Childhood intussusception

In a retrospective study, 38 patients with intussusception presenting to paediatric surgical emergency were studied. The objective was to review the management of childhood intussusception and identify factors that require attention for improved outcome. Out of 38 children 26 were males and 12 were females. Age ranged from 2 months to 10 years. Presenting features were mainly vomiting, abdominal pain/excessive crying, abdominal distension, passage of blood and mucus in the stool and a palpable abdominal mass. Duration of symptoms i.e., time period lapsing between the onset of symptoms and seeking the treatment was < 24hours in 21.3% cases, 24-72 hours in 3l.5% > 72 hours in 39.4% and > 1 week in 7.8% cases. Ileo-colic intussusception was found in 76% cases, colo- colic in 16 and ileo-ileal in 8% cases. Manual reduction was successful in 34% cases and resection of the gut had to be done in 66% cases. Delay in diagnosis was associated with increased morbidity and mortality. The authors recommend that prompt treatment is the key to reduce the morbidity and mortality

Trans-symphyseal urethroplasty in children

Post traumatic posterior urethral strictures were managed by trans-symphyseal urethroplasty in 11 male patients of pediatric age group. The aim of the study was to evaluate the results of the technique in patients who underwent multiple unsuccessful procedures in the past. Two[18.2%] patients were 3-5 years old, 3 [27.3%] were between 6 and 8 years, 1 [9.1%]was 10 years old whereas 5[45.5%] were 12-14 years of age. The length of the strictures varied from 1-3cm. Repair was performed after excising the stricture and anastomosing the spatulated urethral ends with interrupted sutures of 5/0 vicryl over a Foley's catheter. Post operative follow up showed incontinence in 1[9.1%] case and prolonged urinary tract infection in 4[36.4%] cases. Postoperative stricture was not noted in only one of them at I year follow up. The authors recommend that trans-symphyseal urethroplasty is a satisfactory procedure for the treatment of posterior urethral strictures in children as it provides excellent approach and visualization with minimal post operative complications