Coping with respiratory obstruction after thyroidectomy for giant goitres in northern Nigeria.

Thyroidectomy for giant goitres in Northern Nigeria is associated with a high incidence of postoperative asphyxia. Tracheostomy may be a life saving procedure in these circumstances, but delay may prove fatal when its need arises insidiously. It is therefore better established prophylactically in patients who are more than likely to develop asphyxia, as in the case of preoperative complications followed by prolonged surgery. During the dry, dust-laden and desiccating Harmattan season of Northern Nigeria, however, tracheostomy poses life-threatening dangers and should be established only in patients who need it for survival. Postoperative asphyxia can be minimised by adopting certain operative techniques which reduce the risks of postoperative haematoma and laryngeal oedema. Establishment of a thyroidectomy team for surgery and for postoperative management improves results.

Renal masses in neonates: report of eight cases.

Palpable renal masses presenting in eight newly born babies are described. Three of the masses were primary renal tumours, namely renal dysplasia in two and congenital mesoblastic nephroma in one, while in three neonates the masses were secondary to obstruction, in two in the 'prune belly' anomaly and in one caused by posterior urethral valves. In two of the babies the masses were thought to be renal because of their location and in one following an abnormal intravenous pyelogram. Firm diagnoses were not possible in all our patients because some parents defaulted before investigation was complete. While surgical exploration is often crucial in establishing the diagnosis of an abdominal mass it is possible in certain cases to make a correct diagnosis without surgery.