid-term functional enhancements in shoulder motion, with no modification in medial rotation. Improvements were observed even in children beyond 4 years of age, with those having more severe injuries showing greater functional recovery.
BACKGROUND: In developing countries, motorcycles are a widespread transportation method, leading to a notable increase in road traffic injuries, particularly those involving the ankle and foot caused by motorcycle wheel...BACKGROUND: In developing countries, motorcycles are a widespread transportation method, leading to a notable increase in road traffic injuries, particularly those involving the ankle and foot caused by motorcycle wheel spokes. AIMS AND OBJECTIVES: Our study sought to understand the epidemiological features and characteristics of motorcycle-induced wheel spoke injuries to the ankle and foot in children. The objectives were to comprehend injury patterns, evaluate their severity and pinpoint clinical indicators predicting injury nature and extent, aiming to guide prevention strategies. MATERIALS AND METHODS: We conducted a cross-sectional observational study with a retrospective data collection focused on children under the age of 16 years who sustained injuries from motorcycle rear wheel spokes while riding as pillion passengers and were admitted to our department over 11 years, from 1 January 2010 to 31 December 2020, with a minimum follow-up of 2 years. Soft tissue wounds were classified using the Oestern-Tscherne classification. RESULTS: Thirty patients were enrolled in this study. Before 2015, cases ranged from none to one annually, increasing to 2-7 cases per year after 2015. The average age was 6.7 ± 2.1 years. Significantly, more patients were older than 6 years (P < 0.001), injured on the right side (P < 0.001) and suffered the injuries in the afternoon (P < 0.001). All patients were pillion and were injured by the motorcycle's rear wheel. Twenty-five patients (83%) had a Grade 3 injury. There was a tendon rupture in 22 (73%) and a bone fracture in 15 (50%) patients. Loss of soft tissue (P = 0.036) and reduced ankle mobility (P = 0.046) were linked to tendon ruptures. Lengths of wound exceeding 6 cm (P = 0.025) and loss of soft tissue (P = 0.025) were associated with a bone fracture. CONCLUSION: Children's motorcycle wheel spoke injuries have increased in recent years. Loss of soft tissue and ankle mobility deficit proved to be reliable clinical signs of a tendon rupture. A wound length exceeding 6 cm and a loss of soft tissue were indicative of a related bone fracture.
BACKGROUND: Acute appendicitis (AA) is a frequent and emergent surgical abdominal condition that presents some particularities and challenges in young children. PATIENTS AND METHODS: Data of 402 children aged <16 years w...BACKGROUND: Acute appendicitis (AA) is a frequent and emergent surgical abdominal condition that presents some particularities and challenges in young children. PATIENTS AND METHODS: Data of 402 children aged <16 years with a confirmed diagnosis of AA were retrospectively reviewed. Included patients were divided into two groups: Group A (preschool children aged ≤5 years, n = 44) and Group B (school children aged >5 years, n = 358). Clinical presentation, biological findings, calculated diagnosis scores (paediatric appendicitis score [PAS] and Alvarado score), intraoperative findings and outcomes were comparatively analysed between the two groups. RESULTS: Children of Group A had more likely fever, bowel disorders, diffuse abdominal pain and diffuse tenderness than those of Group B (P = 0.001, P = 0.005, P = 0.006 and P = 0.001, respectively). Regarding biomarkers, the mean of white blood cell count and C-reactive protein levels was higher in Group A than in Group B (18,849 cell/mm3 and 162.8 mg/L in Group A versus 15,938 cell/mm3 and 86.7 mg/L in Group B, P = 0.003 and < 0.001, respectively). The mean of calculated PAS and Alvarado scores was higher in Group A than in Group B (8.2 ± 1.1 and 8.2 ± 1 vs. 7.5 ± 1.4 and 7.4 ± 1.5, P = 0.003 and P = 0.001, respectively). Most children with a calculated PAS and Alvarado score equal to or higher than 8 belonged to Group A (PAS: 84.1% vs. 58.4%, P = 0.001, Alvarado score: 84.1% vs. 55.6%, P < 0.001). The perforation of the appendix was seen in 77.3% of Group A patients and only in 41.5% of children in Group B (P < 0.0001). The mean length of stay was 5.1 ± 1.9 days in Group A and 4.3 ± 2.8 days in Group B but without any statistical difference between the two groups (P = 0.094). CONCLUSION: AA in preschool children is associated with atypical presentation and rapid progression of the disease making the early diagnosis mostly challenging in our settings.
Hypospadias is one of the most common and extensively studied pathology of paediatric surgery. Although a plethora of research articles describing hypospadias and its variants exist, new variants are often encountered an...Hypospadias is one of the most common and extensively studied pathology of paediatric surgery. Although a plethora of research articles describing hypospadias and its variants exist, new variants are often encountered and they never cease to surprise us. We, in our case, are trying to add a drop to the sea of variants of hypospadias. A 2-year-old boy was brought with an abnormally large and patulous urethral opening at the mid-penile region with intact prepuce and chordee. In this case report, we will review the available literature on this rare variant and discuss its management.
INTRODUCTION: Posterior fossa tumors are significant in pediatric neurooncological populations due to their frequency and morbimortality. We convey a 10-year experience managing pediatric posterior fossa tumors at two re...INTRODUCTION: Posterior fossa tumors are significant in pediatric neurooncological populations due to their frequency and morbimortality. We convey a 10-year experience managing pediatric posterior fossa tumors at two reference centers in Cameroon. MATERIALS AND METHODS: We conducted a cross-sectional study with data collected retrospectively in the Neurosurgery Department of the Central and General Hospitals of Yaounde from January 2010 to December 2019. Included in the study were all patients aged 0-15 years who underwent surgery for posterior fossa tumors. RESULTS: We retained 43 pediatric posterior fossa tumor files, representing 47.89% of pediatric brain tumors. The male/female sex ratio was 0.86, with a mean age of 6.93 ± 4.345 years. The predominant clinical presentations were headaches + vomiting (97.7%), visual impairment (67.4%), and altered consciousness (14%). The vermis was the most frequent site affected (46.5%). Hydrocephalus was found to be associated with the tumor in 30 patients (69.8%). Tumor excision was total in 90.7% of cases, with cerebrospinal fluid diversion performed within the surgery in 83% of cases. Pilocytic astrocytomas represented 37.2%, medulloblastomas 30.25%, ependymomas 6.9%, and brainstem gliomas 4.6%. The postoperatory mortality rate was 20.9%. The survival rate at 5 years for medulloblastomas was 43%. CONCLUSION: Pediatric posterior fossa tumors are frequent. Pilocytic astrocytomas are the most common histologic type, followed by medulloblastomas. Radical surgery is the leading standard of care. Adjuvant treatment remains limited.
BACKGROUND: Anorectal malformation (ARM) is a common congenital anomaly found in the paediatric age group. Previously, the repair of the vestibular fistula (VF) was performed as three-stage procedure with initial colosto...BACKGROUND: Anorectal malformation (ARM) is a common congenital anomaly found in the paediatric age group. Previously, the repair of the vestibular fistula (VF) was performed as three-stage procedure with initial colostomy followed by a definite procedure and, lastly, colostomy closure. At present, a single-stage procedure is preferred, especially in lower anomalies owing to the convenient and time-saving approach. OBJECTIVE: The clinical profile and outcome of ASARP for treatment of ARM in females (vestibular anus and perineal fistula). METHODS: A retrospective analytical study was conducted at Government Medical College, Jammu. A total of 60 patients were included in the study. RESULTS: Most of the patients were in the age group of 1-5 years (30%), followed by 6 months-1 year age group (25%). Forty-five (75%) females had VF while 15 (25%) had perineal fistula. Intraoperative complication was vaginal tear seen in 6 (10%) patients followed by rectal tear seen in 3 (5%) patients. Early post-operative complications were seen in 9 (15%) patients. Wound infection was the most common complication seen in 5 (8.3%) patients, wound dehiscence in 3 (5%) patients and retraction of rectum in 1 (1.6%) patient. Late post-operative complications were seen in 24 (40%) patients. Perineal excoriation was the most common complication seen in 6 (10%) patients, constipation seen in 5 (8.3%) patients, anal stenosis in 4 (6.6%) patients and mucosal prolapse in 4 (6.6%) patients. CONCLUSION: The single-staged ASARP procedure resulted in satisfactory outcomes. It is an excellent procedure for females with VF and perineal fistula. Appropriate selection, preparation of patient, optimal correction with minimal sphincter damage and needful post-operative care of wound give excellent cosmetic and functional outcomes in terms of continence. It also decreases the burden on treating the surgeon, family and psychological stress on the patients and parents.
Sadjo SA, Destinval C, Kouassi-Dria SAK
… +6 more, Lienard J, Ranke A, Larmure O, Berte N, Gomola V, Lemelle JL
Afr J Paediatr Surg
· 2024 Oct · PMID 39279623
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Epidermoid splenic cyst is a rare benign tumour in children, accounting for 10% of all cystic lesions of the spleen and is the most common diagnosis of non-parasitic splenic cysts. Its discovery could be incidental or ha...Epidermoid splenic cyst is a rare benign tumour in children, accounting for 10% of all cystic lesions of the spleen and is the most common diagnosis of non-parasitic splenic cysts. Its discovery could be incidental or happen after an imaging workup for a mass or abdominal pain. Since total splenectomy exposes a patient to the occurrence of overwhelming post-splenectomy infection, laparoscopic partial splenectomy has been increasingly popular over the past two decades because it preserves the immune function of the spleen. This technique should only be performed by a well-trained team because of the high risk of bleeding. The authors report the cases of three patients who underwent laparoscopic partial splenectomy: a 7-year-old girl with no relevant history with a 4.5-cm epidermoid cyst involving the lower pole of the spleen, a 13-year-old boy, type 1 diabetic on insulin therapy, with a 7-cm epidermoid cyst of the upper pole of the spleen and a 14-year-old girl, with no previous history, with a 6-cm upper pole epidermoid splenic cyst. Operating times were 2 h 30 min, 3 h and 4 h 30 min, respectively. The intraoperative blood loss was 100 mL, 350 mL and 300 mL, respectively. The length of hospital stay was 6 days for each patient. No blood transfusion was performed perioperatively. With a mean follow-up duration of 21 months (32 months, 21 months and 10 months, respectively), no complication or recurrence occurred.
Afr J Paediatr Surg
· 2024 Oct · PMID 39279622
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The management of obstetric brachial plexus palsy (OBPP) can be challenging, particularly in neglected patients. We report the long-term results of the surgical management of a late-presenting adolescent girl with severe...The management of obstetric brachial plexus palsy (OBPP) can be challenging, particularly in neglected patients. We report the long-term results of the surgical management of a late-presenting adolescent girl with severe left shoulder and elbow flexor paralysis secondary to OBPP. She was subjected to staged shoulder and elbow reconstruction in the form of trapezius transfer and latissimus and teres major transfer to enhance shoulder abduction and lateral rotation, and flexor-pronator transfer to the anterior distal humerus to enhance elbow flexion. Flexor-pronator plasty was successful in restoring elbow flexion and function and maintaining joint stability in the long term in a patient with severe OBPP. This further consolidates its role as a feasible secondary reconstructive procedure in carefully selected patients with elbow flexor paralysis. Shoulder function improved less remarkably, yet it augmented the overall upper extremity function and correlated with pre-operative residual shoulder function. Fulfilling the candidacy for each surgical procedure is important to a successful outcome.
Afr J Paediatr Surg
· 2024 Oct · PMID 39279621
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Presacral tumours are rare developmental tumours associated with midline closure defects. A fifteen-month-old girl presented with pain in the lower abdomen and dysuria. After examination, the child underwent investigatio...Presacral tumours are rare developmental tumours associated with midline closure defects. A fifteen-month-old girl presented with pain in the lower abdomen and dysuria. After examination, the child underwent investigations and was diagnosed as a presacral mass with intergluteal extension and caudal mass in the subcutaneous tissue of the left gluteal region. Complete excision of mass along with coccygectomy was done. Histopathology showed presacral as a keratinous cyst and gluteal as a dermoid cyst. Later on, the child also developed a left facial dermoid cyst which was also excised.
Fahiem-Ul-Hassan M, Jadhav V, Hamid R
… +3 more, Mufti G, Munianjanappa N, Saroja M
Afr J Paediatr Surg
· 2024 Oct · PMID 39279620
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BACKGROUND: Wound dehiscence is one of the main complications in complete primary repair of exstrophy (CPRE). In our pediatric urology unit, we have switched to the use of inferior epigastric artery based rectus abdomini...BACKGROUND: Wound dehiscence is one of the main complications in complete primary repair of exstrophy (CPRE). In our pediatric urology unit, we have switched to the use of inferior epigastric artery based rectus abdominis flap cover for abdominal wall closure in addition to measures like osteotomy and postoperative hip spica. AIM: to assess the efficacy of Recus abdominis flap in prevenion of wound dehisence. METHODS: This study was conducted from June 2014 to June 2021 comparing two groups of the patients; group I consisted of thirty patients of CPRE with rectus flap repair of abdominal wall (CPRE-RF) and group II consisted of thirty patients with CPRE without rectus flap. Clinical and surgical details, including the outcome with regards to wound dehiscence and continence, were recorded. RESULTS: The mean age of the patients in CPRE-RF was 5 months and that with only CPRE was 4.6 months. Mean pubic diastasis in Group l was 4.8± 1.07 cm and that of Group II was 4.6±1.3 cm. None of the patients in CPRE-RF had wound dehiscence or bladder prolapse while as 6 patients in CPRE alone had wound dehiscence and 1 had bladder prolapse. This difference was statistically significant. Primary bladder continence was achieved in 4 patients in CPRE-RF and 3 patients in CPRE group. Hypospadias had almost similar occurrence in the two groups. One patient in each group had bladder neck fistula. CONCLUSION: Use of rectus muscle flap in complete Primary Repair ofExtrophy bladder helps in prevention of wound dehiscence and contributes in achievement of final goal of continence in wide gap pubic diatasis.
Afr J Paediatr Surg
· 2024 Oct · PMID 39279619
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BACKGROUND: Hypospadias is one of the common congenital anomalies of male genitalia. Although over 300 different operative techniques have been described, post-operative complications are still common, of which glans deh...BACKGROUND: Hypospadias is one of the common congenital anomalies of male genitalia. Although over 300 different operative techniques have been described, post-operative complications are still common, of which glans dehiscence (GD) is the most severe complication requiring redo urethroplasty. Some surgeons use the vascular flap to cover the glanular part of the neourethra to prevent GD, but there are controversies regarding its usefulness. There is a paucity in the literature, about articles evaluating the risk of GD associated with vascular flap coverage of the glanular neourethra during primary urethroplasty. MATERIALS AND METHODS: We planned a single-blinded, parallel-design, randomised controlled trial involving 56 cases of hypospadias treated with single-stage urethroplasty amongst the admitted cases of hypospadias for primary urethroplasty in the Department of Paediatric Surgery, AIIMS, Bhubaneswar, from November 2017 to December 2019 as an M.Ch. thesis project. This was approved by the Institutional Ethics Committee and enrolled in the national registry of clinical trial. 28 patients were randomised into Group A (without flap coverage of the glanular part of the neourethra) and 28 patients were randomised into Group B (with flap coverage of the glanular neourethra). RESULTS: Only 2 (7.1%) cases amongst the Group A patients developed GD, while 9 (32.1%) cases of Group B had GD (P = 0.013). CONCLUSIONS: Extending the vascular flap coverage up to the glanular part of the neourethra till the neo-meatus during primary urethroplasty is significantly associated with GD.
Salahoudine I, Othmane A, Abdelhalim M
… +2 more, Khalid K, Youssef B
Afr J Paediatr Surg
· 2024 Oct · PMID 39279618
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BACKGROUND: Intestinal intussusception is the most common cause of intestinal obstruction in infants and children under 3 years of age. Any delay in diagnosis or management can lead to intestinal ischaemia and perforatio...BACKGROUND: Intestinal intussusception is the most common cause of intestinal obstruction in infants and children under 3 years of age. Any delay in diagnosis or management can lead to intestinal ischaemia and perforation. The aim of this study is to determine the sociodemographic and clinical risk factors associated with bowel resection in infants and children with intussusception. MATERIALS AND METHODS: This is a retrospective analytical study of 118 patients operated at the Hassan II Hospital and University of Fez between 1 January 2008 and 1 January 2018. A comparison of risk factors between patients with and without bowel resection was performed using multivariate logistic regression. RESULTS: One hundred and eighteen patients met the inclusion criteria. Of these, 44% had undergone bowel resection. Age >2 years (P = 0.006), duration of symptoms progression of more than 2 days (P = 0.002), bilious vomiting (P = 0.04) and palpation of an abdominal mass (P = 0.01) were significantly associated with bowel resection. Multivariate logistic regression showed that age <2 years (odds ratio [OR] =4.47 95% confidence interval [CI]: 1.12-17.78) and duration of symptom progression of more than 2 days (OR = 2.62 95% CI: 1.12-6.11) were independent risk factors for bowel resection. CONCLUSION: Intussusception that occurs in child old than 2 years of age, or which has progressed for more than 2 days, is associated with an increased risk of intestinal resection.