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Patent processus vaginalis: A window to the abdomen
N Rahman, K Lakhoo
July-December 2009, 6(2):116-117
DOI:10.4103/0189-6725.54778  PMID:19661645
A patent processus vaginalis (PPV) allows a communication between the peritoneum and scrotum. Hydrocoele is the usual presentation of a PPV in children. However, with intraabdominal pathology the patent PPV may provide the first clue to the mischief within the abdomen. We present here two unusual cases associated with a PPV and migration of intraabdominal contents from the abdomen to the scrotum.
  42,336 522 10
Urethral mucosal prolapse in young girls: A report of nine cases in Cotonou
MA Fiogbe, GM Hounnou, A Koura, KA Agossou-Voyeme
January-April 2011, 8(1):12-14
DOI:10.4103/0189-6725.78661  PMID:21478579
Background: Urethral mucosal prolapse is rare. This condition may be confused with tumour or sexual abuse in girls. This study aims at reporting the pathology presentation and therapeutic options of urethral prolapse in girls. Materials and Methods: A retrospective study was undertaken from January 2000 to December 2008. Authors analysed the clinical features and the treatment options. Results: There were nine cases of urethral prolapse. The ages ranged from 2.5 to 10 years (mean age: 5.08 years). The main presentation was vaginal bleeding (five cases). Physical examination revealed a soft, non-tender mass that bleeds on touch (six cases), with a length ranging from 0.75 to 1 cm. Urine culture in four patients revealed urinary infection that yielded Escherichia coli in three cases and the Staphylococcus aureus in one case. Six patients had surgical treatment while three had medical treatment. In those who had surgery, one had acute urine retention and one had recurrence that was treated successfully without operation. All the nine girls are cured. Conclusion: Urethral prolapse is a disease of the prepubertal girls of low socio-economic group. Diagnosis is clinical. The treatment of choice is surgical.
  38,038 414 4
Female epispadias
MV Krishna Shetty, A Bhaskaran, TK Sen
May-August 2011, 8(2):215-217
DOI:10.4103/0189-6725.86066  PMID:22005369
Isolated female epispadias without bladder exstrophy is an extremely rare congenital anomaly. The symptoms of female epispadias are primary urinary incontinence and abnormal anatomical features. A 7-year-old girl presented with partial incontinence of urine. On physical examination, bifid clitoris and labia minora were seen. The vagina and hymen were normal. Voiding cystourethrogram showed no reflux. With the diagnosis of isolated female epispadias, single stage reconstruction of the urethra, labia minora and clitoris was performed.
  33,014 522 3
Anovestibular fistula in otherwise normal anorectum
Sandeep Hambarde, Pradnya Bendre, Rajeev Redkar
January-April 2011, 8(1):117-118
DOI:10.4103/0189-6725.79075  PMID:21478605
  31,320 295 -
Correction of incomplete penoscrotal transposition by a modified Glenn-Anderson technique
Amin Saleh
September-December 2010, 7(3):181-184
DOI:10.4103/0189-6725.70422  PMID:20859026
Purpose: Penoscrotal transposition may be partial or complete, resulting in variable degrees of positional exchanges between the penis and the scrotum. Repairs of penoscrotal transposition rely on the creation of rotational flaps to mobilise the scrotum downwards or transpose the penis to a neo hole created in the skin of the mons-pubis. All known techniques result in complete circular incision around the root of the penis, resulting in severe and massive oedema of the penile skin, which delays correction of the associated hypospadias and increases the incidence of complications, as the skin vascularity and lymphatics are impaired by the designed incision. A new design to prevent this post-operative oedema, allowing early correction of the associated hypospadias and lowering the incidence of possible complications, had been used, whose results were compared with other methods of correction. Materials and Methods: Ten patients with incomplete penoscrotal transposition had been corrected by designing rotational flaps that push the scrotum back while the penile skin remains attached by small strip to the skin of the mons-pubis. Results : All patients showed an excellent cosmetic outcome. There was minimal post-operative oedema and no vascular compromise to the penile or scrotal skin. Correction of associated hypospadias can be performed in the same sitting or in another sitting, without or with minimal complications. Conclusion: This modification, which maintains the penile skin connected to the skin of the lower abdomen by a small strip of skin during correction of penoscrotal transposition, prevents post-operative oedema and improves healing with excellent cosmetic appearance, allows one-stage repair with minimal complications and reduce post-operative complications such as urinary fistula and flap necrosis.
  27,191 401 4
Early management of mesenteric cyst prevents catastrophes: A single centre analysis of 17 cases
Advait Prakash, Amit Agrawal, Rahul K Gupta, Beejal Sanghvi, Sandesh Parelkar
September-December 2010, 7(3):140-143
DOI:10.4103/0189-6725.70411  PMID:20859015
Background: Mesenteric cysts are rare intra-abdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal symptoms. Patients and Methods: Seventeen patients (age less than 10 years) with mesenteric cysts were managed in our hospital. The age ranged from 15 days to 10 years. Patients were admitted with acute or chronic symptoms. They were evaluated with complete history, clinical examination, blood investigations and radiological investigations (x-ray abdomen erect, ultrasound abdomen (USG) and computed tomography (CT) scan in selected cases) to reach a provisional diagnosis. The diagnosis was proven on laparotomy and histologically confirmed. Results: The main presenting symptoms were abdominal pain or lump. The most common mode of presentation was acute small intestinal obstruction. USG was not conclusive in all. Abdominal CT scan with intravenous contrast was diagnostic in nine patients. Five patients had volvulus on exploration. Cysts were located in small intestinal mesentery in 14 cases and three were in the sigmoid mesentery. Seven patients had complete excision, intestinal resection was required in four and marsupialisation with cauterisation of margins was done in six patients. Histologically, all were lymphangiomatous mesenteric cysts. Conclusion: The diagnosis of mesenteric cysts should be kept in mind in any patient presenting with acute abdominal symptoms. Small bowel volvulus with mesenteric cyst constituted a significant number in children with acute abdominal symptoms. Early diagnosis and treatment yields excellent outcome.
  26,698 528 27
Intestinal obstruction in children due to Ascariasis: A tertiary health centre experience
PK Mishra, A Agrawal, M Joshi, B Sanghvi, H Shah, SV Parelkar
July-December 2008, 5(2):65-70
DOI:10.4103/0189-6725.44178  PMID:19858669
Background: Ascariasis is the infestation by the largest intestinal nematode of man, a common problem in the tropics attributed to poor hygienic and low socioeconomic conditions. The aim of this research is to analyse the presentation, diagnosis and management of bowel obstruction caused by Ascaris lumbricoides, with special emphasis on the role of conservative management. Materials and Methods: This is a single centre, two consultant based 5 year retrospective study of childhood intestinal obstruction due to worms. Diagnosis in the suspected patients was based on history of passage of worms per mouth or rectum and on x-ray and ultrasonography findings. Only the patients of intestinal obstruction with documented evidence of roundworm infestation were included in the study and were followed for one year. Results: One hundred and three children with intestinal obstruction due to Ascaris lumbricoides were treated in the past five years at our centre. Abdominal pain was the most common presentation seen in 96 children followed by vomiting in 77 children. 20 children had history of vomiting worms and another 43 had history of passing worms in stool. Abdominal tenderness was present in 50 children, 48 had abdominal distension of varying degree, 50 had abdominal mass due to worm bolus, and 16 had or developed abdominal guarding or rigidity. All the children were managed as for acute intestinal obstruction along with hypertonic saline enema. The aim of management was "to starve the worm and hydrate the patient". 87 patients (84.47%) responded favourably and were relieved of the obstruction by the conservative management, 16 children (15.53%) had abdominal guarding or rigidity and underwent emergency exploration. Conclusion: Roundworm obstruction should be considered in the differential diagnoses of all cases of intestinal obstruction in children. Clinical history and examination along with X-ray and ultrasonography are very helpful for diagnosis of this surgical emergency. Most cases of intestinal obstruction due to Ascaris can be managed conservatively; however emergency surgery is needed in patients with abdominal guarding and rigidity.
  25,999 761 14
Bloodless, sutureless circumcision
Nisar A Bhat, Raashid Hamid, Kumar Abdul Rashid
July-September 2013, 10(3):252-254
Background: W e present our experience of sutureless and bloodless elective circumcision in neonates and infants with Gomco clamp. Patients and Methods: From March 2008 to May 2011, 200 babies with age ranging from 2 weeks to 7 months underwent Gomco circumcision. All patients were given chlorohydrate 50 mg/kg, paracetamol suppository 15 mg/kg, and local anesthesia. Procedure was done in minor operation theatre (OT) and babies were observed for 1 h in recovery room before discharging them home. Results: Two of our patients (1%) required immediate suturing on table after Gomco clamp was removed, five patients (2.5%) were shifted back from the recovery room to minor OT for suture repair and eight patients (4%) required reinforcement of primary dressing to control the minor ooze. There was no other complication. Cosmesis was to the satisfaction of the surgeon as well as the parents. Conclusion: Gomco clamp is a bloodless, sutureless, simple, and safe method of circumcision in newborns and infants. It is cost-effective and can be performed under local anesthesia and sedation with excellent cosmetic results.
  25,301 463 -
Cavernous haemangioma mimicking as clitoral hypertrophy
Sajid Nayyar, Naeem Liaqat, Nayyar Sultan, Sajid Hameed Dar
January-March 2014, 11(1):65-66
DOI:10.4103/0189-6725.129238  PMID:24647298
Haemangioma is the most common benign neoplasm of infantile age. It is most commonly located in head and neck region, trunk and extremities but very rarely it can be located at clitoris. However, it is very important to differentiate clitoral haemangioma from enlargement of the clitoris secondary to androgen excess. Only four cases of clitoromegaly caused by cavernous haemangioma have been reported in the literature so far. Herein, we report our experience with a 10-year-old girl who presented with clitoromegaly and normal hormonal assay that turned out to be clitoral cavernous haemangioma after histopathological examination of the clitoral mass.
  25,275 313 2
Choosing a technique for severe hypospadias
Alexis Arnaud, Luke Harper, Marie-Benedicte Aulagne, Jean-Luc Michel, Aude Maurel, Eric Dobremez, Laurent Fourcade, Lalatiana Andriamananarivo
September-December 2011, 8(3):286-290
DOI:10.4103/0189-6725.91668  PMID:22248891
Introduction: We participate in humanitarian missions in Madagascar during which we treat severe hypospadias. We report our experience and results with these patients, in these conditions, and discuss our choice of technique in this particular setting. Materials and Methods: We retrospectively reviewed the data of 27 patients operated for severe hypospadias during our humanitarian missions in Madagascar between November 2006 and September 2009. Twenty one patients underwent a modified Koyanagi procedure, three underwent a Duckett urethroplasty, two an onlay island flap, one an augmented Duckett and one a tubularised plate urethroplasty. Two patients who underwent a modified Koyanagi repair also had a Nesbitt dorsal plication. Results: Patient age at the time of surgery ranged from 22 to 198 months with a median age of 54.1 months. Mean follow-up was 16 months. Of the 21 patients who underwent a modified Koyanagi procedure, 16 presented at least one complication (76%): A fistula developed in 12 patients (57%), meatal regression developed in 7 (33%) and 2 showed complete wound dehiscence (9.5%). None developed stenosis or urethrocoele. Conclusion: In this particular setting, the postoperative complication rate is high. Nevertheless, the Koyanagi technique is appropriate, because its complications are easy to treat and there is always sufficient ventral tissue for the secondary operation, if necessary.
  23,105 360 2
Radiographic signs of gastrointestinal perforation in children: A pictorial review
Olugbenga T Awolaran
July-September 2015, 12(3):161-166
DOI:10.4103/0189-6725.170177  PMID:26612119
Plain abdominal radiographs remain an important aid for clinicians in the diagnosis of gastrointestinal perforation, especially in neonates and very sick children where clinical features of peritonitis may not be as prominent. Suggestive radiographic features are not always very obvious, especially when taken in the supine position and may lead to delayed or missed diagnosis. Through a pictorial review of plain radiographs, this article highlights a number of documented features of gastrointestinal perforation on X-ray in the paediatric setting, which increases the accuracy of diagnosis.
  20,424 259 2
Male circumcision: An overview
Prosanta Kumar Bhattacharjee
January-June 2008, 5(1):32-36
DOI:10.4103/0189-6725.41634  PMID:19858661
Circumcision is one of the common operations performed worldwide, for various reasons. Controversy exists as to whether circumcision is an operation. This literature review discusses the indications of circumcision, benefits and complications of circumcision, and alternatives to circumcision. Relevant articles on the benefits, complications, indications and alternative to circumcision from 1964 to 2005 were reviewed, from National Library of Medicine's Pubmed database. Additional articles were obtained from the reference lists of key articles and recent reviews.
  19,698 767 2
A simple procedure for management of urethrocutaneous fistulas; post-hypospadias repair
S Mohamed, N Mohamed, T Esmael, Sh Khaled
May-August 2010, 7(2):124-128
DOI:10.4103/0189-6725.62844  PMID:20431229
Objectives : The treatment of urethral fistulas is quite challenging. We try to evaluate the results of a simple procedure in post-hypospadias urethral fistula repair. Materials and Methods: In the period from 2003 to 2007, 35 patients with 35 fistulas, with an average age 3.5 years [range: 2-8], were classified into coronal 12, mid-penile 13 and proximal 10. Based on the size they were grouped into two - either less than 5 mm (20) or more than 5 mm (15). Midline relaxing incision was used for large fistulas and then covered with a vascularised flap dartos-based flap [flip flap] in 19 and tunica vaginalis in 16. If a patient had more than one small fistula adjacent to each other, they were joined into a large single fistula and then repaired. Results: We have successfully repaired all urethrocutaneous fistulas using our protocol, with success rate [97.3] 1/35. Conclusions: Dorsal midline urethral incision (DUMI), with dartos flip flap or tunica vaginalis coverage is an appropriate procedure to repair midline and proximal urethral fistulas.
  18,999 456 2
Yolk sac tumour of the penile shaft: A rare primary extra-gonadal presentation
Modupeola Omotara Samaila, Hussaini Y Maitama, Kabiru Abdullahi, Hyacinth Mbibu, Garba Dahiru Waziri
May-August 2011, 8(2):241-243
DOI:10.4103/0189-6725.86074  PMID:22005377
Germ cell tumours (GCTs) commonly involve the ovaries, testes, and other midline structures in children and adolescents and comprised a variety of tumours that have a common histiogenetic origin. The yolk sac tumour (YST) variant is the most common one seen in over 80% of testicular GCTs in children. Other sites of occurrence of these tumours include the mediastinum, prostate, retroperitoneum, and sacrococcygeal region. Penile malignancies account for less than 10% of male malignancies in the elderly, while its occurrence in children is rare. We present the case of a 5-year-old child with YST of the penile shaft and uninvolved testes.
  18,756 258 -
Anterior sagittal anorectoplasty: An alternative to posterior approach in management of congenital vestibular fistula
Man Mohan Harjai, Navdeep Sethi, Naveen Chandra
April-June 2013, 10(2):78-82
Background: Better exposure, possibility of extension if needed and precise placement of the anal canal within the external sphincter complex have made the posterior and anterior sagittal approaches more popular and established for the correction of anovestibular fistula. The mini posterior sagittal anorectoplasty (PSARP) was the procedure of choice for female ARM at our center till date. As an alternative surgical option, we performed anterior sagittal anorectoplasty (ASARP) in 15 cases of anovestibular fistula and compared them with 12 cases of vestibular fistula operated by PSARP technique. Patients and Methods: Fifteen female infants with vestibular fistula who had anterior sagittal anorectoplasty (ASARP) procedure were reviewed. The procedure and its outcome were evaluated. Results : The manoeuvering during anesthesia and operative access were quite easier in ASARP compared to PSARP. Delineation of plane in ASARP between rectum and vagina was easier and clearer in comparison to PSARP. Rent occurred in the posterior vaginal wall in three cases of ASARP and two cases of PSARP. There were two cases of wound infection in each group. Three cases of PSARP group developed anal stenosis and constipation while one in the ASARP group developed constipation. Conclusion : Anesthesia and access in ASARP makes it an easier alternative option to PSARP in the management of anovestibular fistula in girls.
  17,657 610 6
The management of dog bite injuries of genitalia in paediatric age
Mirko Bertozzi, Antonino Appignani
July-September 2013, 10(3):205-210
DOI:10.4103/0189-6725.120875  PMID:24192460
Dog bite injuries are common in children and represent an important health-care problem. Most dog bite injuries involve the face or an extremity. Victims tend to seek medical care quickly. Dog bites to the external genitalia are rarely reported, but they potentially result in morbidity if improperly managed. Morbidity is also directly related to the severity of initial wound. Guidelines for the management of dog bites include irrigation, dιbridment, antibiotic therapy, consideration of tetanus and rabies immunisation and suture of wounds or surgical reconstruction. Literature review was conducted and focused to analyze the management of dog bite lesions involving external genitalia.
  17,721 489 2
Outcome of non-operative management of femoral shaft fractures in children
AL Akinyoola, OO Orekha, FO Taiwo, AO Odunsi
January-April 2011, 8(1):34-39
DOI:10.4103/0189-6725.78666  PMID:21478584
Background: Femoral shaft fractures are common injuries in childhood. There is paucity of information on their presentation and outcome of the available treatment methods in the African population. This study evaluated the outcome of non-operative methods of treatment of femoral shaft fractures in our centre. Patients and Methods: A retrospective review of the database of children aged 14 years and below with femoral shaft fractures treated non-operatively over a 10-year period. Results: A total of 134 patients with 138 fractures met the study criteria. This consisted of 71 boys (mean age = 6.1 years ± SD) and 63 girls (mean age = 6.5 years ± SD). Pedestrian vehicular accident was the most common cause of femoral shaft fractures in the study population. The midshaft was the most common site of fractures. There were associated injuries to other parts of the body (especially head injury) in 34.3% of the patients. The commonest mode of treatment was skin traction only (87.7%). The mean time to fracture union was 4.9 weeks ± SD (range = 3-15 weeks). The mean length of hospitalisation was 6.7 weeks ± SD (range = 5 days-11 weeks). There was a fairly strong positive correlation between the length of hospitalisation and the presence of associated injuries, especially head injury, upper limb fractures and bilaterality of the fractures. The mean total cost of treatment was #7685 (Naira) or $51.2 (range = $14.2-$190). At the last follow up, 97.8% of the fractures united without significant angulation or shortening. Conclusion: The outcome of non-operative treatment of femoral shaft fractures in our setting is comparable to the results of other workers. Methods of treatment that shorten the length of hospitalisation without unduly increasing cost should be encouraged.
  17,816 359 9
Persistent Mullerian duct syndrome: A case report and review of the literature
Temitope O Odi, Lukman O Abdur-Rahman, Abdulrasheed A Nasir
September-December 2010, 7(3):191-193
DOI:10.4103/0189-6725.70425  PMID:20859029
Persistent Mullerian duct syndrome is a rare form of internal male pseudohermaphroditism, in which Mullerian duct derivatives (uterus and fallopian tubes) are present in a genotypic (46XY) and phenotypic male. Over 150 cases have been reported, mainly from outside the African setting. This article presents an unexpected case encountered in an African setting. Handicaps in the management were unavailability of necessary diagnostic tools as well as lack of finance to assess those available. Although a diagnosis was eventually arrived at and the parents thoroughly counseled, the patient has not represented for definitive surgery.
  16,696 434 8
Surgical outcome and complications following cleft lip and palate repair in a teaching hospital in Nigeria
Taiwo O Abdurrazaq, Adeyemi O Micheal, Adeyemo W Lanre, Ogunlewe M Olugbenga, Ladeinde L Akin
October-December 2013, 10(4):345-357
DOI:10.4103/0189-6725.125447  PMID:24469486
Background: Measurement of treatment outcome is important in estimating the success of cleft management. The aim of this study was to assess the surgical outcome of cleft lip and palate surgery. Patients and Methods: The surgical outcome of 131 consecutive patients with cleft lip and palate surgeries between October 2008 and December 2010 were prospectively evaluated at least 4 weeks postoperatively. Data collected included information about the age, sex, type of cleft defects, and type of surgery performed as well as postoperative complications. For cleft lip repair, the Pennsylvania lip and nose (PLAN) score was used to assess the surgical outcome, while the integrity of the closure was used for cleft palate repair. Results: A total of 92 patients had cleft lip repair and 64 had palate repair. Overall, 68.8% cases of cleft lip and palate repair had good outcomes; 67.9% of lip repairs had good lip and nose scores, while 70.2% of palatal repair had a good surgical outcome. Oro-fistula was observed in 29.8% of cleft palate repairs Inter-rater reliability coefficient was substantially significant. Conclusions: The fact that 25.7% of those treated were aged >1 year suggests a continued need to enlighten the public on the availability of cleft lip and palate expertise and treatment. Although an overall good treatment outcome was demonstrated in this study, the nasal score was poorer than the lip score. Complication rate of about 14% following surgical repair is consistent with previous reports in the literature.
  16,263 606 20
Acute spontaneous gastric perforation in neonates: A report of three cases
Ashok Y Kshirsagar, Gaurav O.P Vasisth, Manoj D Ahire, Rajkamal K Kanojiya, Sanjitsingh R Sulhyan
January-April 2011, 8(1):79-81
DOI:10.4103/0189-6725.78935  PMID:21478593
Gastric perforation in neonates is a rare, serious and life-threatening problem. The precise aetiology is obscure in most cases. By virtue of its high mortality rate, it requires prompt recognition and surgical intervention. We report three cases of neonatal gastric perforation managed by early resuscitation and primary repair.
  16,279 414 5
Degloving injury to the penis
Raj K Mathur, Brajesh K Lahoti, Gaurav Aggarwal, Bhaskar Satsangi
January-April 2010, 7(1):19-21
DOI:10.4103/0189-6725.59354  PMID:20098004
A case of reconstruction after penile skin avulsion is described in an eight-year-old boy. Penile coverage was gained by use of the avulsed skin flap itself, without a graft or local tissue flap. The procedure avoids any valuable time delay; thus, enhancing the chances to obtain adequate flap viability, avoids patient discomfort caused by perineal expansion, gives a satisfactory cosmetic appearance, and taking into account his age, avoids future psychosomatic and psychosexual problems.
  16,033 363 6
Sternal cleft repair: A report of two cases and review of literature
Sangram Singh, BK Lahoti, Saurabh Garge, Anupama Negi, Vishal Jain
September-December 2010, 7(3):211-213
DOI:10.4103/0189-6725.70432  PMID:20859036
A cleft sternum is a rare congenital anomaly often diagnosed as asymptomatic at birth. Clinical outcome may be unfavourable when an associated anomaly, particularly, an intra cardiac anomaly coexists with the defect. Primary repair should be employed in the neonatal period because the flexibility of the chest wall is maximal and thus the compression of underlying structures is minimal. However, patients with sternal cleft may even present late in the childhood or adolescence period. We herein report two cases of successful repair of sternal clefts with review of the available literature.
  14,637 331 6
Urethral duplication in a 12-year-old child
Faustin Félicien Mouafo Tambo, Jacques Birraux, Ambroise Wonkam, Zacharie Sando, Yvonne Walburga Joko, Pierre-Yves Mure, Claude Le Coultre, Gervais Ondobo Andze, Maurice Aurélien Sosso
September-December 2011, 8(3):313-316
DOI:10.4103/0189-6725.91667  PMID:22248898
Urethral duplication is a rare congenital malformation affecting mainly boys. The authors report a case in a Cameroonian child who was diagnosed and managed at the Gynaeco-Obstetric and Paediatric Hospital, Yaounde. The malformation was characterized by the presence of an incontinent epispadic urethra and a normal apical urethra. We describe the difficulties faced in the management of this disorder in a developing country.
  14,479 225 -
Sirenomelia (mermaid syndrome): A rare anomaly
Yogender S Kadian, Nirmala Duhan, Kamal N Rattan, Manoj Rawal
July-December 2008, 5(2):105-106
DOI:10.4103/0189-6725.44190  PMID:19858681
  14,101 419 3
Cleft lip and palate surgery in children: Anaesthetic considerations
DY Kwari, JY Chinda, HO Olasoji, OO Adeosun
September-December 2010, 7(3):174-177
DOI:10.4103/0189-6725.70420  PMID:20859024
Background: The Care of cleft patients is very challenging. Team cleft care is usually lacking in many developing countries due to shortage of qualified manpower. This study is aimed at highlighting anaesthetic challenges in the management of cleft in children. Patients and Methods: This was a study of cleft lip and palate patients who were managed during team cleft care activities at University of Maiduguri Teaching Hospital and Federal Medical Centre Nguru both in north eastern Nigeria from January to June 2009. Results: One hundred and six cleft patients presented for surgical repair under general or local anaesthesia. Fifteen (14%) patients all of whom children were unfit for general anaesthesia due to various medical reasons. Ninety-one (86%) cleft patients comprising 53(50%) children and 38(36%) adults had cleft repair under halothane general endotracheal anaesthesia and local anaesthesia, respectively. There was no anaesthetic complications recorded under local anaesthesia. Fifteen percent of children who received general endotracheal anaesthesia suffered various anaesthetic complications which included hypoxia (3.8%), laryngospasm (1.9%), kinking of endotracheal tube (5.7%), inadvertent extubation (1.9%) and pulmonary aspiration (1.9%). There was no mortality or anaesthesia-related morbidity at the time of discharge in all the cases. Conclusion: We conclude that anaesthesia for cleft lip and palate repair in hospital based team-cleft care activities in our environment is relatively safe. We recommend general anaesthesia with controlled ventilation for children and local anaesthesia for adult and older children who can cooperate.
  13,736 644 10
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