The History and Evolution of the West African College of Surgeons/Jos University Teaching Hospital Trauma Management Course.

Background: Inadequate trauma care training opportunities exist in Low- and Middle-Income Countries. Jos University Teaching Hospital and the West African College of Surgeons (WACS) have synergized, over the past 15 years, to introduce a yearly, certified, multidisciplinary Trauma Management Course. We explore the history and evolution of this course.

Laparoscopy-assisted Transanal Endorectal Pull-through for the Management of Hirschsprung's Disease in Nigeria: Report of Two Cases.

Hirschsprung's disease is a relatively common disease in pediatric colorectal surgery. The treatment modalities have evolved from third-stage to single-stage in the past three decades. The single-stage procedure can be performed using the open, transanal or laparoscopy-assisted techniques.

PNEUMATIC REDUCTION OF INTUSSUSCEPTION IN CHILDREN: EXPERIENCE AND ANALYSIS OF OUTCOME AT JUTH, JOS, A TERTIARY HEALTH CENTRE IN NORTH CENTRAL NIGERIA.

Context: Intussusception is a common childhood abdominal surgical emergency worldwide resulting in considerable morbidity and mortality if not promptly treated. Ultrasound-guided pneumatic reduction has been proven to be the most reliable and successful non-operative management option with the least complication rate.

Aims: To evaluate our local experience with the ultrasound-confirmed pneumatic reduction of childhood intussusception and to determine factors that predict successful outcome.

Trauma Registry Development for Jos University Teaching Hospital: Report of the First Year Experience.

Adequate intervention in trauma management and prevention requires a well-documented database for objective study of the disease characteristics, hence the need for a trauma registry. The aim and objective of this study is to document in a database all patients admitted in our hospital following trauma. This study was conducted at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria.

Neonatal surgery in Africa.

The management of neonatal surgical problems continues to pose considerable challenges, particularly in low-resource settings. The burden of neonatal surgical diseases in Africa is not well documented. The characteristics of some neonatal surgical problems are highlighted.

Laparoscopic-assisted retrieval of migrated intra-abdominal pacemaker generator.

A 5-year-old boy born with a congenital heart defect had insertion of an epicardial pacemaker that was found on routine evaluation to have been displaced into the rectovesical pouch. He underwent transvenous insertion of another pacemaker, and the displaced pacemaker was successfully retrieved by laparoscopy without incident.

Small intestinal obstruction from peritoneal adhesions in children small intestinal obstruction from peritoneal adhesions in children.

Purpose: The purpose of this study was to assess the incidence of peritoneal adhesions leading to small intestinal obstruction after laparotomy in children in a tertiary paediatric surgical centre.

Methods: A retrospective review of 430 children aged <15 years who had trans-abdominal procedures over a 7 year period.

Results: Four hundred and fifty nine abdominal procedures were performed in 430 children during the study period.

Challenges of training and delivery of pediatric surgical services in Africa.

Background: The practice of pediatric surgery in Africa presents multiple challenges. This report presents an overview of problems encountered in the training of pediatric surgeons as well as the delivery of pediatric surgical services in Africa.

Methods: A returned structured self-administered questionnaire sent to pediatric surgeons practicing in Africa was reviewed and analyzed using SPSS version 11.

Sacrococcygeal teratoma: clinical characteristics and long-term outcome in Nigerian children.

Background/purpose: The excision of sacrococcygeal teratoma (SCT) may be associated with significant long-term morbidity for the child. We reviewed our experience with SCT in a tertiary health care facility in a developing country with particular interest on the long-term sequelae.

Methods: Between January 1990 and May 2008 inclusive, 38 consecutive children with the diagnosis of SCT were identified from the operation register and the Cancer Registry of the Jos University Teaching Hospital.

Childhood cancers: challenges and strategies for management in developing countries.

The developing countries bear the greatest burden of childhood cancers as over 90% of the world's children live in these countries. Childhood cancer in most instances is curable, but many children die from cancer because most children live in developing countries without access to adequate treatment due to high cost of treatment and poor organization in these countries. Initiatives to increase cancer care in developing countries would therefore include establishment of standard cancer care centres, manpower training, establishment of standardized management protocols, procurements of standard drugs and collaboration with international organizations.

Gastrointestinal injuries following blunt abdominal trauma in children.

Purpose: Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma.

Patients And Methods: From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma.

Childhood Wilms' tumour: prognostic factors in North Central Nigeria.

Background: Childhood Wilms' tumour or nephroblastoma represents one of the challenges for paediatric oncologists in developing countries.

Objective: To review the clinical characteristics and outcome of management of childhood nephroblastoma in North- Central Nigeria.

Methods: The clinical, operative and histological records of children aged 15 years and below, that were managed for Wilms' tumour at the Jos University Teaching Hospital between 1998 and 2005 were retrospectively reviewed.

Colostomy for high anorectal malformation: an evaluation of morbidity and mortality in a developing country.

Colostomy is a life-saving procedure in newborns with high anorectal malformations (ARM). However, the procedure may be attended by complications, particularly in resource limited settings. This is an evaluation of the morbidity and mortality following colostomy for ARM in newborns in two paediatric teaching centres in a developing country.

Clinical characteristics and outcome of surgical treatment of childhood rhabdomyosarcoma: a 7-year experience.

Background: The aim of this study was to describe the outcome and determine the prognostic factors of outcome of childhood rhabdomyosarcoma in a tertiary hospital in a developing country.

Patients And Methods: This was a retrospective review of the clinical presentation, investigation, intervention, and treatment outcomes of children with rhabdomyosarcoma in our hospital over a 7-year period. Statistical analysis was performed using Chi-square test.

Pilot study on one-stage colonic resection without lavage in obstructed left colon in children in an emergency setting.

Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctioning colostomy. The purpose of this study was to examine the feasibility of single-stage resection and anastomosis without intraoperative colonic lavage for acute left-sided colonic obstruction in children. Between October 2000 and May 2006, nine consecutive patients who had a one-stage left-sided colon resection without preceding colonic lavage were evaluated.

Paediatric blunt abdominal trauma: challenges of management in a developing country.

Background: In developed countries, the availability of advanced imaging techniques has reduced the necessity for laparotomy following blunt abdominal trauma in children. Laparotomy rates still remain high in developing countries where these advanced imaging techniques are lacking. A simple management protocol to identify patients who require laparotomy could reduce the laparotomy rate in children with blunt abdominal trauma in these countries.

Colostomy in children--an evaluation of acceptance among mothers and caregivers in a developing country.

Background: Colostomy is a common procedure performed in children, mostly for anorectal malformation and Hirschsprung's disease. However, acceptance by parents in developing countries is thought to be poor.

Methods: A prospective evaluation was done to determine the acceptability of colostomy among parents and caregivers, and their attitude towards colostomy in their children.

Typhoid intestinal perforation in children: a continuing scourge in a developing country.

Typhoid intestinal perforation is a principal cause of morbidity and mortality affecting both adults and children. This study aims to evaluate the pattern of typhoid intestinal perforation and outcome of its management in Nigerian children. The records of consecutive children managed for typhoid intestinal perforation at Juth, between 1996 and 2005 have been reviewed.

Persistent umbilical discharge in infants and children.

Background: Umbilical discharge is not an unusual presentation in infants and children. However, the evaluation and management are rarely discussed.

Method: A retrospective review of 18 patients presenting with persistent umbilical discharge over a period of 22 years, excluding neonates with omphalitis.

Anorectal anomaly: a review of 82 cases seen at JUTH, Nigeria.

Background: The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out to determine the pattern and outcome of management of anorectal malformations (ARM) in a Nigerian tertiary hospital.

Patients And Methods: The clinical and operative records of consecutive children with anorectal anomaly managed between October 1990 and September 2000 at the Jos University Teaching Hospital, Jos, were reviewed.

Incarcerated umbilical hernia in children.

Background: Umbilical hernia is common in children. Complications from umbilical hernias are thought to be rare and the natural history is spontaneous closure within 5 years.

Patients And Methods: A retrospective analysis was performed of the medical records of a series of 23 children who presented with incarcerated umbilical hernias at our institution over an 8-year period.

Management of cystic lymphangioma in children: experience in Jos, Nigeria.

The management of cystic lymphangiomas (CL), especially in the head and neck region, presents challenges to the pediatric surgeon. This is a retrospective study of all children seen with lymphangioma at the Pediatric Surgical Unit of the Jos University Teaching Hospital from 1996 to 2004. There were 27 children, 14 (51.

Intestinal malrotation: presentation in the older child.

Background: The clinical diagnosis of intestinal malrotation in the older child is not always easy because of its non-specific presentations. The aim of this study was to determine the pattern of presentation of malrotation in older Nigerian children.

Methods: The clinical, radiological and operative records of all the children aged 2 years or above, managed for malrotation at the Jos University Teaching Hospital between March 1992 and December 2002 were retrospectively reviewed.