ABSTRACT
Background: Gastroschisis denotes a congenital or sporadic malformation of the anterior abdominal wall, which is rarely associated with other anomalies. The mortality in African countries is still high almost 100%. Objective: The aim was to determine the feasibility and safety of bedside reduction of gastroschisis and factors affecting the outcome in low-income setting. Methodology: This was a retrospective, descriptive and analytic study over a period of 6 years conducted in the Pediatric Surgery Service of the Yaoundé Gyneco-Obstetric and Pediatric Hospital. Only neonates with gastroschisis seen within 6 h of life without bowel necrosis and in whom bedside reduction was attempted in the neonatology unit under sedation (with 0.5 mg/kg of diazepam intra-rectally and 0.5-1 mg of atropine intravenously) were included in this study. Ethical clearance was obtained for the Ethical Committee of the Yaoundé Gyneco-Obstetric and Pediatric Hospital and a signed consent form was required from the parents of the children prior to the procedure. Results: Twelve neonates with a mean age of 16.8 h (0 and 24 h) and mean birth weight of 2245 g (1860-3600 g) were enrolled. The mean time to presentation at hospital was 3.5 h (2-9 h). Bedside closure was successful in 10 patients. Two patients underwent primary closure in the theatre after failure of bedside reduction due to the volume of contents of gastroschisis. Mortality rate in our study was 33.3% and the morbidity was dominated by compartment syndrome and malnutrition. Conclusion: Bedside reduction of gastroschisis under sedation in Yaoundé seems to be way to reduce the mortality.
Subject(s)
Abdominal Wall , Gastroschisis , Infant, Newborn , Pregnancy , Female , Child , Humans , Adolescent , Gastroschisis/surgery , Retrospective Studies , Treatment Outcome , Cameroon/epidemiology , Abdominal Wall/surgeryABSTRACT
Based on evidence from two collected and treated clinical observations of hypertrophic pyloric stenosis in children of 5 and 12 months of age, the authors give their point of view on the unresolved issue of the etiology of hypertrophic pyloric stenosis. They emphasize that there are more and more factors to prove this is an acquired condition.
À partir de 2 observations cliniques colligées et traitées de sténose hypertrophique du pylore chez les nourrissons de 5 mois et 12 mois, les auteurs font part de leurs réflexions sur la question non encore résolue de l'étiologie de la sténose hypertrophique du pylore. Ils soulignent l'existence de plus en plus de facteurs en faveur d'une affection acquise.
ABSTRACT
Phocomelia is a developmental abnormality which occurs during pregnancy and results in congenital ectromelia (developmental arrest of one or more limbs), with characteristically atrophied limbs that look as if they were directly implanted on the trunk, that is, like seal (phocid) flippers. The authors report the case of a Cameroonian neonate. Abnormalities were limited to the upper limbs. The lack of useful causal information and especially the difficulties in therapeutic management in this context are highlighted.
Subject(s)
Ectromelia , Cameroon , Ectromelia/diagnostic imaging , Humans , Infant, Newborn , Male , Phenotype , RadiographyABSTRACT
IntroductionSickle cell osteomyelitis in children is one of the complications of osteoarthritis in sickle cell disease.ObjectiveTo describe the epidemiology, diagnosis and treatment of sickle cell osteomyelitis in children in Africa to improve management.Tools and methodA review of records showed that from April 2004 through September 2009, eleven cases of osteomyelitis in children aged 0 to 15 years who carried the sickle cell trait were treated in the surgical and pediatric unit of the Women's and Children's Hospital of Yaounde.ResultThe children's mean age was 7 years, but frequency was highest for those aged 1 to 5 years. The sex ratio was 2:1 male. The portal of entry was found for only 30% of cases. The predilection of the disease for long bones, the non-fistulated forms, the homozygous type, and the frequency of Salmonella were all remarkable. Medical and preventive treatment, always applied, were followed by orthopedic treatment. The usefulness of surgery, on the other hand, is subject to debate. Healing was obtained in 80% of cases.ConclusionThe authors describe the profile of osteomyelitis in children with sickle cell disease in Africa.
