INTESTINAL OBSTRUCTION IN CHILDREN AT EL OBEID HOSPITAL, WESTERN SUDAN.

Background: Intestinal obstruction is a common cause of childhood surgical emergency in the developing countries with considerable morbidity and mortality. Objectives: To assess the magnitude, pattern and management outcomes of intestinal obstruction in children presenting to a General Surgical Unit at a rural setup, in Western Sudan. Patients and Methods: The clinical records of all children below 15 years of age admitted to the University General Surgical Unit at El Obeid Teaching Hospital, in Western Sudan with the diagnosis of intestinal obstruction during the period from 2006 to 2007 were retrospectively reviewed. The mean age, gender, causes of obstruction and management outcomes were studied and analyzed. Results: There were 72 patients.  48 were males (66.7%). Neonates and infants were 70% of patients. Hirschsprung’s disease, intussusception, obstructed hernias and ano-rectal anomalies accounted for 21.8%, 19.4%, 16.7% and 13.9% respectively. Less common causes were pyloric stenosis 8.3% and gut atresia 6.9%. Lymphoma, adhesions, peritonitis and faecal impaction were 2% each. The overall mortality rate was 13.9%. Conclusions: The main causes of childhood intestinal obstruction at Western Sudan were congenital anomalies in neonates, intussusception in infants and obstructed hernias in elder children. The management was associated with high mortality due to poor hospital facilities and late presentations resulting in bowel ischaemia

Mirror image polydactyly in a foot of young female with late presentation: management and three years follow-up

Background: Polydactyly (extra digits) is a common congenital anomaly which has familial tendency and its incidence vary widely a according to many factors including race, geographical distribution and familial tendency. It's commonly affect the hands but also can be found in the foot. We report a case of mirror foot polydactyly with late presentation with successful management. Case presentation: A 17-year-old female patient presented to our plastic surgery clinic complain of left foot deformity and inability to wear her shoe (closed) since birth. Examination of the left foot showed 4 extra digits in the medial aspect. The diagnosis of polydactyly (mirror foot) was made based on clinical and radiological finding. She underwent excision of the extra digit with correct the valgus deformity of the big toe. She had no postoperative complications with excellent result after 6 years follow up. Conclusion: This a case of mirror foot (9 toes) with late presentation. We successfully treated this case by removing the extra digit and correction of varus deformity of the big toe. Despite the late presentation, the outcome is goo

Review of Plastic and Reconstructive Surgery in a General Hospital Setting: Experience from a Developing Country

Abstract Background: Plastic and reconstructive surgery in developing countries and underserved areas are significantly limited and face changes to start a proper service. This study presents a review of plastic surgery services and experiences in a district hospital located in an underserved area. Methods: This descriptive, retrospective, hospital-based study was conducted to review patients who presented to the plastic and reconstruction departments from January 2014 to January 2015. All patients seen in the outpatient clinic or emergency departments for plastic surgical consultation or management were included in the study. Results: The total of 403 cases fulfilled the inclusion criteria. The emergency surgical operation performed in our unit were distributed in the following descending order; fingertip injury (32%), cut wrist (12.7%), cut extensor tendon (9.9%), gunshot injuries (9.4%), fracture of a small bone of the hand (8.3%), and lower limb trauma. Surgery for congenital deformities constituted the most elective operation done in our unit (31.6 %), followed by tumor surgery (18.7%), burn surgery (17.3%), aesthetic surgery procedure (12.2%), and other miscellaneous cases (12.2%). Conclusion: This report demonstrates the efficacy of secondary hospital setting to accommodate a large volume of patients during the first year of establishment, and further predicting development needs, staff training, and governmental support

Gunshot Injuries: Patterns, Presentations, and Outcomes of Civilian Hospital Experiences in a Developing Country Setting

Abstract Background: Gunshot injuries are considered a health burden as well as one of the intricate emergencies in civilian medical practice. In this study, we aim to determine the pattern of presentation and management outcome in a general hospital setting in a sub-Saharan African country. Methods: This is a retrospective, hospital-based study conducted between January 2015 and December 2019 in a general teaching hospital to review the clinical presentation and management outcome of gunshot injuries. All patients' records were reviewed during the study period. Results: The total number of patients involved in the study was 157 with 83% male predominant. About 50% were from the age group 20–29 years that were most affected. The commonest anatomical site affected in the study was the lower limb (41.4%) and upper limb (22.9%), and most of the patients had been diagnosed with limb fractures (49.7%) and soft tissue injuries (28.7%). Wound debridement is the commonest procedure performed for 91 (58.0%) patients. The site of the pullet has a significant relation to the management outcome with a P-value of 0.002. Additionally, about 45% (72 patients) have stayed more than 20 days and it was affected significantly by the types of treatment provided, which has a significant relation to a hospital stay with a P-value of 0.00. Conclusion: Most of the patients in this study were young males. Upper and lower limb fractures were the most common presentations. Wound debridement, bone fixation, and laparotomy were the most common treatments with significant success rates, despite prolonged hospital stays