Faecal Incontinence in Children in Calabar

Objective: To determine the prevalence of faecal incontinence in children in Calabar. Methods: A study of children who were admitted for faecal incontinence at the University of Calabar Teaching Hospital and the Faith Foundation Specialist Clinic in Calabar over a seven year period from January 1994 to December 200 was done. Results: Faecal incontinence in children was common as a result of previous anorectal surgery. The modal age at presentation was the 6 to 10 years age group; this corresponds with the time when the societal embarrassment of soilage at school became obvious. The expensive surgical operation for this condition was avoided as the patients were rather offered the simple conservative management consisting of diet manipulations; daily enema and training of sphincter muscles. To these was added a simple but effective surgical narrowing of the anorectal junction. This procedure complemented with psychotherapy was effective in improving continence to various degrees in 90of the patients. Conclusion: Faecal Incontinence is a societal problem and before school age is not taken seriously as diapers may be applied in the home environment

Results of treatment in children with anorectal malformations in Calabar; Nigeria : paediatric surgery

Leading symptoms of anorectal malformation in the neonatal period are abdominal distention; non-passage of meconium and constipation. When present; vomiting is a late symptom. In a study in Calabar; Nigeria; patients were observed to present late; and teenage mothers in rural communities were mostly affected. Female neonates were affected more than males in a ratio of 1.5:1. Classification into low and high abnormality was adopted and proved practical in terms of identification of the pathology and treatment of the lesion. Patients with low abnormality (N = 24; 44.4) were treated with perineal cut-down; while those with high abnormality (55.6) had initial palliative colostomy before a definitive abdominal perineal pullthrough procedure. Faecal incontinence (13); anal stenosis (11.1); constipation (7.4) and colostomy prolapse (5.6) were noted to be associated complications. Poverty and ignorance were noted to be the main factors affecting treatment outcome. A concerted public enlightenment campaign is therefore required

Pattern of dysphagia in Calabar

A retrospective study of dysphagia in 55 children; aged between six months and 12 years (mean age 4.3 years) in Calabar; has revealed foreign body impaction in the throat to be the commonest cause; occurring in 40.0 percent of the cases. Children; aged between five and 10 years; were commonly involved in foreign body impaction which was caused by coins and food (meat and fish bones) in 31.8 and 27.3 percent respectively; of the 22 cases. Oesophageal stricture due to accidental ingestion of caustic soda was found in 14.5 percent of the cases and involved children in the age group; six to eight years. The cause of dysphagia was however; unknown in 25.5 percent of the patients. Malnutrition (56.4 percent) and aspiration pneumonia (27.3 percent) were the major complications in the series. It is concluded that most of the causes of dysphagia in the series are preventable