A Method of Conservative Management of Giant Omphalocele Useful in Preventing Rupture of Sac.

BACKGROUND: Omphalocele consists of congenital malformation of anterior abdominal wall defects occurring at the midline with herniation of the viscera through this defect. Giant omphaloceles constitute a challenging situation as such conservative management has been advocated as an effective method of treatment. This study aimed to compare the conventional method of dressing the omphalocele sac using gauze, an escharotic agent, and a crepe bandage to our improvised method of the usage of a sterilization wrap over the escharotic agent with a crepe bandage. METHODS: This was a retrospective comparative review of 7 babies with giant omphalocele that was treated with topical honey and the non-adherent sterilization wrap covering (group B) and compared with 6 babies that had honey, sofratulle ,and dry gauze covering (group A) that was initially done in our center. RESULTS: All of the babies who were in group B had an uneventful epithelization of the sac with no rupture; also, no death occurred in this group. However, three in group A had sacs that ruptured before epithelization. Two of these died from complications of sepsis following rupture of the sac, one had a small point on the sac which was ruptured and it healed with a dressing left in place for a week. CONCLUSION: The use of Kimberley-Clark sterilization wrap prevents rupture of the sac while using the escharotic agent, thereby reducing mortality. We advocate that gauze should not make any contact with the omphalocele sac.

CONTEXTE: Omphalocele consiste en une malformation congénitale deanomalies de la paroi abdominale antérieure survenant à la ligne médiane avechernie des viscères à travers ce défaut. Omphalocèles géantsconstituent une situation difficile en tant que telle gestion conservatricea été préconisé comme une méthode de traitement efficace. Cette étudevisant à comparer la méthode conventionnelle d'habillage dusac omphalocèle utilisant de la gaze, un agent escharotique et un pansement en crêpeà notre méthode improvisée d'utilisation d'une enveloppe de stérilisation sur leagent escharotique avec un pansement en crêpe. MÉTHODES: Il s'agissait d'une revue comparative rétrospective de 7 bébés atteints deomphalocèle géant qui a été traité avec du miel topique et le revêtement d'enveloppement de stérilisation non adhérent (groupe B) et comparé à 6bébés qui avaient du miel, de la sofratulle et de la gaze sèche couvrant (groupe A)cela a d'abord été fait dans notre centre. RÉSULTATS: Tous les bébés qui étaient dans le groupe B ont eu une situation sans incident.épithélisation du sac sans rupture; de plus, aucun décès n'est survenu dans cegroupe. Cependant, trois dans le groupe A avaient des sacs qui se sont rompus avantépithélisation. Deux d'entre eux sont morts de complications de la septicémiesuite à la rupture du sac, on avait une petite pointe sur le sac quia été rompu et il a guéri avec un pansement laissé en place pendant une semaine. CONCLUSION: L'utilisation de l'emballage de stérilisation Kimberley-Clark prévientrupture du sac lors de l'utilisation de l'agent escharotique, réduisant ainsimortalité. Nous préconisons que la gaze ne devrait pas entrer en contact avecle sac omphalocèle. MOTS-CLÉS: Omphalocèle géant, Enveloppe de stérilisation Kimberly.

Gastrointestinal Lesions in a Nigerian Tertiary Care Centre: A Histopathological Study.

BACKGROUND AND OBJECTIVE: Gastrointestinal diseases account for significant morbidity and mortality across the world. The study aims at establishing the epidemiological profile of gastrointestinal diseases in a Nigerian tertiary care center. METHODS: This is a descriptive retrospective study of all gastrointestinal specimens, submitted to the histopathology department of Delta State University Teaching Hospital (DELSUTH) for diagnosis. The age, sex, and histological diagnosis were extracted from the archives of the department. These were re-reclassified into diagnostic groups, analyzed using Excel spread sheet 2007 and summarized in tables. RESULTS: The study involves 570 patients (290 males and 280 females) with gastrointestinal tract (GIT) diseases within the age range of 10 days to 99 years, and of a mean age of 48.4 years. Congenital, inflammatory, benign neoplasms, malignant neoplasms and vascular diseases accounted for 1.6%, 77.5%, 2.6%, 18.1% and 0.18% of the cases respectively. These lesions were domiciled in the esophagus (1.4%), stomach (53.3%), small intestine (7.9%), appendix (10%), colorectum (25.4%) and anus (2%). The peak incidence corresponded to the 5th decade with 72.5% of cases affecting patients of 30-69 years. Malignant lesions were found in the esophagus (5.8%), stomach (14.6%), small intestine (4.9%), colorectum (72.8%) and anus (1.9%) and were mostly adenocarcinomas. CONCLUSION: The study showed that GIT lesions were slightly more common among males. Majority of cases were inflammatory diseases (gastritis, appendicitis) with GIT cancers (colorectal and gastric cancer) being the next most common. The preponderance of GIT lesions among the productive age calls for action to ameliorate the trend. Preventive public enlightenment campaign on GIT cancer risk factors and population-based screening programmes especially for Helicobacter pylori infection and colorectal cancer is highly recommended.