PubMed Health⌕ Search

Biomedical subjects

E A Ameh

Publications and source records attributed to E A Ameh.

At least 19 recordsLinked to original sources
PubMed2006

Persistent umbilical discharge in infants and children.

BACKGROUND: Umbilical discharge is not an unusual presentation in infants and children. However, the evaluation and management are rarely discussed. METHOD: A retrospective review of 18 patients presenting with persistent umbilical discharge over a period of 22 years, excluding neonates with omphalitis. RESULTS: The patients' ages ranged between 11 days and 9 years. Presentation was usually discharge of clear, serous or purulent fluid or faecal matter from the umbilicus, sometimes dating back to the neonatal period. Evaluation consisted of bacteriology, fistulogram (one patient) and histopathology. The cause of discharge was patent vitello-intestinal duct in 11 patients, umbilical granuloma in three, umbilical sinus in two and patent urachus and osteomyelitis of the ischium in one each. Definitive treatment was exploration and complete excision of the lesion and antibiotics. Two patients with patent vitello-intestinal duct died, one before surgery from hypokalaemia and sepsis, and the other from anaesthetic complications. CONCLUSION: There is a need for early referral and treatment in patients with persistent umbilical discharge. Conservative treatment is usually not successful as the common causes would normally require complete excision.

Child↗
PubMed2006

Lingual harmatoma in an infant.

Lingual tumours are uncommon in infants and harmatomas are rarely reported. A 5-month-old boy presented with a growth on the dorsum of the tongue which had been present from birth. The growth produced no respiratory or feeding difficulties. It was confirmed to be a harmatoma after complete excision. There has been no recurrence.

Hamartoma↗
PubMed2005

Osteomyelitis of the ischium: unusual presentation.

A 7-year-old boy presented with urinary symptoms and umbilical discharge. A perivesical abscess was drained from which Staphylococcus aureus was cultured. He responded to antibiotics. Subsequently, he developed a discharging sinus in the gluteal region. A plain radiograph, which had previously been normal, confirmed osteomyelitis of the ischial bone.

Abscess↗
PubMed2005

Acute ileus following ventriculoperitoneal shunt: case report.

A three month old girl with progressive hydrocephalus from birth had a ventriculoperitoneal (VP) shunt, during which the cerebrospinal fluid (CSF) was found to be xanthochromic. She developed acute ileus four hours post-operatively and continued to deteriorate. The shunt was exteriorised as an external ventricular drain. She did well and another VP shunt was inserted later. Acute ileus following VP shunt is not common, but can occur in the presence of xanthochromic CSF. It is advisable that when such CSF is encountered during VP shunt, the initial management should be external ventricular drainage, followed later by VP shunt when the CSF becomes clear. This can be life saving.

Acute Disease↗
PubMed2004

A rare left-sided abdominal wall defect.

A 4-hour-old boy is presented here, who was born with a large abdominal wall defect situated in the left flank. Silo closure was necessary due to the large size of the defect. A Medline search up to December 2002 revealed only 2 other left-sided abdominal wall defects distant from the umbilicus. The possible embryology of this anomaly is discussed.

Abdominal Wall↗
PubMed2004

Fournier's gangrene in neonates and infants.

BACKGROUND: Fournier's gangrene is uncommon in childhood and little is known about the disease in this age group. METHOD: A retrospective review was carried out of neonates and infants treated for Fournier's gangrene over a period of 16 years. RESULTS: Twelve neonates and infants aged 5 days-3 months (median 3 weeks) were treated in our hospital. The precipitating cause was omphalitis in 7 babies, strangulated inguinal hernia in 2 and in 3 babies there was no identifiable cause. Gram-negative bacteria were cultured in 3 patients, but in most the culture was sterile. Treatment consisted of debridement of devitalised tissue and administration of broad-spectrum antibiotics. Primary closure was achieved in 1 baby and secondary closure in 2 others. In 7 babies the wound contracted rapidly and healed. There was no mortality. CONCLUSION: Fournier's gangrene in neonates and infants in our environment is largely preventable. Early debridement and appropriate antibiotics give good results.

Anti-Bacterial Agents↗
PubMed2004

Acute scrotum in Nigeria: an 18-year review.

One hundred and seventy-eight patients presenting with an acute scrotum during a period of 18 years (1978-1997) were reviewed retrospectively. Fifty per cent had testicular torsion, with a mean age of 23 years (range 3 weeks-55 years). Torsion was significantly more common in the cold harmattan season (October-early March). The salvage rate of torted testes was 52%. Inguinoscrotal hernia was the cause of testicular infarction in 10% and is an important contributor to male infertility. Twelve per cent of cases of suspected torsion were found to have epididymo-orchitis, at exploration. Twenty-three (13%) patients presented with scrotal gangrene (Fournier's gangrene) which did not result in testicular loss. There was significant morbidity following intervention by non-doctors, and misdiagnosis from unsuspecting physicians. The acute scrotum affecting young patients is a significant cause of male infertility and morbidity in Zaria. Early recognition, prompt treatment and re-education of those who may provide the first line care for such patients will reduce the morbidity and pathologic consequences following neglect.

Acute Disease↗
PubMed2004

Adhesion intestinal obstruction in children in northern Nigeria.

In developing countries, reports on adhesion intestinal obstruction in children are scanty. We report 30 children managed for adhesion intestinal obstruction during a 16-year period. The age range was 10 weeks-14 years (median 9 years). There were 24 boys and 6 girls. Postoperative adhesion was the cause in 13 (43%) patients, inflammatory in 11 (37%), and in 5 (17%) no cause could be identified. In one patient, adhesion followed missed ileal perforation from blunt abdominal trauma. Duration of symptoms was 1-21 days (median 4 days). Only four of the 13 patients with postoperative adhesion obstruction were managed conservatively initially, but this failed in all; one was found to have an intestinal perforation at laparotomy. The remaining nine had immediate laparotomy owing to presence of features of strangulation at presentation; two required intestinal resection for gangrene. All other patients had laparotomy soon after resuscitation. The resection rate for gangrene was 13% and 3% required closure of perforations. Postoperatively six (20%) patients developed eight infective complications. There was recurrence in three of 27 (11%) surviving patients within 3 months. Mortality was three (10%). The presentation of adhesion intestinal obstruction in children in northern Nigeria is late and morbidity and mortality are high. Early presentation should improve the outcome.

Child↗
PubMed2004

Gastrointestinal injuries from blunt abdominal trauma in children.

OBJECTIVE: To determine the pattern, presentation and outcome of gastrointestinal injuries from blunt abdominal trauma in children. DESIGN: A retrospective study. SETTING: Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. SUBJECTS: Twenty one children managed for gastrointestinal injuries from blunt trauma from 1984-2002. MAIN OUTCOME MEASURES: The pattern, presentation, management and outcome of gastrointestinal injuries from blunt trauma. RESULTS: In the 19 year period, 1984-2002, 92 children were treated for blunt abdominal trauma, 21(23%) of who had injuries to the gastrointestinal tract. Three presenting after 24 hours had evidence of peritonitis. In six children with isolated gastrointestinal tract (GIT) injury who presented within two hours, abdominal signs were vague at initial evaluation but became marked over a few hours at repeated examination. In eight with associated intraabdominal injuries, abdominal signs were marked at initial examination and five presented with shock. Free peritoneal air was present on plain abdominal and chest radiograph in three of ten patients, dilated bowel loops in six and fluid levels in one. Diagnostic peritoneal lavage or paracentesis was positive in four patients with isolated GIT injuries and eight with associated intraabdominal injuries. There were 24 injuries in the 21 patients consisting of 15 perforations, five contusions, two seromuscular tears, and two gangrene from mesenteric injury. The small intestine was involved in 11 patients, colon six, stomach five, duodenum one and rectum one. Seven (35%) patients had associated extraabdominal injuries. Treatment consisted of simple closure of perforations, over sewing of contusions, resection and anastomosis for gangrene and repair with protective stoma for the rectal injury. One patient each developed prolonged ileus, urinary tract infection and chest infection, respectively postoperatively. Mortality was 28%, all of who had associated intraabdominal or extraabdominal injuries. CONCLUSION: Gastrointestinal injury from blunt abdominal trauma in children, though uncommon, carries a high mortality, usually from associated intraabdominal or extraabdominal injuries.

Abdominal Injuries↗
PubMed2003

Scrotoshisis, bilateral extra-corporeal testicular ectopia and testicular torsion.

Although anomalies of testicular descent are common, scrotoschisis and extracorporeal testicular ectopia is rare with only 3 reported cases in literature. This is a report of a neonate presenting with scrotoschisis and bilateral extracorporeal testicular ectopia. The right testis underwent torsion before presentation, resulting in gangrene of that testis, requiring orchidectomy. The scrotum was explored and the viable left testis placed in the scrotum and fixed in that position. The left testis has remained normal at 9 months of follow up. The possible embryology and management of this curious anomaly is discussed.

Gangrene↗
PubMed2003

Bilateral pneumothorax complicating miliary tuberculosis in children: case report and review of the literature.

An 11-year-old boy presented with a 4-week history of fever and 2 weeks later developed a cough with breathlessness. His chest X-ray showed bilateral miliary shadows with pneumothorax on the left side. While on antituberculous therapy which was started on admission, he developed right-sided pneumothorax with significant collapse of the left lung. He was managed by tube thoracotomy with underwater seal but died 4 hours after the procedure was completed.

Antitubercular Agents↗
PubMed2003

Colorectal perforation following barium examination in children.

Barium contrast study is a frequently performed investigation in children, but colorectal perforation complicating the procedure is uncommon. A 2-month-old boy suspected of having Hirschsprung s disease developed an intraperitoneal rectal perforation following barium enema for which repair and diversion colostomy was performed. Another 4-year-old boy with Hirschsprung s disease and a transverse colostomy developed a colorectal perforation during distal colostogram using barium and was managed non-operatively. Both patients are well. The management of this uncommon complication is discussed.

Barium Sulfate↗
PubMed2002

Isolated rupture of an accessory liver from blunt abdominal trauma in childhood.

An accessory liver is uncommonly encountered in surgical practice. It can rarely cause acute abdominal pain. An isolated injury to an accessory liver from blunt trauma in a 10-year-old boy caused major intraperitoneal haemorrhage. Laparotomy and excision of the lacerated accessory liver lobe was necessary; the patient recovered uneventfully. The literature on accessory liver is reviewed.

Abdominal Injuries↗
PubMed2002

Intralingual foregut duplication cyst: a case report.

A 20-month old girl presented with an intralingual cyst from birth, which interfered with feeding but not respiration. The cyst was completely excised and histology of the wall showed an epithelial lining of stratified squamous and respiratory type epithelium. There has been no recurrence and function of the tongue has remained normal.

Cysts↗