African Journal of Paediatric Surgery : AJPS

Neuroblastoma (NBL) and nephroblastoma present with abdominal mass and various imaging features help in differentiating the two; however, localisation is difficult in large masses and at times imaging features can be confusing. Here, we describe the case of large left-sided NBL arising from the adrenal and involving the left kidney with moderate hydronephrosis.

Acute abdominal pain is a common complaint in children. We came across several unusual causes of acute abdomen including jejunal haematoma, perforation and abdominal abscess following hydrostatic intussusception reduction, twisting of mesenteric cyst, perforation of sigmoid colon and Meckel's diverticulum presenting with intussusception. In this article, we aim to present imaging features of these entities so that paediatric surgeons, radiologists and other health-care providers are aware of these unusual manifestations of acute abdomen...

Peritonitis by perforation of the gall bladder of typhic origin is a rare condition. In Côte d'Ivoire, no studies to our knowledge have addressed the vesicular complications of typhoid fever in children. The aim of this work was to describe the epidemic-clinical, therapeutic and evolutionary aspects of the perforation of the gall bladder of typhic origin in subjects under 15 years of age. In 6 years, five children showed a vesicular perforation of typhic origin or 9.4% of peritonites of typhic origin. They were 5 boys with an average age of 07...

BACKGROUND: Oesophageal atresia (EA) is the most common congenital anomaly of the oesophagus. Despite improvement of survival observed over the previous two decades in developed countries, the mortality remains very high and the management greatly challenging in resource-poor settings such as Cameroon. We report our experience of management of EA in this environment, with a successful outcome. MATERIALS AND METHODS: We prospectively assessed patients diagnosed with EA and operated in January 2019, at the University Hospital Centre of Yaounde...

INTRODUCTION: In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. MATERIALS AND METHODS: A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed...

INTRODUCTION: Despite the benefits of analgesic suppositories, there remains controversy around their administration. The perceptions of the parents and caregivers regarding this are unknown in our population. We investigated the perceptions of parents/caregivers towards the use of analgesic suppositories in elective paediatric surgery. We also explored whether parents/caregivers perceived a need for additional consent for the administration of suppositories. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted at Charlotte Maxeke Johannesburg Academic Hospital, South Africa...

INTRODUCTION: Bilateral femoral fractures in children (BFFC) are an uncommon condition. Only a few cases were reported in the literature. The frequency and outcome in low-setting facilities are unknown. This study aims to describe our experience in managing BFFC. PATIENTS AND METHODS: A 10-year ongoing study spanning from 2010 to 2020 was held in a level-1 paediatric facility. We included all cases of BFFC on a bone-free disease with at least 10 months of follow-up time...

BACKGROUND: Oesophageal stricture is one of the most important and redoubtable complications following caustic ingestions in children. Instrumental dilatation is usually considered the first line of treatment. AIMS AND OBJECTIVES: This study aims to evaluate the outcomes of caustic stenosis treatment when using Lerut dilatators. MATERIALS AND METHODS: This is a descriptive retrospective study from May 2014 to April 2020. All children under 15 years hospitalised in our department for caustic oesophageal stricture and had a gastrostomy and oesophageal dilatation with insertion of an endless wire were included...

OBJECTIVES: The primary objective of this study was to analyse the demographics of the children who presented with ventriculoperitoneal shunt (VPS) complications. The secondary objectives were to review the clinical characteristics, surgical procedures performed for the management of VPS complications and the final outcome. MATERIALS AND METHODS: This is a single-institution observational study that included children below 12 years of age who required VPS revisions during the study period...

INTRODUCTION: Idiopathic talipes equinovarus (ITEV) 'aka clubfoot' is the most common foot deformity in children. Ponseti technique had been accepted as a standard method for correction. The traditional Ponseti technique for correction is well known. Accelerated Ponseti technique is said to offer some advantages over the standard technique. The aim of this study was to determine and document the efficiency and success rate of accelerated Ponseti technique. METHODS: This was a prospective interventional study which lasted 26 months from February 2017 to April 2019...

CONTEXT: Hypospadias is a common urological anomaly which could be surgically corrected with good cosmetic results. AIMS: We aimed to detect changes in urinary flow parameters both before and after tubularised incised plate urethroplasty (TIPU) using uroflowmetry. SETTINGS AND DESIGN: Data collected were clinically implemented hypothesising the probability of urethrocutaneous fistula following stricture with Qmax variation. MATERIALS AND METHODS: This study is a prospective analysis done from December 2017 to October 2019...

BACKGROUND: The most common type of duodenal atresia (DA) (Type I), also known as duodenal web or membrane can present later in infancy or early childhood if the membrane or web is fenestrated. We describe six patients with delayed presentation of DA. MATERIALS AND METHODS: Retrospective review of hospital records of six patients with delayed presentation of DA due to fenestrated web managed in Paediatric Surgery Department at a tertiary care institute over a period of 2 years (January 2019 to December 2020) was done...

BACKGROUND: Circumcision is regarded as the most common surgical procedure world over. It is also perceived to be a simple and safe procedure; however, it could be fraught with major urological complications such as urethrocutaneous fistula (UCF). Repair of these fistulae poses a great reconstructive challenge to the paediatric surgeon/urologist with varied outcomes. AIM: We seek to review the presentations, repair and outcome of post-circumcision UCFs managed in a tertiary centre...

INTRODUCTION: Anal dilation with Hegar dilator is recommended as part of the post-operative management following surgical correction of anorectal malformation (ARM) in children to prevent strictures. Parents usually continue dilation at home with a personal set of dilators. However, in low-resource settings, many parents cannot afford the Hegar dilator. Devices that have been improvised as dilators include appropriately sized candles, spigot from Foley catheter, rounded ball pen ends and mothers' fingers...

INTRODUCTION: Despite all the advances, the mortality rate of congenital diaphragmatic hernia (CDH) ranges from 30% to 60% for isolated CDH and as high as 89% when they are associated with additional structural or chromosomal anomalies. Hence, a study was conducted to evaluate the factors contributing to the mortality of neonates treated for CDH or the eventration of diaphragm. MATERIALS AND METHODS: A retrospective study was conducted in the department of paediatric surgery at a tertiary centre...

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Cysts of the prepuce are rare, and documented reports from the English literature are mostly from Asia. Presentations in children are worrisome to the parents. We report a case of a preputial cyst occurring in a neonate who was brought to our facility due to parental anxiety. After a thorough clinical evaluation, a freehand circumcision technique was performed which allowed exposure of the full extent of the cyst, the external urethral meatus and the glans, thus ensuring complete excision and minimising the risk of injury to the adjoining structures...

The incident of being wounded by free-falling bullets is not usual in provinces where there is limited civilian armament in large metropolises. Cases that are wounded by falling bullet wounding apply to health-care institutions with major clinical manifestations. The patient was admitted with minor complaints, which manifested itself with mild back pain and spotting bleeding. An ovoid-style open wound was detected on the left scapula. Radiographic examination showed a semi-ovoid bullet-like radiodensity image inside the thoracic wall...

Transverse testicular ectopia (TTE) is an uncommon congenital anomaly, in which both the gonads migrate towards the same hemi-scrotum. We report a rare case of TTE discovered coincidentally during surgery in a 1-year-old boy who presented with bilateral undescended testis and right inguinoscrotal swelling. The use of laparoscopy during evaluation for impalpable testis can aid in the diagnosis of TTE, before inguinal exploration. Findings such as the vascular supply and vas deferens of the crossed testis and the identification of Müllerian structures can be confirmed by laparoscopy...

Despite numerous cases of trichobezoars reported in the literature, few Rapunzel syndromes have been described. Rapunzel syndrome is a rare case of bowel obstruction resulting from hair ingestion (trichobezoar). The obstruction can occur in any level of the intestinal tract. This syndrome is usually reported in patients affected by trichotillomania and trichophagia. We reported a case of Rapunzel syndrome in a 5-year-old girl diagnosed on an abdominal computed tomography scan and confirmed during surgery.