Tosadeque Hossain Siddiqui, Shoheli Alam, Z. Ahmed
Spina bifida and Hydrocephalus is one of the most common malformations in Paediatric Surgery. Though the two diseases has their own way of presentation but Spina bifida is accompanied by hydrocephalus in 80 to 90% of cases and treatment protocol is interrelated. As a general paediatric surgeon of the third world country we are facing the challenging job in our day to day practice. The etiology, pathophysiology, diagnosis, treatment and prognosis is not well understood and gratifying. We dont have so much interest on the most vital but neglected birth defect. My aim of discussing this two entity at a time to show light on this malformation and make all paediatric surgeon a bit conscious about the disease process and treatment modalities. So that only referring the patient to a tertiary hospital is not the job of a paediatric surgeon rather we must come forward to prevent and treat this major morbid diseases with ourselves. As a paediatric surgeon our role is not to become a good general paediatric surgeon, also acquire proficiency on other speciality like urology, neurosurgery, orthopaedics, reconstructive & oncology. J. Paediatr. Surg. Bangladesh 3 (1): 37-46, 2012 (January)
{"title":"Spina Bifida and Hydrocephalus in children: Role of a Paediatric Surgeon","authors":"Tosadeque Hossain Siddiqui, Shoheli Alam, Z. Ahmed","doi":"10.3329/JPSB.V3I1.23907","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23907","url":null,"abstract":"Spina bifida and Hydrocephalus is one of the most common malformations in Paediatric Surgery. Though the two diseases has their own way of presentation but Spina bifida is accompanied by hydrocephalus in 80 to 90% of cases and treatment protocol is interrelated. As a general paediatric surgeon of the third world country we are facing the challenging job in our day to day practice. The etiology, pathophysiology, diagnosis, treatment and prognosis is not well understood and gratifying. We dont have so much interest on the most vital but neglected birth defect. My aim of discussing this two entity at a time to show light on this malformation and make all paediatric surgeon a bit conscious about the disease process and treatment modalities. So that only referring the patient to a tertiary hospital is not the job of a paediatric surgeon rather we must come forward to prevent and treat this major morbid diseases with ourselves. As a paediatric surgeon our role is not to become a good general paediatric surgeon, also acquire proficiency on other speciality like urology, neurosurgery, orthopaedics, reconstructive & oncology. J. Paediatr. Surg. Bangladesh 3 (1): 37-46, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115541999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Talukder Sa, D. C. Talukder, Mahmud Aa, M. S. Ali, N. Khan, Shankar Chandra Das, Sangul Islam, Shafiqul Bari
Urethro cutaneous fistula( U-C fistula) is the most common complication of hypospadias surgery. It frequently needs separate surgeries for closure, which bring a great deal of physical and mental agony and monetary involvement of the patient and his family. Many efforts have been invented to prevent the u-c fistula with various degree of success. We would like to see the outcome of Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula. This interventional study was performed to see the outcome of preputial dartos reinforced Snodgrass tubularized incised plate urethroplasties in distal hypospadias specially urethrocutaneous fistula prevention. For this purpose 40 patients were selected having distal hypospadias age ranging from 6 months to 11 years admitted in the Department of Pediatric Surgery, Mymensingh Medical College & Hospital during the period of January 2010 to March 2011. Out of 40 patients, 20 were in group-A (preputial dartos flap) and another 20 were included in group - B (without flap). All this patients were followed by perioperative and postoperative care. Few patients developed postoperative pyrexia, wound infection, stent blockage which were treated accordingly leaving minimum morbidity. Both groups of patients were followed up for 3 months after surgery. Present study is probably a better technique to prevent fistulaassociated morbidities in distal Snodgrass TIP urethroplasties. J. Paediatr. Surg. Bangladesh 3 (1): 12-17, 2012 (January)
{"title":"Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula","authors":"Talukder Sa, D. C. Talukder, Mahmud Aa, M. S. Ali, N. Khan, Shankar Chandra Das, Sangul Islam, Shafiqul Bari","doi":"10.3329/JPSB.V3I1.23901","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23901","url":null,"abstract":"Urethro cutaneous fistula( U-C fistula) is the most common complication of hypospadias surgery. It frequently needs separate surgeries for closure, which bring a great deal of physical and mental agony and monetary involvement of the patient and his family. Many efforts have been invented to prevent the u-c fistula with various degree of success. We would like to see the outcome of Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula. This interventional study was performed to see the outcome of preputial dartos reinforced Snodgrass tubularized incised plate urethroplasties in distal hypospadias specially urethrocutaneous fistula prevention. For this purpose 40 patients were selected having distal hypospadias age ranging from 6 months to 11 years admitted in the Department of Pediatric Surgery, Mymensingh Medical College & Hospital during the period of January 2010 to March 2011. Out of 40 patients, 20 were in group-A (preputial dartos flap) and another 20 were included in group - B (without flap). All this patients were followed by perioperative and postoperative care. Few patients developed postoperative pyrexia, wound infection, stent blockage which were treated accordingly leaving minimum morbidity. Both groups of patients were followed up for 3 months after surgery. Present study is probably a better technique to prevent fistulaassociated morbidities in distal Snodgrass TIP urethroplasties. J. Paediatr. Surg. Bangladesh 3 (1): 12-17, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131814462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gastric Transposition in Long- Gap Esophageal Atresia","authors":"A. Jafor","doi":"10.3329/JPSB.V3I1.23899","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23899","url":null,"abstract":"","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127915832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah Al Farooq, M. Rahman, Tania Tajreen, Mohammad Ali
Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative resection becomes impossible. These are labeled as unresectable carcinoma pancreas where only palliative medical or surgical measures could be done. Objectives: To observe the various types of palliations with their early result. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in BIRDEM hospital, Dhaka, Bangladesh from July 2004 to June 2006. After careful check 50 patients were labeled as unresectable carcinoma pancreas. Surgical intervention was thought impossible in 10 patients and these patients took only chemotherapy. Laparotomy was carried out in the rest 40 patients with the plan to take open biopsy along with surgical palliation. Curative resection was seemed not to be possible in any patient. After abdominal exploration resectability of the pancreatic lesion was assessed and compared with prior plan. Post operative histopathology revealed pancreatic carcinoma in 35 patients. Postoperative treatment modalities used like chemotherapy, chemoradiation were assessed. Overall outcome of all the palliations were noted and compared with initial presentations. Result: Among 50 patients male were 28 (n 1 ) & female were 22 (n 2 ) with male female ratio was 1.27:1. Eighty percent (80%) patients presented between 51 to 70 years of age. Preoperative plan of surgical palliation noted to be changed significantly after laparotomy. Curative resections were possible in 2 patients. No palliative surgery was possible in 2 patients with gross disease and only biopsy was taken. Palliative surgeries along with biopsy were done in 36 patients. Only biliary bypass carried out in 04 patients, choledochojejunostomy with gastrojejunostomy were performed in 18 patients and hepatico- jejunostomy with gastrojejunostomy were performed in 12 patients. Only gastrojejunostomy were carried out in 02 patients to relieve duodenal obstruction. For pain control chemical splanchnicectomy done in 07 patients.There was no perioperative mortality. Early post operative complications were wound infection in 6 (15%) patients, haemorrhage in 2 (5%) patients and bilioenteric anastomotic leakage in 1(2.5%) patient. Post operative histopathology reports revealed pancreatic carcinoma in 35 patients. After one year follow up it was noted that jaundice again developed in 02 patients (4.6%) underwent choledochojejunostomy and gastrojejunostomy. Control of pain was satisfactory in 31 patients (72.1%) by multimodal analgesia. Chemical splanchnicectomy was satisfactory in 4 (56%) patients to control pain. Twenty seven patients (54%) had died within a year. Only 16 (36%) patients were alive after one year. Seven patients (14%) had lost from follow up. Conclusion: Surgical palliation along with other medical palliations is recommended for unresectable carcinoma pancreas. J. Paediatr. Surg. Bangladesh 3 (1): 18-25, 2012 (January)
{"title":"Short Term Outcome of Palliative Measures Taken for Clinically Labeled Unresectable Carcinoma Pancreas","authors":"Abdullah Al Farooq, M. Rahman, Tania Tajreen, Mohammad Ali","doi":"10.3329/JPSB.V3I1.23902","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23902","url":null,"abstract":"Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative resection becomes impossible. These are labeled as unresectable carcinoma pancreas where only palliative medical or surgical measures could be done. Objectives: To observe the various types of palliations with their early result. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in BIRDEM hospital, Dhaka, Bangladesh from July 2004 to June 2006. After careful check 50 patients were labeled as unresectable carcinoma pancreas. Surgical intervention was thought impossible in 10 patients and these patients took only chemotherapy. Laparotomy was carried out in the rest 40 patients with the plan to take open biopsy along with surgical palliation. Curative resection was seemed not to be possible in any patient. After abdominal exploration resectability of the pancreatic lesion was assessed and compared with prior plan. Post operative histopathology revealed pancreatic carcinoma in 35 patients. Postoperative treatment modalities used like chemotherapy, chemoradiation were assessed. Overall outcome of all the palliations were noted and compared with initial presentations. Result: Among 50 patients male were 28 (n 1 ) & female were 22 (n 2 ) with male female ratio was 1.27:1. Eighty percent (80%) patients presented between 51 to 70 years of age. Preoperative plan of surgical palliation noted to be changed significantly after laparotomy. Curative resections were possible in 2 patients. No palliative surgery was possible in 2 patients with gross disease and only biopsy was taken. Palliative surgeries along with biopsy were done in 36 patients. Only biliary bypass carried out in 04 patients, choledochojejunostomy with gastrojejunostomy were performed in 18 patients and hepatico- jejunostomy with gastrojejunostomy were performed in 12 patients. Only gastrojejunostomy were carried out in 02 patients to relieve duodenal obstruction. For pain control chemical splanchnicectomy done in 07 patients.There was no perioperative mortality. Early post operative complications were wound infection in 6 (15%) patients, haemorrhage in 2 (5%) patients and bilioenteric anastomotic leakage in 1(2.5%) patient. Post operative histopathology reports revealed pancreatic carcinoma in 35 patients. After one year follow up it was noted that jaundice again developed in 02 patients (4.6%) underwent choledochojejunostomy and gastrojejunostomy. Control of pain was satisfactory in 31 patients (72.1%) by multimodal analgesia. Chemical splanchnicectomy was satisfactory in 4 (56%) patients to control pain. Twenty seven patients (54%) had died within a year. Only 16 (36%) patients were alive after one year. Seven patients (14%) had lost from follow up. Conclusion: Surgical palliation along with other medical palliations is recommended for unresectable carcinoma pancreas. J. Paediatr. Surg. Bangladesh 3 (1): 18-25, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125301726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis, proximal to the end of glans. Fistulas are the most common complication following hypospadias repairs. This study was carried out to see that application of vascularized Tunica Vaginalis Blanket Wrap (TVBW) in urethroplasty reduces fistula rate in hypospadias repair. Objectives: To study the efficacy of Tunica vaginalis blanket wrap to prevent urethrocutaneous (UC) fistula in urethroplasty for hypospadias repair. Methods: Study Design : Prospective comparative study Place of Study :Department of Paediatric surgery, Dhaka Shishu Hospital (DSH), Dhaka. Period of Study :April, 2003 to October, 2004 for a total period of 19 months. The study of population : Twenty (20) admitted patients of hypospadias were selected. Patients were grouped into group A and group B on the basis of lottery method. Group A included 10 cases, who were subjected to repair of hypospadias with the application TVBW. Group B included 10 cases, who were subjected to repair of hypospadias without TVBW. Statistical Analysis : Chi-square test ( X 2 test ) were applied. p value <0.01 was taken as significant. Ethical aspect : Research protocol was accepted by DSH. Written consent were taken from parents. Result : Occurrence of post operated UC fistula found significantly higher in non TVBW. Discussion: In our patients for group A (study group), TVBW was used in urethroplasty while urethroplasty for group B (control group) was carried out without TVBW. UC fistula was present in 1 patient (10%) in group A post operatively and in 5 patients (50%) in group B postoperatively and subsequently 2 more patients developed fistula during follow up period. In control group 7 patient (70%) developed UC fistula out of 10 patients (n=10) despite of using periurethral flap of tissue as second layer over the neourethra. In our study, the rate of development of UC fistula is much less (only 10%) in study group. So the result is significant as evidenced by p value which is less than <0.01.This study demonstrates that use of tunica vaginalis as a blanket wrap as second layer over the neourethra reduces the rate of development of UC fistula. Conclusion: TVBW is recommended for urethroplasty to decrease the postoperative UC fistula. J. Paediatr. Surg. Bangladesh 3 (1): 30-36, 2012 (January)
{"title":"Comparison between the Outcome of Tunica Vaginalis Blanket Wrap and Non-wrap Procedures in Urethroplasty","authors":"Mohammad Minhajuddin Sajid, S. Karim","doi":"10.3329/JPSB.V3I1.23904","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23904","url":null,"abstract":"Background: Hypospadias is a developmental anomaly characterized by a urethral meatus that opens onto the ventral surface of the penis, proximal to the end of glans. Fistulas are the most common complication following hypospadias repairs. This study was carried out to see that application of vascularized Tunica Vaginalis Blanket Wrap (TVBW) in urethroplasty reduces fistula rate in hypospadias repair. Objectives: To study the efficacy of Tunica vaginalis blanket wrap to prevent urethrocutaneous (UC) fistula in urethroplasty for hypospadias repair. Methods: Study Design : Prospective comparative study Place of Study :Department of Paediatric surgery, Dhaka Shishu Hospital (DSH), Dhaka. Period of Study :April, 2003 to October, 2004 for a total period of 19 months. The study of population : Twenty (20) admitted patients of hypospadias were selected. Patients were grouped into group A and group B on the basis of lottery method. Group A included 10 cases, who were subjected to repair of hypospadias with the application TVBW. Group B included 10 cases, who were subjected to repair of hypospadias without TVBW. Statistical Analysis : Chi-square test ( X 2 test ) were applied. p value <0.01 was taken as significant. Ethical aspect : Research protocol was accepted by DSH. Written consent were taken from parents. Result : Occurrence of post operated UC fistula found significantly higher in non TVBW. Discussion: In our patients for group A (study group), TVBW was used in urethroplasty while urethroplasty for group B (control group) was carried out without TVBW. UC fistula was present in 1 patient (10%) in group A post operatively and in 5 patients (50%) in group B postoperatively and subsequently 2 more patients developed fistula during follow up period. In control group 7 patient (70%) developed UC fistula out of 10 patients (n=10) despite of using periurethral flap of tissue as second layer over the neourethra. In our study, the rate of development of UC fistula is much less (only 10%) in study group. So the result is significant as evidenced by p value which is less than <0.01.This study demonstrates that use of tunica vaginalis as a blanket wrap as second layer over the neourethra reduces the rate of development of UC fistula. Conclusion: TVBW is recommended for urethroplasty to decrease the postoperative UC fistula. J. Paediatr. Surg. Bangladesh 3 (1): 30-36, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133403530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Litu, N. Chowdhury, M. A. Hossain, Abdullah Al Mamun, M. Mahmud, D. Bishwas, U. Dutta, Zahedul Alam
Tonsillectomy is considered as a relatively safe procedure. This report aimed at describing an uncommon complication of this surgical procedure - subcutaneous emphysema. A 12 years old girl admitted for tonsillectomy operation. After routine preoperative assessment her operation was performed under general anesthesia. Surgery was uneventful. 7-8 hours after surgery, during follow-up in postoperative room progressing subcutaneous emphysema was noticed which initially involved the neck. But later on, it extended upper chest, upper arms, face & back. Crepitus swelling of neck and bilateral parotid region, typical of subcutaneous emphysema was noted. Chest X ray showed free air in the cervical regions reaching upper mediastinum. There was no airway obstruction and patient’s general condition was stable. Emphysema was no longer clinically evident 3 days after & patient was released. Subcutaneous emphysema is an uncommon complication of tonsillectomy, appearing almost ever after deeper dissections of the pharyngeal mucosa, when a porous surface is created, thus providing a route for the entry of air. Increased upper airway pressure may contribute to this injury. J. Paediatr. Surg. Bangladesh 3 (1): 51-53, 2012 (January)
{"title":"Subcutaneous Emphysema: A Rare Postoperative Complication after Tonsillectomy","authors":"M. Litu, N. Chowdhury, M. A. Hossain, Abdullah Al Mamun, M. Mahmud, D. Bishwas, U. Dutta, Zahedul Alam","doi":"10.3329/JPSB.V3I1.23909","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23909","url":null,"abstract":"Tonsillectomy is considered as a relatively safe procedure. This report aimed at describing an uncommon complication of this surgical procedure - subcutaneous emphysema. A 12 years old girl admitted for tonsillectomy operation. After routine preoperative assessment her operation was performed under general anesthesia. Surgery was uneventful. 7-8 hours after surgery, during follow-up in postoperative room progressing subcutaneous emphysema was noticed which initially involved the neck. But later on, it extended upper chest, upper arms, face & back. Crepitus swelling of neck and bilateral parotid region, typical of subcutaneous emphysema was noted. Chest X ray showed free air in the cervical regions reaching upper mediastinum. There was no airway obstruction and patient’s general condition was stable. Emphysema was no longer clinically evident 3 days after & patient was released. Subcutaneous emphysema is an uncommon complication of tonsillectomy, appearing almost ever after deeper dissections of the pharyngeal mucosa, when a porous surface is created, thus providing a route for the entry of air. Increased upper airway pressure may contribute to this injury. J. Paediatr. Surg. Bangladesh 3 (1): 51-53, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114237495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Rahman, Abdullah Al Farooq, A. Bhuiyan, M. Sajid, T. Chowdhury, G. Habib
Background: Neonatal intestinal obstruction due to jejunoileal atresia is not uncommon. Recommended treatment is resection with end to back anastomosis and post operative care in Neonatal Intensive Care Unit (NICU) with Total Parenteral Nutrition (TPN) support. In a setup without NICU and TPN, mortality of primary anastomosis is very high due to unusual delay in starting enteral feeding. Bishop Koop technique seems to allow early oral feeding and rapid establishment of normal gastrointestinal function and thus reduce mortality and morbidity. Objective: To find out the outcome of Bishop Koop procedure in patients with Jejunoileal atresia. Methods: This is an ongoing study started from March, 2011 in the Department of Pediatric Surgery, Chittagong Medical College Hospital. Here we are presenting our initial experience till June, 2012 (duration of 16 months). During this period total 13 patients of uncomplicated Jejunoileal atresia was treated surgically. Four patients were treated by classical end to oblique anastomosis and all died. Rest of the 9 patients were treated by Bishop Koop technique. Overall outcome of this technique was assessed considering time to establish oral feeding and normal bowel movement, ceasation of coming distal stoma’s effluent, weight gain, death etc. Result: Out of 9 patients, 6 patients weighing less than 2.5 Kg. Type- III A was the commonest variant. Two patients died following surgery due to sepsis. Oral feeding was possible within 4-7 postoperative day in all survived patients except one. In follow up satisfactory weight gain was observed in all those patients. Conclusion: Bishop Koop technique could be considered as preferred surgical option in a set up without NICU and TPN. J. Paediatr. Surg. Bangladesh 3 (1): 5-11, 2012 (January)
{"title":"Bishop Koop Technique is Preferred than Primary Anastomosis in Managing Jejunoileal Atresia in a Setup without Neonatal Intensive Care Unit - Our Initial Experience","authors":"M. Rahman, Abdullah Al Farooq, A. Bhuiyan, M. Sajid, T. Chowdhury, G. Habib","doi":"10.3329/JPSB.V3I1.23900","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23900","url":null,"abstract":"Background: Neonatal intestinal obstruction due to jejunoileal atresia is not uncommon. Recommended treatment is resection with end to back anastomosis and post operative care in Neonatal Intensive Care Unit (NICU) with Total Parenteral Nutrition (TPN) support. In a setup without NICU and TPN, mortality of primary anastomosis is very high due to unusual delay in starting enteral feeding. Bishop Koop technique seems to allow early oral feeding and rapid establishment of normal gastrointestinal function and thus reduce mortality and morbidity. Objective: To find out the outcome of Bishop Koop procedure in patients with Jejunoileal atresia. Methods: This is an ongoing study started from March, 2011 in the Department of Pediatric Surgery, Chittagong Medical College Hospital. Here we are presenting our initial experience till June, 2012 (duration of 16 months). During this period total 13 patients of uncomplicated Jejunoileal atresia was treated surgically. Four patients were treated by classical end to oblique anastomosis and all died. Rest of the 9 patients were treated by Bishop Koop technique. Overall outcome of this technique was assessed considering time to establish oral feeding and normal bowel movement, ceasation of coming distal stoma’s effluent, weight gain, death etc. Result: Out of 9 patients, 6 patients weighing less than 2.5 Kg. Type- III A was the commonest variant. Two patients died following surgery due to sepsis. Oral feeding was possible within 4-7 postoperative day in all survived patients except one. In follow up satisfactory weight gain was observed in all those patients. Conclusion: Bishop Koop technique could be considered as preferred surgical option in a set up without NICU and TPN. J. Paediatr. Surg. Bangladesh 3 (1): 5-11, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133928221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Surgery without audit is like playing without keeping the score. Medical/Surgical Audit is the evaluation of the quality and efficiency of the surgical services offered to the patients by a group of Medical Personnel in a Hospital. A surgical Audit of the patients of Department of Pediatric Surgery in a non-government Hospital was performed to evaluate overall performance and the quality of service delivered to the patients. Methods: It was a randomized study carried out in the department of Pediatric surgery in Ad-din Women’s’ Medical College Hospital during the period of January 2008 to December 2012 (total 5 years). Total 4613 patients were included in this study. Among them 832 (15.91%) patients were treated after admission and 4396(84.09%) patients were treated as OPD patients. Results: Among the total 4613 patients, 3953 patients were male and 660 patients were female. Total 3127 patients were under 5 years and 1486 patients were over 5 years. Among total 832 admission, 551 (66.22%) were elective cases and 281 (33.78%) were emergency cases. Conclusion: Clinical audit is a process. It is a process used by clinicians who seek to improve patient care. So in this audit we have tried to evaluate our overall performance and the quality of service delivered to our patients in the last 5 years period to find out the limitations and deficiencies prevailing in this field. J. Paediatr. Surg. Bangladesh 3 (1): 26-29, 2012 (January)
{"title":"An Audit of the Patients Treated in Paediatric Surgery Department of Ad-din Women’s Medical College Hospital, Dhaka","authors":"Musrat Rahman, Rezaul Islam, S. M. Alim","doi":"10.3329/JPSB.V3I1.23903","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23903","url":null,"abstract":"Background: Surgery without audit is like playing without keeping the score. Medical/Surgical Audit is the evaluation of the quality and efficiency of the surgical services offered to the patients by a group of Medical Personnel in a Hospital. A surgical Audit of the patients of Department of Pediatric Surgery in a non-government Hospital was performed to evaluate overall performance and the quality of service delivered to the patients. Methods: It was a randomized study carried out in the department of Pediatric surgery in Ad-din Women’s’ Medical College Hospital during the period of January 2008 to December 2012 (total 5 years). Total 4613 patients were included in this study. Among them 832 (15.91%) patients were treated after admission and 4396(84.09%) patients were treated as OPD patients. Results: Among the total 4613 patients, 3953 patients were male and 660 patients were female. Total 3127 patients were under 5 years and 1486 patients were over 5 years. Among total 832 admission, 551 (66.22%) were elective cases and 281 (33.78%) were emergency cases. Conclusion: Clinical audit is a process. It is a process used by clinicians who seek to improve patient care. So in this audit we have tried to evaluate our overall performance and the quality of service delivered to our patients in the last 5 years period to find out the limitations and deficiencies prevailing in this field. J. Paediatr. Surg. Bangladesh 3 (1): 26-29, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133775489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Md. Akbar Hossain Bhuyian, Md Abdullah Al Farooq, M. Sajid, M. Rahman, M. Hoque, Khurshid Alam Sarwar, T. Chowdhury, M. Kabir, T. Banu
Background: Ascariasis is a common gastrointestinal infestation worldwide. It affects more children who live in poor hygenic condition. Pediatric surgeons are supposed to manage related surgical complications of ascariasis. Objective: To evaluate the recent pattern of occurrence of intestinal and biliary ascariasis with morbidity and mortality related to it. Materials and Methods: Study design: Retrospective study. Period of study: Study was conducted between Jan 2006 - Dec 2011 (total 06 years). Place of study: This study was carried out in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH), Chittagong; Bangladesh. Study Subjects: Patients admitted and diagnosed as intestinal (1591) and biliary (181) ascariasis in the department of Pediatric surgery, CMCH were evaluated. Results: A total of 1772 patients were admitted with surgical complication of ascariasis. Among them 1591 (89.78%) patients were diagnosed as intestinal ascariasis and 181 (10.22%) patients as biliary ascariasis. Age range was 6 months to 12 years with mean age of 6 years for intestinal ascariasis. Biliary ascariasis presented between 3 years to 12 years with mean age of 7 years. Male (1060) suffered more than female (531). Male to female ratio was 2:1 for intestinal ascariasis while females (120) suffered more than male(61) in biliary ascariasis ( ratio 2: 1). Total 231 surgery both elective and emergencies were done. Discussion: Most of the patients (52-81% ) were treated by endoscopic removal of worm from common bile duct. Some patients (15 - 31 %) were treated successfully by conserevative approach. Only a few patients needed open surgical procedure. No patient had died from biliary ascariasis and death from complications of intestinal ascariasis reduced from 20% to 4% over the last 6 years. Conclusion: There has been a reduced number of disease burden over the last few years from ascariatic and biliary ascariasis. DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19551
{"title":"Decreased Morbidity and Mortality from Intestinal Ascariasis: Experience of a Single Center","authors":"Md. Akbar Hossain Bhuyian, Md Abdullah Al Farooq, M. Sajid, M. Rahman, M. Hoque, Khurshid Alam Sarwar, T. Chowdhury, M. Kabir, T. Banu","doi":"10.3329/JPSB.V2I2.19551","DOIUrl":"https://doi.org/10.3329/JPSB.V2I2.19551","url":null,"abstract":"Background: Ascariasis is a common gastrointestinal infestation worldwide. It affects more children who live in poor hygenic condition. Pediatric surgeons are supposed to manage related surgical complications of ascariasis. Objective: To evaluate the recent pattern of occurrence of intestinal and biliary ascariasis with morbidity and mortality related to it. Materials and Methods: Study design: Retrospective study. Period of study: Study was conducted between Jan 2006 - Dec 2011 (total 06 years). Place of study: This study was carried out in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH), Chittagong; Bangladesh. Study Subjects: Patients admitted and diagnosed as intestinal (1591) and biliary (181) ascariasis in the department of Pediatric surgery, CMCH were evaluated. Results: A total of 1772 patients were admitted with surgical complication of ascariasis. Among them 1591 (89.78%) patients were diagnosed as intestinal ascariasis and 181 (10.22%) patients as biliary ascariasis. Age range was 6 months to 12 years with mean age of 6 years for intestinal ascariasis. Biliary ascariasis presented between 3 years to 12 years with mean age of 7 years. Male (1060) suffered more than female (531). Male to female ratio was 2:1 for intestinal ascariasis while females (120) suffered more than male(61) in biliary ascariasis ( ratio 2: 1). Total 231 surgery both elective and emergencies were done. Discussion: Most of the patients (52-81% ) were treated by endoscopic removal of worm from common bile duct. Some patients (15 - 31 %) were treated successfully by conserevative approach. Only a few patients needed open surgical procedure. No patient had died from biliary ascariasis and death from complications of intestinal ascariasis reduced from 20% to 4% over the last 6 years. Conclusion: There has been a reduced number of disease burden over the last few years from ascariatic and biliary ascariasis. DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19551","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128068394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Md Abdullah Al Farooq, M. Rahman, M. Kabir, M. A. H. Bhuiyan, M. Sajid, R. Talukder, T. Chowdhury, T. Banu
Spontaneous bile duct perforation (SBDP) is a relatively rare condition. The cause of SBDP is still speculative. Presentation , site of the perforation and management varies. Pancreatic lithiasis ( PL) is a very rare entity in childhood. Biliary perforation on the background of PL is still a rare event. This is a case report of 10 years old girl presented as acute abdomen with theclinical diagnosis of acute on chronic pancreatitis, for which conservative treatment followed by laparotomy was carried out.Common bile duct (CBD) perforation was found near its junction with cystic duct. T tube was instituted and a drain was kept in situ. Postoperative period ( POP )was uneventful. T Tube Cholangiogram was carried out on 12th postoperative day( POD ) that showed dye had passed to duodenum easily and patency and caliber of the CBD was found normal. Multiple stones were noted in the vicinity. No apparent cause of CBD perforation was found. After one month, in follow up visit the patient was found alright. She was asked to come after 3 months for further evaluation. The plan is to evaluate the patients conditions clinically and biochemically and to do an MRCP to see details of pancreatic pathology. As SBDP in children with PL is a rare condition, high index of suspicion is needed for early diagnosis and proper management of such patient. DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19553
{"title":"Spontaneous Common Bile Duct Perforation on The Background of Pancreatic Lithiasis: A Case Report and The Review of The Literatures","authors":"Md Abdullah Al Farooq, M. Rahman, M. Kabir, M. A. H. Bhuiyan, M. Sajid, R. Talukder, T. Chowdhury, T. Banu","doi":"10.3329/JPSB.V2I2.19553","DOIUrl":"https://doi.org/10.3329/JPSB.V2I2.19553","url":null,"abstract":"Spontaneous bile duct perforation (SBDP) is a relatively rare condition. The cause of SBDP is still speculative. Presentation , site of the perforation and management varies. Pancreatic lithiasis ( PL) is a very rare entity in childhood. Biliary perforation on the background of PL is still a rare event. This is a case report of 10 years old girl presented as acute abdomen with theclinical diagnosis of acute on chronic pancreatitis, for which conservative treatment followed by laparotomy was carried out.Common bile duct (CBD) perforation was found near its junction with cystic duct. T tube was instituted and a drain was kept in situ. Postoperative period ( POP )was uneventful. T Tube Cholangiogram was carried out on 12th postoperative day( POD ) that showed dye had passed to duodenum easily and patency and caliber of the CBD was found normal. Multiple stones were noted in the vicinity. No apparent cause of CBD perforation was found. After one month, in follow up visit the patient was found alright. She was asked to come after 3 months for further evaluation. The plan is to evaluate the patients conditions clinically and biochemically and to do an MRCP to see details of pancreatic pathology. As SBDP in children with PL is a rare condition, high index of suspicion is needed for early diagnosis and proper management of such patient. DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19553","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134051537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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