Scrotoschisis: Management Challenges and Review of Literature.

Scrotoschisis (extracorporeal testicular ectopia) is a rare congenital defect of the scrotal sac associated with the extrusion of one or both testicles. The exact mechanism causing the anomaly is largely unknown. This is a report of two infants aged 3 and 4 days, respectively, presented with infected unilateral extracorporeal testicular ectopia.

Outcome of Transanal Endorectal Pull-Through in Patients with Hirschsprung's Disease.

Background: Transanal endorectal pull-through (TERPT) has become one of the preferred treatments for Hirschsprung's disease (HD) in our setting. This report aims to evaluate the current outcome of TERPT in the setting.

Materials And Methods: A retrospective review of 71 children who had TERPT for histologically-confirmed HD in 11 years (2006-2017) in Nigeria.

The Impact of Global Collaboration on the Academic Focus of the West African College of Surgeons: Are Worldwide Efforts Aligning with Local Priorities?

Background: Global collaboration has the potential to induce a shift in research focus away from the priorities of those in low- and low-middle-income countries (LICs and LMICs). This study quantified international collaboration among surgery publications by Fellows of the West African College of Surgeons (WACS) and investigated if collaboration with upper-middle-income and high-income countries (UMICs and HICs) decreases the homophily of research focus.

Methods: Publications by WACS surgery Fellows from 1960 to 2019 were characterized as local WACS publications, collaborative publications without UMIC/HIC participation, or collaborative publications with UMIC/HIC participation.

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.

A Modified Rectal Mucosal Biopsy for the Diagnosis of Hirschsprung's Disease: Zaria Experience.

Background: Full-thickness rectal biopsy is often used for the diagnosis of Hirschsprung's disease (where a suction biopsy kit is not available). This is associated with some challenges such as limited theatre space and the need for general anaesthesia. We aim to highlight the usefulness and sensitivity of a modification of the rectal mucosal biopsy without general anaesthesia in the diagnosis of Hirschsprung's disease.

Duodenal obstruction due to missed pre-duodenal portal vein in a patient with intestinal malrotation.

Pre-duodenal portal vein (PDPV) is a rare anomaly and a rare cause of duodenal obstruction (DO), with only a few cases reported in the literature. We present an infant whose bilious vomiting persisted despite having Ladd's procedure for intestinal malrotation due to a missed diagnosis of DO from PDPV that was found at re-exploration. The patient was diagnosed with malrotation and had Ladd's procedure at 12 weeks of age, but bilious vomiting persisted post-operatively.

Surgical subspecialists in West Africa: Workforce size, training opportunities, and contributing factors.

Background: The global burden of disease treatable by surgical subspecialists remains an outstanding area of need, and yet little is known about the subspecialist workforce worldwide, especially in sub-Saharan Africa. This study aims to quantify the subspecialty surgical workforce and number of subspecialty training programs in West Africa and to identify socioeconomic factors predicting the number of subspecialists in West African countries.

Methods: West African subspecialists and accredited fellowship training programs in 17 West African countries were quantified using membership data from the West African College of Surgeons and compared with publicly available workforce data from the United States, the United Kingdom, and East, Central, and Southern Africa.

Accuracy of ultrasonography in the evaluation of abdominal masses in children in Nigeria.

Introduction: Abdominal masses in children constitute a spectrum of lesions of diverse origin, nature and significance. In a low-income setting with limited investigative facilities, accurate diagnosis of abdominal masses can be very challenging. However, ultrasound has been used preferentially as a diagnostic tool in evaluating abdominal masses in children.

Presentation and outcome of treatment of jejunoileal atresia in Nigeria.

Background: Intestinal atresia is a common cause of neonatal intestinal obstruction. Previous reports from Nigeria have indicated a high mortality rate. This is a report of current outcome review from one tertiary center.

Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children.

Background: Primary wound closure following laparotomy for peritonitis is generally believed to be associated with wound complications and long hospital stay. Open wound management has long been the most common practice after laparotomy for peritonitis. Primary closure (PC), however, has recently been advocated to reduce cost and morbidity.

Perceived role of the journal clubs in teaching critical appraisal skills: a survey of surgical trainees in Nigeria.

Background: Critical appraisal skills allow surgeons to evaluate the literature in an objective and structured manner, with emphasis on the validity of the evidence. The development of skills in critical acquisition and appraisal of the literature is crucial to delivering quality surgical care. It is also widely accepted that journal clubs are a time-honored educational paradigm for teaching and development of critical appraisal skills.

Role of damage control enterostomy in management of children with peritonitis from acute intestinal disease.

Background: Intestinal anastomosis in severely ill children with peritonitis from intestinal perforation, intestinal gangrene or anastomotic dehiscence (acute intestinal disease) is associated with high morbidity and mortality. Enterostomy as a damage control measure may be an option to minimize the high morbidity and mortality. This report evaluates the role of damage control enterostomy in the treatment of these patients.

Anorectal malformation coexisting with Hirschsprung's disease: a report of two patients.

Anorectal Malformation (ARM) and Hirschsprung's Disease (HD) are common causes of congenital intestinal obstruction in children. Simultaneous occurrence of both conditions is rare. Few have been reported in Europe and Asia, but we have no knowledge so far of such report from Nigeria.

Early oral feeding following intestinal anastomoses in children is safe.

Background: Oral feeding following intestinal anastomoses is frequently delayed. In settings with limited utilisation of parenteral nutrition, this policy is problematic. This report evaluates the safety of early oral feeding following intestinal anastomoses in children.

One-day bowel preparation in children with colostomy using normal saline.

Background: Colonic and colorectal surgery frequently requires bowel preparation. This is an evaluation of the use of normal saline for one-day bowel preparation in children with colostomy.

Patients And Methods: A prospective study of 55 children with colostomy who had one-day bowel preparation for colonic and colorectal surgical procedures in a 3-year period.

Congenital vaginal obstruction in neonates and infants: recognition and management.

Background: Congenital vaginal obstruction commonly presents after puberty and presentation in infancy is uncommon. Due to lack of awareness, diagnosis may be missed in infants, sometimes with disastrous consequences.

Method: A retrospective review of 9 neonates and infants treated for congenital vaginal obstruction in 16 years.

Surgical site infection in children: prospective analysis of the burden and risk factors in a sub-Saharan African setting.

Background: Surgical site infections (SSI) add substantially to the morbidity of surgical patients. Our hypothesis was that the SSI rate is high in our setting, but there were no data regarding the prevalence and risk factors.

Methods: Three hundred twenty-two children who had surgery (elective 144, emergency 178) between January, 2001 and September, 2005 were studied prospectively.

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.

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.

Symptomatic vitelline duct anomalies in children.

A wide variety of anomalies may occur as a result of the vitelline duct (VD) failing to obliterate completely. Most reports on symptomatic VD focus on Meckel's diverticulum, while other anomalies are given little attention. A retrospective review was conducted at our institution.