African journal of paediatric surgery : AJPS最新文献

{"title":"Primary Anterior Sagittal Anorectoplasty Shift from Staged to Single-stage Procedure for Low Anorectal Malformations in Female Children: Our Initial Experience in Single Centre.","authors":"Ab Hamid Wani, Narinder Singh, Gurbir Singh, Satish Parihar","doi":"10.4103/ajps.ajps_116_23","DOIUrl":"10.4103/ajps.ajps_116_23","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>The clinical profile and outcome of ASARP for treatment of ARM in females (vestibular anus and perineal fistula).</p><p><strong>Methods: </strong>A retrospective analytical study was conducted at Government Medical College, Jammu. A total of 60 patients were included in the study.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Gastrointestinal Perforations: A 4-year Experience in a Single Centre.","authors":"Gonca Gerçel, Ali Ihsan Anadolulu","doi":"10.4103/ajps.ajps_96_23","DOIUrl":"10.4103/ajps.ajps_96_23","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal perforation (GIP) during the neonatal period is still a significant problem despite improved neonatal care. The study aimed to report on incidence, management, morbidity and mortality.</p><p><strong>Material and methods: </strong>Records of neonates with GIPs between October 2018 and November 2022 were retrospectively analysed.</p><p><strong>Results: </strong>There were 47 patients, 22 (46.8%) males and 25 (53.2%) females. The incidence of neonatal GIP was 0.39% amongst all newborns treated in the neonatal intensive care unit. The mean gestational age was 30.4 ± 4.5 (23-38) weeks, and the mean birth weight was 1493.08 ± 753 (580-2940) g. Of 47 neonates, 5 (10.6%) were full term and 42 (89.4%) were preterm. The mean age of surgery was 12.25 ± 9.89 (0-41) days. A laparotomy was performed in 43 (91.4%) of 47 neonates, while seven of the patients underwent surgical intervention after decompression by percutaneous drainage. Four patients were managed with peritoneal drainage alone due to poor general condition. The pathologies unrelated to necrotising enterocolitis (NEC) were the most common cause of GIPs (55.3%) and included spontaneous intestinal perforation (n = 18), stomach perforation (n = 4), segmental volvulus (n = 2), acute mesenteric ischaemia (n = 1) and meconium peritonitis (n = 1). Overall survival was 55.4%.</p><p><strong>Conclusion: </strong>GIPs are one of the most significant causes of mortality in newborns. The most common cause of perforations is non-NEC entities and can be seen in the entire intestinal system from the stomach to the colon. Surgical exploration is still the primary management model.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Anal Position Indexes from Anal Dimple and Neoanus at Sphincter Muscle Complex in Children with High Anorectal Malformations in Kano, Nigeria.","authors":"Bilyaminu Ibrahim Liman, Muhammad Aminu Mohammed, Lofty-John Chukwuemeka Anyanwu, Lawal Barau Abdullahi, Sani Ali Aji, Muhammad Salele Aliyu, Bashir Sa'ad, Rabiu Ibrahim Jalo, Atiku Mamuda, Mujahid Muhammad Hassan, Abubakar Nagoma Usman","doi":"10.4103/ajps.ajps_100_23","DOIUrl":"10.4103/ajps.ajps_100_23","url":null,"abstract":"<p><strong>Background: </strong>Anorectal malformations (ARMs) comprise a spectrum of congenital anomalies that continue to present a challenge to patients, caregivers and paediatric surgeons. The main objective of this study was to determine the anal position index (API) from anal dimple and neoanus at the sphincter muscle complex in children with high ARM.</p><p><strong>Methods: </strong>Using a cross-sectional study design, the API was assessed from anal dimple and neoanus at the sphincter muscle complex in children with high ARM. All eligible children with high ARM who presented to AKTH during the study period were recruited into the study.</p><p><strong>Results: </strong>Forty eligible patients with an age range of 8 months to 108 months were recruited. Twenty-five were males (62.5%) with a male: female ratio of 1.7:1. The mean pre-operative API using anal dimple was 0.47 ± 0.05, while that of the post-operative API using neoanus was 0.53 ± 0.04. There was a statistically significant difference between the two indices (t = -11.8, P < 0.01). There was also a statistically significant difference amongst male and female indices P < 0.05, but there were no significant differences between different age groups.</p><p><strong>Conclusion: </strong>This study has shown that there was a statistically significant difference between the pre-operative API and post-operative API; thus, the position of the anal dimple does not significantly predict the central position of the sphincter muscle complex.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Histologic, and Therapeutic Pattern of Posterior Fossa Tumors in Children in Cameroon: A Cross-sectional Study.","authors":"Bello Figuim, Oumarou Haman Nassourou, Ndouh Roland Nchufor, Ewane Khadije Gael Nicaise, Ndome Toto Orlane, Djientcheu Vincent de Paul","doi":"10.4103/ajps.ajps_37_23","DOIUrl":"10.4103/ajps.ajps_37_23","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Review of the Management of Impacted Coin Ingested in Children.","authors":"Kmj Kasakanga, A Groenewald, M E Mabitsela, N Tshifularo","doi":"10.4103/ajps.ajps_114_23","DOIUrl":"10.4103/ajps.ajps_114_23","url":null,"abstract":"<p><strong>Introduction: </strong>Accidental coin ingestion is a common presentation amongst paediatric patients in emergency departments (ED) worldwide, necessitating prompt management to prevent complications.</p><p><strong>Objectives: </strong>This study aimed to describe the clinical features of paediatric patients with impacted oesophageal coins at Dr. George Mukhari Academic Hospital ED and compare outcomes between the balloon catheter and oesophagoscopic techniques for coin extraction.</p><p><strong>Methods: </strong>This was a retrospective review of the medical records of patients aged ≤12 years over 5 years. Data were collected from the hospital records and analysed using SAS® (SAS Institute Inc, Cary, NC), Release 9.3, running under Microsoft Windows.</p><p><strong>Results: </strong>The analysis included 95 patients (51 females, 44 males) with a median age of 3 years, ranging from 0.70 to 10 years. Coins were predominantly located in the upper oesophagus (71.6%). Thirty-five (36%) children presented 8 h after the ingestion of the coin. At presentation, 82 (86.3%) patients were asymptomatic. The most observed symptoms were hypersalivation in 17 (17.9%) patients and vomiting in eight (8.4%) patients. Of the 62 patients for whom the balloon catheter was solely used, it was successful in 77.4% of the cases. Rigid oesophagoscopy was used in 33 patients as the first procedure (34.7%), and its overall success rate was 100% (44 patients).</p><p><strong>Conclusion: </strong>This study contributes valuable insights into the management of oesophageal coin ingestion in a resource-constrained setting, emphasising the safety and efficacy of the balloon catheter and the role of rigid oesophagoscopy in cases of failure or delayed presentation.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virilising Adrenal Adenoma in Children.","authors":"Anjali Verma, Yogender Singh Kadian, Pradeep Kajal, Md Mokarram Ali, Kusum Lata, Surender Verma","doi":"10.4103/ajps.ajps_94_23","DOIUrl":"10.4103/ajps.ajps_94_23","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendicitis in Children: Does Age Really Matter?","authors":"Kamal El Haissoufi, El Hassan Hadi, Salaheddine Habib, Hanane Aissaoui, Mariam Atassi, Abdelouhab Ammor, Houssain Benhaddou","doi":"10.4103/ajps.ajps_99_23","DOIUrl":"10.4103/ajps.ajps_99_23","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis (AA) is a frequent and emergent surgical abdominal condition that presents some particularities and challenges in young children.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>AA in preschool children is associated with atypical presentation and rapid progression of the disease making the early diagnosis mostly challenging in our settings.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-operative Pain Control: A Comparison between Bupivacaine and Tramadol Local Wound Infiltration in Children Undergoing Herniotomy and Orchidopexy.","authors":"Efosa Aisien, Chukwuemeka Ndubuisi Chibuzom, David Osarumwense Osifo, Iyekeoretin Evbuomwan","doi":"10.4103/ajps.ajps_172_22","DOIUrl":"10.4103/ajps.ajps_172_22","url":null,"abstract":"<p><strong>Background: </strong>Post-operative pain control improves patient's satisfaction and affects the period of admission. Local wound infiltration following hernia surgery using xylocaine or bupivacaine has been a common practice. The use of tramadol for such infiltration is relatively new and has not been studied in our environment. This study compared the efficacy of post-operative pain control between Bupivacaine and Tramadol wound infiltration in children who underwent herniotomy and orchidopexy.</p><p><strong>Materials and methods: </strong>This was a prospective randomised study involving 104 patients. A simple random method was used to allocate the study group into two equal groups (A, n = 52 and B, n = 52) using sealed envelopes with contents labelled A or B. Pre- and post-operative respiratory rate, heart rate, and C-reactive protein (CRP) were all recorded. Time to first and subsequent analgesia was determined using face, legs, activity, cry, consolability (FLACC) pain score.</p><p><strong>Results: </strong>Fifteen patients in Group A and 18 patients in Group B received each two doses of supplemental analgesia within the first 24 h, ( P = 0.527). Time to first analgesia was significantly different between the two groups, (6.93 ± 0.80 h and 6.11 ± 1.08 h, P = 0.020). The mean FLACC pain score at the time of first analgesia in hours was 4.93 ± 0.59 and 4.72 ± 0.67 for Group A and B, respectively, P = 0.350. The changes in CRP were not different in the two groups, ( P = 0.665). Four patients in Group A, but none in Group B had an episode each of post-operative vomiting.</p><p><strong>Conclusion: </strong>Tramadol showed comparable efficacy with bupivacaine in post-operative pain control by wound infiltration in children who had unilateral herniotomy or orchidopexy. Tramadol, however, achieves a longer duration of action before rescue analgesic is required. Caution is necessary to avoid post-operative vomiting.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"217-222"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative Serum Albumin Predicts Native Liver Survival in Biliary Atresia.","authors":"Kakeru Machino, Kotaro Mimori, Seiya Ogata, Yosuke Minami, Hirofumi Shimizu, Michitoshi Yamashita, Hideaki Tanaka","doi":"10.4103/ajps.ajps_158_22","DOIUrl":"10.4103/ajps.ajps_158_22","url":null,"abstract":"<p><strong>Background: </strong>To predict native liver survival (NLS) after Kasai portoenterostomy (KP) for biliary atresia (BA) using pre-operative clinical data.</p><p><strong>Materials and methods: </strong>Pre-operative data were collected from 29 patients with BA who underwent KP at our department between 1989 and 2017 and were analysed including serum albumin, bilirubin, prothrombin time-international normalised ratio, body height, body weight, age at KP, paediatric end-stage liver disease score calculated using the pre-operative data and the period of NLS.</p><p><strong>Results: </strong>The 10-year NLS rate of all patients was 51%. A multivariate analysis revealed that among all factors, the pre-KP serum albumin level was the only independent predictor of NLS ( P = 0.04, hazard ratio = 0.269, 95% confidence interval = 0.077-0.934). The area under the receiver operating characteristic curve for NLS, determined using pre-KP serum albumin was 0.760 and 3.75 mg/dl was selected as the cut-off value. There was a significant difference in NLS between patients with high (≥3.8 mg/dl) and low (≤3.7 mg/dl) pre-KP serum albumin (90.0% vs. 31.5%, P < 0.01).</p><p><strong>Conclusions: </strong>Decreased pre-KP serum albumin may reflect not only functional impairment of the liver, but also the inflammatory process, which is hypothesized to occur during its advancement. The pre-KP serum albumin level may be a good prognostic factor for NLS in post-KP BA patients.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":"232-235"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of the Postural Difference in Antero-Posterior Diameter of Renal Pelvis on Ultrasonography of Unilateral Ureteropelvic Junction Obstruction in Determining the Need For Surgery.","authors":"Bijay Kumar Suman, Ram Jeewan Singh, Aditya Arvind Manekar, Subrat Kumar Sahoo, Bikasha Bihari Tripathy, Manoj Kumar Mohanty, Sudipta Mohakud","doi":"10.4103/ajps.ajps_25_23","DOIUrl":"10.4103/ajps.ajps_25_23","url":null,"abstract":"<p><strong>Background: </strong>Ureteropelvic junction obstruction (UPJO) is the most common cause of antenatal hydronephrosis. Although majority of them improve with time, none of the existing diagnostic modalities can accurately predict which hydronephrotic kidney is at the risk of progressive renal damage and will benefit from early surgery. Postural variations in the anteroposterior pelvic diameter (APPD) of the hydronephrotic kidney in children during follow-up postnatal ultrasonography (USG) reflect the intrapelvic tension, which might help in predicting the need of surgery amongst these patients.</p><p><strong>Materials and methods: </strong>We designed this prospective observational study in all unilateral UPJO patients on postural variation in the APPD of renal pelvis on ultrasonography. The mean age of all patients were 2.15 years (0-5 years) and managed at our institute at All India Institute of Medical Sciences, Bhubaneswar. The study duration was from July 2019 to May 2021. The management of these patients was done as per the standard institutional protocol and there was no deviation due to inclusion in this study. We documented the variations in postural APPD both amongst the conservatively managed group and the surgically managed group of patients. Linear correlation between two continuous variables was explored using Pearson's correlation (if the data were normally distributed) and Spearman's correlation (for non-normally distributed data).</p><p><strong>Results: </strong>We found a higher prone APPD than supine APPD in all these patients indicating the obstruction at ureteropelvic junction. However, in the surgical group, there was less variation in the postural APPD compared to the conservative group, and when there was no variation in the postural APPD, the need of surgery was 100%. The limitation of our study was the small sample size (n = 36). A study involving a larger population or involving multiple institutions may further add significance to our findings.</p><p><strong>Conclusion: </strong>We found less postural variation in APPD on USG to be more likely associated with severe UPJO requiring early surgery. This may indicate a non-compliant renal pelvis. However, it was statistically not significant.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 4","pages":"242-246"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}