Giant bladder diverticulum: a rare cause of bladder outlet obstruction in children.

Giant bladder diverticula are rare causes of bladder outlet obstruction in children and have rarely been reported.([1]) In this paper, we present three children with giant bladder diverticula who presented with bladder outlet obstruction within a year. Micturating cystourethrogram is important for investigating bladder outlet obstruction in children and was used to confirm the diagnosis in all the patients. The relationship between the diverticula and ureters varied, with the ureters running either through the wall of the diverticulum and opening directly into the bladder, or opening into the diverticulum. In one patient, there was a recurrence, which was excised successfully. Excision is important to reduce the risk of recurrence.

[Morgagni hernia: Concerning 2 pediatric cases in Sub-Saharan Africa]. / Hernie de morgagni: a propos de deux cas pediatriques en Afrique Sub Saharienne.

Morgagni hernias are uncommon diaphragmatic hernias that are generally asymptomatic, and so far, very limited data is available about them. We report two cases of repaired successfully Morgagni hernias using a transabdominal approach. The aim of this study is to illustrate the diagnostic difficulties and the excellent post operational prognostic observed following the transabdominal procedure. Both patients were female, one 8 months old and the other 3 months old. The presenting symptom was recurrent chest infection. Chest x-rays were carried out on both patients, which showed a pre-cardiac gas mass. A transabdominal surgical approach enabled surgeons to sow the defect with non resorbable suture material in one patient, and a prolene plate in the other. The patients fully recovered and no postoperative difficulties were reported.

La hernie de Morgagni ou hernie diaphragmatique congénitale antérieure est une entité peu décrite dans la littérature et est le plus souvent asymptomatique. Le but de cette étude est d'illustrer les difficultés diagnostiques et l'excellent pronostic après traitement chirurgical après abord trans abdominal sus ombilical de cette forme rare de hernie des coupoles diaphragmatiques. Nous rapportons deux cas simulant une pneumopathie chronique chez deux nourrissons de sexe féminin âgés respectivement de 8 mois et 3 mois. Les radiographies pulmonaires de face et de profil ont permis de poser le diagnostic par la mise en évidence d'une clarté gazeuse pré cardiaque. La laparotomie transversale sus ombilicale a permis la fermeture du défect par suture avec du fil non résorbable chez une patiente et une obturation à l'aide d'une plaque de prolène chez la deuxième patiente. Les suites opératoires ont été simples.

Inversion appendicectomy.

OBJECTIVES: (i) To emphasise that incidental appendicectomy has indications and, to highlight this indications. (ii) To teach that, even when indicated, this procedure should not convert a clean surgical wound into a clean contaminated or even less optimal wound. (iii) To recommend that if an incidental appendicectomy is to achieve (ii) above, inversion appendicectomy is the better option to choose. (iv) To prove that inversion appendicectomy is fast, easy and achieves a similar result as the more popular excision appendicectomy. PATIENTS AND METHODS: This study was carried out in the paediatric surgical unit of Korle-Bu Teaching Hospital Accra, Ghana - between March 2003 and May 2004. PATIENT SELECTION: Fifteen patients qualified for enrollment into this study. These were (i) Those who had clear cut indications for incidental appendicectomy, and had it done as an inversion appendicectomy. (ii) Cases of incidental appendicectomy. METHODS: Eleven of these cases were done for intussusceptions and four for malrotation. Only wounds that qualified as clean surgical wounds were included in this study. There was no age or sex discrimination. RESULTS: Follow up on these patients did not reveal any complications. CONCLUSION: Incidental appemdicectomy has well-defined indications. When indicated in clean wound, inversion appendicectomy is the procedure of choice.

Duodenal duplication: a rare congenital abnormality two case reports

Duodenal duplication is an extremely rare congenital malformation. Two cases seen at the Korle-Bu Teaching Hospital are reported here - one in a 3 year old and the other in a 2 week old neonate. Diagnosis was made by ultrasound and treatment was by partial excision in one case and by entrotomy and complete excision of the mucosa in the other. Both cases are doing well two years postoperatively

Korle-Bu Paediatric surgical experience of Buruli ulcer

Buruli ulcer is a chronic skin ulcer caused by the organism Mycobacterium ulcerans. In the paediatric surgical practice at the Korle-Bu Teaching Hospital; 15 patients with confirmed Buruli ulcers aged from 3 to 10 years were seen and treated over the period 1989-1991. Diagnosis was by biopsy which was positive in all cases in which it was done. Surgery by wide excision was the mainstay of treatment. Skin grafting was done in 3 cases. Length of hospital stay was in excess of 2 months. There were no deaths in the group presented; however; residual deformity occurred in all cases. The experience of these cases is presented here with a review of the literature