Inversion appendicectomy.

OBJECTIVES: (i) To emphasise that incidental appendicectomy has indications and, to highlight this indications. (ii) To teach that, even when indicated, this procedure should not convert a clean surgical wound into a clean contaminated or even less optimal wound. (iii) To recommend that if an incidental appendicectomy is to achieve (ii) above, inversion appendicectomy is the better option to choose. (iv) To prove that inversion appendicectomy is fast, easy and achieves a similar result as the more popular excision appendicectomy. PATIENTS AND METHODS: This study was carried out in the paediatric surgical unit of Korle-Bu Teaching Hospital Accra, Ghana - between March 2003 and May 2004. PATIENT SELECTION: Fifteen patients qualified for enrollment into this study. These were (i) Those who had clear cut indications for incidental appendicectomy, and had it done as an inversion appendicectomy. (ii) Cases of incidental appendicectomy. METHODS: Eleven of these cases were done for intussusceptions and four for malrotation. Only wounds that qualified as clean surgical wounds were included in this study. There was no age or sex discrimination. RESULTS: Follow up on these patients did not reveal any complications. CONCLUSION: Incidental appemdicectomy has well-defined indications. When indicated in clean wound, inversion appendicectomy is the procedure of choice.

Dicephalic-dipus: a case report.

Bipagous conjoined twins are rare with an incidence of 1 in 50,000 to 1 in 100,000 births, but rarer still are heteropagous dicephalic dipus with an incidence of 0.1-0.2 per 10,000 births. No more than 4 sets of such surviving twins-sharing an undivided torso and two legs have been recorded in history consequently, the usual recommendation is for termination of pregnancy following prenatal diagnosis since historically, postnatal survival is unlikely. We present a case of dicephalic-dipus seen in our institution.