African journal of paediatric surgery : AJPS最新文献

{"title":"Epidemiology of Childhood Fractures in Cotonou: A Retrospective Observational Study.","authors":"Pascal S Chigblo, Fiacre Tidjani, Éric Lawson, Bruno Noukpozounkou, Francois Amossou, Adébola Padonou, Oswald Goukodadja, Aristote Hans-Moévi Akué, Michel Fiogbe","doi":"10.4103/ajps.ajps_35_23","DOIUrl":"10.4103/ajps.ajps_35_23","url":null,"abstract":"<p><strong>Background: </strong>Childhood fractures are frequent. The aim of this study was to evaluate their epidemiological and clinical peculiarities in our context.</p><p><strong>Materials and methods: </strong>This was a retrospective study that focused on the files of children with a fracture. They were aged 0-15 years and received between January 2011 and December 2015 at the Emergency Department of the National Teaching Hospital of Cotonou.</p><p><strong>Results: </strong>Two hundred and eighty fractures were recorded in 257 children. The average age was 8.24 years (7 days-15 years). Older children (6-10 years) were the most affected with 33.8% of cases. The predominance was male (sex ratio = 2.3:1). The aetiologies were dominated by road traffic accidents (45.1%) followed by domestic accidents (42.7%). Fractures were predominant in the lower limbs (52.1%). The most affected segments were the leg (25.4%) and the femur (23.6%). The fracture was open in 13.9% of cases.</p><p><strong>Conclusion: </strong>Childhood fractures interest preferentially the older boys. Then, road traffic accidents are the most frequent circumstances of occurrence in our context. Measures to prevent the main causes of these fractures must be taken, in order to reduce their frequency and ensure the development of children.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"48-52"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522274","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":"A Novel Method to Fix Paediatric Mandibular Fracture using 2-0 Polyglactin Suture: A Technical Note.","authors":"T R Marimallappa, Supriyo Pal, Keerthana Rao, M S Sreelakshmi","doi":"10.4103/ajps.ajps_127_22","DOIUrl":"10.4103/ajps.ajps_127_22","url":null,"abstract":"<p><strong>Background: </strong>Reduction and stabilisation of fractures at the earliest is valuable in the paediatric age groups. This novel technique focuses on stabilisation of the fracture fragments using vicryl, which has an added advantage to conventional plating and wiring. This study aimed on a novel cost-effective technique of stabilising the paediatric mandibular fracture using 2-0 resorbable polyglactin 910 suture with minimal trauma to tooth buds and bone and adequate stability.</p><p><strong>Technique: </strong>After raising a full-thickness mucoperiosteal flap, the fracture segments are identified and reduced. 1.6mm drill bit is used to make holes through the buccal cortex on either side of the fractured segment in an anteroposterior direction. The patency of holes is checked by passing a long 26-gauge wire. The proximal end of the wire is bent into a loop, a 2-0 resorbable polyglactin suture (vicryl) is passed through this loop and the loop is pressed in place to lock the suture. The wire with the attached suture is pulled through the distal end. Once the suture is secure in place, the 26G wire is cut, and the two ends of sutures are knotted and stabilised. The mucoperiosteal flap is then closed.</p><p><strong>Conclusion: </strong>A novel method of stabilisation of paediatric fracture without hampering the tooth and jaw growth, especially in the financially unstable population. 2-0 polyglactin 910 suture is cost-effective, $2 US, compared to resorbable plates costing about $150 US, and easily available. Polyglactin 910 takes 40-60 days for resorption, and half-life tensile strength is 2 weeks; thus, it gives adequate stability and time for callus formation and does not damage the tooth buds or bone by cutting through them.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"56-57"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522313","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":"Advocating for Routine Post-natal Surveillance and Urgent Neonatal Inguinal Hernia Repair.","authors":"Shreyas Dudhani, Sourav Jana, Ramjeewan Singh, Amit Kumar Sinha, Bindey Kumar","doi":"10.4103/ajps.ajps_91_22","DOIUrl":"10.4103/ajps.ajps_91_22","url":null,"abstract":"<p><strong>Abstract: </strong>Inguinal hernias are more common in preterm and neonates and incidence of incarceration are reported to be more in the first 6 months of life. Strangulation follows incarceration and various incarcerated and strangulated contents having been reported in the sac. The fistulation of the herniated content through the scrotal skin is quite rare with only a few reported cases. We present the case of entero-scrotal fistula in a neonate managed with staged repair along with a brief review of the literature. A 27-days-old, full-term male presented with faecal discharge from the right scrotum. He had no tell-tale signs of obstructed hernia. A faecal fistulous opening was located in the right hemi-scrotum. The terminal ileum was seen as the content with an antimesenteric perforation, divided ileostomy and scrotal debridement was done and later ileo-ascending anastomosis was performed electively. Neonatal hernias should be considered an urgency and we advocate early surgery. The resource-limited setting and poor post-natal surveillance may have added to the worries. In our case, swelling and fistulation occurred in a very brief period of 36 h. We managed the child with a diversion stoma followed by ileo-ascending anastomosis later.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"64-68"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70662954","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":"Comparative Study between Modified Millard and White Roll Vermilion Flap Techniques in Unilateral Lip Repair: A Randomised Controlled Study.","authors":"Mohamed M Mabrouk, Khaled Salah Abdullateef, Ayman Hussein Abdelsattar, Mohamed Elbarbary, Sherif Kaddah, Wesam Mohamed","doi":"10.4103/ajps.ajps_20_23","DOIUrl":"10.4103/ajps.ajps_20_23","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip and palate, which affects 0.5-1.6 out of every 1000 live births, is the most prevalent congenital defect of the head and neck. Several approaches, including quadrangular flaps, triangular flaps and rotation-advancement procedures, White Roll Vermilion Turn Down Flap (WRV flap) from the lateral lip element were employed by Mishra to modify Millard's technique to create the vermilion and white roll on the medial lip segment. This study aimed to use the anthropometric measurements taken pre- and post-operation to evaluate quantitative assessment of modified Millard technique compared with WRV flap technique in unilateral cleft lip (UCL) repair.</p><p><strong>Materials and methods: </strong>Prospective, randomised controlled study recruited infants scheduled for UCL repair. Infants aged 3-6 months, either complete or incomplete deformity. A total of 42 patients were randomized in 1:1 ratio to undergo either WRV flap technique (group A) or modified Millard technique (group B) and another control included 21 age-matched healthy children. We compared WRV flap procedure to Modified Millard's procedure in terms of both qualitative (another surgeon's opinion) and quantitative (anthropometric) evaluation.</p><p><strong>Results: </strong>Vertical lip length and philtral lip height significantly longer in Millard group (B) than WRV flap group (A) in immediate postoperative assessment and nasal width was significantly wider in WRV flap group (A) than Millard group (B) in 3-month post-operative assessment. The lip shape, the vermilion shape was better in Millard technique than WRV flap technique; however, this was statistically insignificant. However, no major difference in the overall results between the WRV flap and Millard rotation-advancement repairs.</p><p><strong>Conclusion: </strong>Anthropometric measurement of surgical outcome evaluates the surgical technique used and helps to compare between cleft and non-cleft side showing the degree of deformity and we used subjective assessment to analyse facial aesthetics. Overall results demonstrate no significant differences between modified Millard technique and WRV flap technique.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"18-27"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522272","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":"Multiple Gastrointestinal Haemangiomatosis: A Report of Two Cases.","authors":"Shina Adefarakan, Nyaweleni Tshifularo","doi":"10.4103/ajps.ajps_87_22","DOIUrl":"10.4103/ajps.ajps_87_22","url":null,"abstract":"<p><strong>Abstract: </strong>Gastrointestinal (GI) haemangiomatosis is a very rare cause of GI bleeding in children. Due to this fact, making the diagnosis sometimes is delayed. In this case report, two different patients with multiple GI haemangiomatosis are presented. Of note is an 8 year old male with a previous history of a vascular malformation of the face presented with features of bowel obstruction (intussusception) and a history of recurrent blood in stool. At laparotomy, multiple haemangiomatosis were seen on the small bowel, right colon, liver, diaphragm and on the body of the gallbladder. Surgical management with excision of the enteric lesions and stapled anastomosis was done.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"78-80"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522277","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":"Laparoscopic Management of Auto-Amputated Ovarian Cyst in an Infant.","authors":"T K Jayakumar, Rahul Saxena, Taruna Yadav, Neha Satyaprakash Mathur, Arvind Sinha","doi":"10.4103/ajps.ajps_30_22","DOIUrl":"10.4103/ajps.ajps_30_22","url":null,"abstract":"<p><strong>Abstract: </strong>The routine schedule of antenatal ultrasound scans has led to an increased frequency of detection of foetal ovarian cysts. Although most of them regress spontaneously, some may grow into large cysts and undergo torsion followed by auto-amputation. However, pre- and post-natal scans may fail to identify this event. We report a case of a prenatally diagnosed ovarian cyst that failed to resolve conservatively and was increasing in size in post-natal ultrasounds. Pre-operative ultrasound and magnetic resonance imaging failed to detect the auto-amputation. The diagnosis was confirmed on laparoscopy which offers a safe and effective method for the removal of ovarian cysts in neonates and infants.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"58-60"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70661229","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":"Giant Colpolithiasis in Urogenital Sinus Anomaly with Urethral Duplication: A Case Report and Review of Literature.","authors":"Shreyas Dudhani, Amit Kumar Sinha, Bindey Kumar, Amit Kumar, Monika Anant","doi":"10.4103/ajps.ajps_89_22","DOIUrl":"10.4103/ajps.ajps_89_22","url":null,"abstract":"<p><strong>Abstract: </strong>Primary vaginal calculi are uncommon in children. Urethral duplication in females is seen to occur in association with complex congenital malformations. We report the case of perianal persistent urogenital sinus with a hypertrophied clitoris with phallic urethra, scrotum-like pouch, uterus didelphys with obstructed hemivagina, and giant colpolithiasis in 46XX female. A 16-year-old presented with pain abdomen and cyclic passage of blood clots per rectum. She had a tender lump in left iliac region, a phallus like protrusion and a ruggous sac below it. Vaginal opening was absent. Computed tomography showed two uterine horns with a separate cervix and distended non-communicating hemivaginas with a large calcified oval mass in the left hemivagina. On exploration, calculus was extracted from the left hemivagina. The large calculus found in the left hemivagina appears to be the cause of all presenting symptoms. It obstructed the left hemivagina, filling the left uterine horn with menstrual blood causing its gradual enlargement and secondary infection. The early diagnosis and prompt referral of such an anomaly can only be ensured in institutional deliveries. For a significant proportion of newborns in the developing world, the ability to afford or even be referred to institutes which deal with such cases is a luxurious affair. We hope to bridge bridging the knowledge, attitude and practice gap that exists in our health-care system with this report.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"1 1","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70663128","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":"Our Experience of the De la Torre-Mondragon Technique in the Surgical Management of Hirschsprung's Disease: A Report on 52 Cases.","authors":"Mouafo Tambo Faustin Félicien, Gacelle Fossi Kamga, Eugénie Caroline Dikongue Dikongue, Florence Obono Ebo, Maurice Aurélien Sosso","doi":"10.4103/ajps.ajps_44_22","DOIUrl":"10.4103/ajps.ajps_44_22","url":null,"abstract":"<p><strong>Background: </strong>The authors report their experience of the transanal endorectal pull through technique as described by De la Torre Mondragon in the treatment of Hirschsprung's disease (HD).</p><p><strong>Materials and methods: </strong>It was a retro prospective, observational and descriptive hospital based study involving all proven cases of HD managed within a time frame of 8 years.</p><p><strong>Results: </strong>Fifty two patients with a mean age of 18 months at the time of surgery. The male pre dominance was remarkable. The mean duration of the surgery was 2 h and a half hours. The surgical indication was based on the history, clinical findings and on the contrast enema (transition zone) with a 24 h film (prolonged contrast evacuation) and calculation of the rectosigmoid index (<1). With a mean follow up of 16 months, the morbidity was dominated by soiling, anastomotic strictures and enterocolitis. The mortality in one case was related to a post operative enterocolitis that was not amenable to resuscitation.</p><p><strong>Conclusion: </strong>Soiling, anastomotic strictures and enterocolitis are the main post operative complications of TEPT in the treatment of HD in our practice.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522280","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":"Penile Agenesis Associated with Anorectal Malformation and Bilateral Renal Agenesis: A Case Report and a Review of the Literature.","authors":"Collins Chijioke Adumah, Iniofon Clement Akpaette, Owolabi Oni, Igwe Arua Obasi, Ibukunolu Olufemi Ogundele, Abdulhafiz Adesunkanmi, Oluwaseun Abioye Oyinloye, Ademola Olusegun Talabi, Oludayo Adedapo Sowande, Olusanya Adejuyigbe","doi":"10.4103/ajps.ajps_81_22","DOIUrl":"10.4103/ajps.ajps_81_22","url":null,"abstract":"<p><strong>Abstract: </strong>Penile agenesis is complete absence of the penis in an otherwise normal phenotypic and genotypic male at birth that results from failure of development of the genital tubercle. It is an extremely rare anomaly that may be associated with anomalies in other organ systems, the extent and severity of which may affect the prognosis. The management is challenging and may have far reaching implications for the individual and family. While gender reassignment with bilateral orchidectomy and feminising genitoplasty has been carried out for most patients, significant psychosexual and social issues related to the male identity may occur due to foetal or postnatal sex steroid imprinting. We report a neonate with penile agenesis with bilateral renal agenesis and anorectal malformation.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522284","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":"Management of Complete Persistent Rectal Prolapse in Children: A Comparative Study Between Mesh Repair Versus Suturing Rectopexy.","authors":"Mostafa Gad, Mostafa Nabil Dessouky, Khaled Salah Abdullateef, Osama Abdelazim, Ahmed E Fares, Sherif Nabhan Kaddah, Moutaz Ragab","doi":"10.4103/ajps.ajps_92_22","DOIUrl":"10.4103/ajps.ajps_92_22","url":null,"abstract":"<p><strong>Background: </strong>Rectal prolapse is a relatively common, usually self-limiting illness in children. Peak incidence is between 1 and 3 years. The primary treatment of rectal prolapse is non-operative. Surgical intervention is needed in long-standing intractable cases of rectal prolapse, rectal pain/bleeding/ulceration and prolapse that needs frequent manual or difficult reduction. The aim of this study was to compare the efficacy and outcome of laparoscopic ventral mesh rectopexy versus laparoscopic suture rectopexy in the management of persistent rectal prolapse in children not responding to conservative management and/or recurrent after sclerotherapy or anal encirclement.</p><p><strong>Materials and methods: </strong>Twenty-four cases were randomised into two groups at the ratio of 1:1, Group 1 patients were managed by laparoscopic ventral mesh rectopexy, whereas Group 2 cases were managed by laparoscopic suture rectopexy. Patients with primary surgical conditions such as anorectal malformations, Hirschsprung's disease, rectal polyps or masses and Ectopia Vesicae were excluded from the study. Inclusion criteria were complete rectal prolapse cases with failed medical treatment for at least 6 months and/or recurrent after injection sclerotherapy or anal encirclement.</p><p><strong>Results: </strong>In the mesh rectopexy group, one case had recurrence in the form of partial prolapse 3 weeks postoperatively which improved 2 months postoperatively with conservative management, one case had bleeding per rectum 2 months postoperatively, stool analysis was done revealing parasitic infestation which was treated medically. In the suture rectopexy group, one case had one attack of bleeding per rectum on the 2nd day postoperatively which resolved spontaneously and one case was readmitted on the 5th day postoperatively for non-bilious vomiting which improved by medical treatment. No recurrent cases of complete rectal prolapse were reported in both groups.</p><p><strong>Conclusion: </strong>Laparoscopic rectopexy can be an effective modality for the treatment of refractory complete rectal prolapse in children. It is effective, safe and easy. Although the current study has shown that laparoscopic suture rectopexy and mesh rectopexy have nearly the same results, a larger number of patients are needed to compare more deeply between the two groups.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 1","pages":"28-33"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522276","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}