Malrotation of the intestine

This is a study of 15 patients of malrotation operated in the Department of Paediatric Surgery, Chandka Medical College Hospital Larkana, between January 1996 to June 2000. The patients were divided into three age groups: newborns [3], infants [7] and older children [5] because of the difference in their clinical presentations. Associated anomalies were present in 2 patients [13.3 percent]. Upper GI study was the main diagnostic investigation. All patients underwent laparotomy. Resection and anastomosis was done in one newborn with volvulus and necrosis of bowel; Ladd's procedure was carried out in all other patients without appendectomy. Postoperative recovery was quicker in older children. Postoperative complications occurred in 4 patients [27 percent] and 14 patients got total relief of symptoms; only one patient had persistent GI symptoms even after surgery. There was no mortalty in the series. Follow up ranged from 3 months to 3 years

Hypospadias repair: a five year experience

Ninety cases of hypospadias were operated in the Department of Paediatric Surgery, Chandka Medical College, Larkana, from January 1993 to December 1997. The most common age group was between 1-5 years [63.3%] and the most common variety of hypospadias was penile [68.8%]. Chordee was present in 76 patients [84.5%] and other associated anomalies were present in 8 patients [9%]. Family history of hypospadias was present in 3 patients [3.3%]. Patients without chordee were selected for single stage repair and those with chordee were selected for two stage Byar's method of repair. Chordee was corrected in 76 cases, out of which 37 patients are waiting for urethroplasty. Urethroplasty has been done in 53 patients; single stage urethroplasty in 16 patients and two stage Byar's urethroplasty in 37 patients. Overall complication rate of urethroplasty was 36%. Fistula was the most common complication [28.3%]. Byar's method of hypospadias repair was found most satisfactory and adaptable to all degrees of hypospadias

Surgical complications of typhoid fever

This is a prospective study, carried out in the Department of Paediatric Surgery. Chandka Medical College Hospital, Larkana from January 1993 to December, 1997. A total of 90 cases of typhoid fever with surgical complications were admitted in the unit. Of 90 patients, 88 had gut and 2 had gall bladder perforations. In majority of patients [61.2%], duration of fever was two or more weeks. Leucopenia was found in 33.3% and pneumoperitoneum in 72.2%; Widal test was positive in 33.3% and blood culture, though done in 40 patients, were positive in all. Laparotomy was done in 89 patients. In 70 patients single and in 17 patients, multiple ileal perforations were present. Surgical procedures performed were: simple double layer closure [80], resection and anastomosis [5], hemicolectomy [2], and cholecystesctomy [2]. Postoperative complications occurred in 36 patients [44.4%]; wound infection being the most common complication [38.2%] in our series. Average hospital stay was 14.2 days. Seven patients [7.7%] died, one preoperatively and six postoperatively

Atypical conjoined twins: a case report and review of classification

Conjoined twins which are incomplete are labeled as atypical conjoined twins. Though the classification of typical conjoined twins is more or less standardized, that of atypical conjoined twins is still not very clear and uniform. We present here a case of successfully separated atypical conjoined twins, pygopagus parasiticus and brief review of various classifications of conjoined twins