Biomedical subjects

L B Chirdan

Publications and source records attributed to L B Chirdan.

23 records · Page 2Linked to original sources

PubMed1999

Small bowel and mesenteric injury following traditional treatment and self-inflicted trauma to inguinal hernia.

Inguinal hernia is a common indication for emergency surgery in our environment after intestinal obstruction. Occasionally other rare indications may be seen. Recently, two patients with such unusual presentation were managed in this institution. One had his hernia incised, by a traditional barber with evisceration and the other incised his hernia himself with evisceration and laceration of the small bowel. Both patients were successfully managed. The menace of traditional barbers and medical ignorance in tropical Africa are reported.

Adult↗

PubMedDate not supplied

Intestinal malrotation: presentation in the older child.

BACKGROUND: The clinical diagnosis of intestinal malrotation in the older child is not always easy because of its non-specific presentations. The aim of this study was to determine the pattern of presentation of malrotation in older Nigerian children. METHODS: The clinical, radiological and operative records of all the children aged 2 years or above, managed for malrotation at the Jos University Teaching Hospital between March 1992 and December 2002 were retrospectively reviewed. RESULTS: There were 9 patients, with a median age of 5 years (range: 3-14 years). The commonest complaint was intermittent colicky abdominal pain in 9 (100%), followed by recurrent vomiting in 8 (88.9%), haematemesis and constipation each in 5 (55.6%) and repeated episodes of bloody stools and diarrhoea. Other features included abdominal distension in 5 (55.6%) and failure to thrive in 4 (44.4%). Preoperative diagnosis was possible only in 3 patients, through the use of barium meal. Operative findings included obstructing bands of Ladd, partial volvulus and mesocolic hernias. Surgery promptly and satisfactorily relieved the symptoms. CONCLUSION: The diagnosis of intestinal malrotation should be considered in any child with prolonged history of recurrent colicky abdominal pain, vomiting or diarrhoea, especially if there is associated history of failure to thrive. Surgical intervention provides satisfactory relief of symptoms and should be implemented as soon as the diagnosis is made.

Abdomen, Acute↗

PubMedDate not supplied

Paediatric surgery in the rural setting: prospect and feasibility.

This report is based on a 6-year experience with surgery in children in a rural hospital in Northern Nigeria. Paediatric surgery represents 6.6% of all paediatric work-load and 9.6% of all operative surgery. Majority of the operations were performed for congenital problems (40%) and less frequently infections (22%) and trauma (21%). Most of the infective and trauma problems were preventable. The mortality was 7.3%, due mostly to septic complications. Overall, 95% of the operations were not of complex nature and could be performed by general duty doctors with general surgical experience. These doctors who are more readily available in rural areas should be encouraged to perform these operations to reduce the economic and emotional burden on rural families. However, the more complex congenital conditions should always be referred early to specialist hospitals. Surgical conditions cause significant morbidity and mortality in children and should not be overlooked in the planning of child health care services in rural areas.

Age Distribution↗

PubMedDate not supplied

Intestinal malrotation: experience in Zaria, Nigeria.

This report retrospectively reviews the presentation, management and outcome in 14 patients with intestinal malrotation. There were 7 males and 7 females, with a median age of 4 months (range 5 days-22 years). Most neonates and infants presented with persistent or recurrent vomiting while older children had recurrent abdominal pain. Five patients (36%) including 2, < 1 year and 3 older children developed midgut volvulus. Malrotation was an incidental finding at laparotomy for unrelated conditions in 2 patients (14%). Overall, preoperative diagnosis was not made in any patient. Associated congenital anomalies were present in 3 (21%) patients. Treatment was by Ladd's procedure in 12 (86%) patients and caecopexy in 2 (14%) without recurrence of symptoms in any. One patient each developed wound infection and adhesive intestinal obstruction requiring relaparotomy respectively. Mortality was 2 (14%) from overwhelming infection and hypokalaemia following midgut volvulus. Children presenting with recurrent or persistent abdominal pain, vomiting or failure to thrive may well have malrotation and should be investigated promptly and the condition corrected to avoid midgut volvulus which is attended by significant morbidity and mortality.

Adolescent↗

PubMedDate not supplied

Appraisal on fluid and electrolyte management in paediatric surgical patient.

Fluid and electrolyte disorders are common occurrences in Paediatric surgical practice. Despite this, the management of fluid and electrolyte imbalance in the paediatric surgical patients remains problematic. This is partly because authorities vary considerably in their recommendations for therapy, despite the great advances being attained in the understanding of the fluid and electrolyte homeostasis in the Paediatric age group. This has, in no doubt, resulted in a number of morbidity and mortality that could have been prevented based upon rational and acceptable recommendations for fluid and electrolyte therapy in children. In this review, the normal homeostasis, disorders and management of fluid and electrolyte and corrections of metabolic disorders in children are highlighted, with the aim to update the practice of fluid and electrolyte therapy in children.

Age Factors↗