[Show abstract][Hide abstract] ABSTRACT: The purpose of this study is to describe the experience of managing leech infestation in lower urinary tract from a tropical country.
Medical records (January 2002 to December 2010) of children with history of leech infestation in the urinary system, admitted in the Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong, Bangladesh were reviewed. All patients underwent saline irrigation through urethral catheter. When saline irrigation failed, cystoscopic examination was done with removal of leeches by flexible graspers. Follow-up was done 2 weeks later.
The study included 117 patients. Age ranged from 4 to 12 years. Male and female ratio was 3.7:1. All patients had per urethral bleeding. 51 (43.6%) patients had suprapubic pain. All children underwent saline irrigation through urethral catheter. Spontaneous expulsion occurred after saline irrigation in 57 (48.7%) patients. The expelled leeches were alive in 11 cases; dead in 46 patients. Cystoscopic removal of leeches was done in 60 patients (51.3%). In the cystoscopic group, 54 of the removed leeches were dead and 6 were alive.
Cystoscopic removal can be a useful technique for the removal of leeches from the urinary tract when saline irrigation fails.
No preview · Article · Jul 2012 · European Journal of Pediatric Surgery
[Show abstract][Hide abstract] ABSTRACT: Introduction : Malrotation is a common anomaly in the pediatric age group which includes a wide spectrum of anomalies of Rotation. Both acute and chronic presentations are common. Atypical malrotation not having all the features of classic malrotation is frequently found which a diagnostic dilemma is and the management varies from centre to centre. Materials and Methods : The medical records of all patients with symptomatic malrotation, who underwent surgery between July 2001 to June 2011, were retrospectively reviewed. Patients' presentation, management, operative findings and complications were evaluated. Results : 68 patients underwent surgery for malrotation at a median age of 2 years. Male to female ratio was 2:1. 28(41%) presented with acute symptoms and 40(59%) with chronic symptoms. 54(79%) patients had vomiting, 36 (53%) presented with abdominal distension, 19(28%) had recurrent abdominal pain. Diagnostic laparoscopy was done in 7(10%) patients. Ladd's band was found in 16(24%) patients and Volvulus was found at the time of surgery in 5(7%) patients. 5(7%) patients also had associated anomalies. Ladd's procedure was done in 15(22%) patients and 23(34%) patients needed resection and anastomosis. Median length of hospital stay was 10 days. Postoperative bowel obstruction was seen in 4(6%) patients and 2(3%) patients had post operative intussusception. There was 2(3%) death due to septicaemia with volvulus and gangrenous gut. Conclusion : The clinical presentation and anatomy of malrotation occurs along a wide clinical and anatomic variations and a high index of suspicion is required to prevent a delay in diagnosis.
[Show abstract][Hide abstract] ABSTRACT: Amniotic band syndrome refers to the uncommon occurrence of a variety of congenital deformities, most probably due to fetal entanglement in strands ruptured from the amniotic sac. We present a case of a constriction band in the leg together with a short literature review.
[Show abstract][Hide abstract] ABSTRACT: Although burns are rare in neonates, in our country we see quite a number of neonatal burns and we are presenting our experience. All records of neonatal burns, from January 2005 to December 2009 were reviewed. Causes, Types, Extent, Management and Outcomes were analyzed. Total patients were 47. Male female ratio was 1:1.04. Superficial burns were eight(17%) patients , superficial dermal 19(40%), deep dermal 15(32%), and full thickness five(11%). Twenty nine(61.7%) patients had scald and 18 flame burn. The body surface area burned ranged from 5% to 75%. 30 patients (63.8%) had less than 10% burn and 17 (36.17%) were more than 10% burn. Four (8.5%) patients died [> 30%], due to septicaemia and multi- organ failure. 15(31.91%) patients developed burn contracture, depigmentation of the burnt area. Our experience shows most of the neonatal burns are preventable.
[Show abstract][Hide abstract] ABSTRACT: We report two cases of syndactyly of both hands in two sibs with their father also having syndactyly of both hands and feet. All of them had beaked nose suggestive of syndromic patients. Release of syndactyly and skin grafting was done in the children with acceptable functional outcome.