Transanal pull through operation for Hirschsprung's disease, preliminary results

This study was done on 32 patients [30 males and 2 females] who were diagnosed to have Hirschsprung's disease for them transanal pull through operation was done. There was no operative or early post operative complications. Late post operative stricture of the anastamosis occurred in one patient who responded well to dilatation There was frequency of defecation up to 10 times per day in most patients which improved gradually over few weeks. We concluded that trasanal pull through operation for Hirschsprung's disease is safe and feasible in selected patients

new method for non operative treatment of giant omphalocele

The incidence of omphalocele is approximately, 1 in 500 live born. More than 50% have other serious defects. Ideal treatment would be primary closure which is not always possible. When the defect is large [> 10 cm], the infant has a small abdominal cavity or in cases of suspected chromosomal anomalies, non operative management using topical application of escharotic agent is a reasonable choice of treatment. Thirty Five patients were treated for omphalocele at Assiut University hospital, Pediatric surgery unit between years 1998 and 2004, using topical application of paste of Acacia Nilotica mixed with gentian violet to the intact sac twice daily for variable periods. The sac changes to a very tough structure without any infection or any other local or systemic complications and the skin creeps under it and it takes off gradually leaving a ventral hernia for later repair. Non operative management of large omphalocele with Acacia Nilotica is a good initial treatment

Arc to line repair of hare lip geometrical explanation and clinical evaluation

This work was carried out in Assiut University Hospital, Surgery Department, Unit B[2] in the period between August 1996 to October 1997. The study involved 25 patients with males representing 72% and females representing 28% of the total. The age of the patients ranged from 3 month to 8 years where 2-4 years age group has the highest incidence being 28% of the total. Is to evaluate clinically and explain geometrically arc to line repair of the cleft lip. Arc to line repair of the cleft lip. Height of the repaired lip matched the normal side in 88% of the total. [This percentage includes all cases with incomplete cleft lip and most cases of complete cleft lip]. Regular philtrum was obtained in 84% of cases where distorted philtrum occurred in 16% of cases and these were affected by complete cleft lip deformity. Cupid's bow became smooth in 88% of the repaired cases where tented Cupid's bow affected cases with complete cleft lip in three cases [12%]. Smooth vermilion was obtained in 88% of the total where notching of vermilion affected cases with complete cleft lip in three cases [12%] of the total. From these results it will be easy to conclude the following: cleft lip repair by arc to line method suits more cases with incomplete cleft lip where satisfactory results were obtained. Arc to line repair is not advised in complete cleft lip where drawbacks were encountered. This technique has the advantage of being easy to perform by a beginner as it does not need complex measuring steps. It takes short time so minimising the time of exposure to anaesthesia

Sacrococcygeal teratoma in Upper Egypt: ten years experience

This study reviewed twenty-six patients operated with sacrococcygeal teratoma [SCT], they were twenty-two females and four males with female to male ration of 5.5: 1. Twelve patients of them were diagnosed during neonatal period, six were diagnosed between the age of one to two months, three were diagnosed between the age of two months and one year and five between the age of one year and seven years. Four of the five delayed cases were Altman type [hidden tumor]. Five of the twenty-six cases of SCT were malignant, three of them died within one year of the initial diagnosis and the other two were still under multi- agent chemotherapy. Ten cases were Altman type I, eight cases were type II, three cases were type III and five cases were type IV. Recurrence occurred in two cases of benign SCT at nine and fourteen months after the original operation and were treated by surgical excision. Awareness and early diagnosis of hidden SCT [Altman type IV]by rectal examination and imaging by CT and ultrasonography may improve the outcome of the malignant SCT