Neonatal gastric perforation: a report of 3 cases and literature review

Neonatal gastric perforation (NGP) is an uncommon disease. Historical reports regard the aetiology as spontaneous while the mortality remains high. We present the report of the cases of neonatal gastric perforations who presented to our facility, its diverse aetiology and a review of the literature. Their clinical data including age, sex, weight, maternal complications, aetiology, location of perforation and the operation performed are summarized. NGP was complicated by anaemia, leukocytosis and thrombocytopaenia in all cases. The overall mortality rate was 66.7% and this was attributed to late presentation. We recommend early recognition and prompt surgical intervention as a way to salvage the condition. Also, passing a nasogastric tube and ensuring free drainage of gastric air and fluid should form part of neonatal resuscitation procedures as a way to prevent gastric over distension and subsequent perforation

Wilms' Tumour: Experience in a Developing Tertiary Centre in Nigeria

Background: Children with Wilms' tumour present early in the developed countries with correspondingly good prognosis. The same however is not true in the developing countries where the patient present rather late. This study evaluates the impact of late presentation on the management of childhood Wilms' tumour in our environment. Methods: This was a retrospective study of children aged 0-15 years managed for Wilms' tumour from January 2004 to April 2010 in a Teaching Hospital in South Western Nigeria. Results: Thirty five patients that had nephroureterectomy for Wilms' tumour with a histological confirmation were included in this study. One child had a Stage 1 disease, 9 had Stage II disease, 20 had Stage III disease, 4 had Stage IV disease and 1 child had a bilateral lesion (Stage V). Five (14.28%) patients have completed their chemotherapy and survived without clinical and radiological evidence of recurrence for a period equal to their age at diagnosis plus 9 months (Cullen's law). Therefore they have been deemed cured. Ten patients were lost to follow-up. Others are on various phases of their chemotherapy, 2 patients had Adriamycin cardiomyopathy. There were 6 (17.14%) deaths. Conclusion: Childhood Wilms' tumour presents late in our setting with its consequent management challenges. The need to educate the populace and the primary healthcare providers on the benefits of early diagnosis and treatment of this condition cannot be overemphasized