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Biomedical subjects

S D Adeyemi

Publications and source records attributed to S D Adeyemi.

16 recordsLinked to original sources
PubMed1992

Management of cystic hygroma of the head and neck in Lagos, Nigeria; a 10-year experience.

Management of cystic hygroma in 25 children as practised in Lagos, Nigeria during 1980 through 1989 was studied. Thirteen (52%) were infants out of which 7 were newborns. Thirty-three operations were performed including those for recurrences. There were 29 excisions out of which 22 (76%) were one-stage complete excisions. Complications included 4 cases of facial paresis, 6 recurrences and respiratory obstruction which led to death in 5 newborns, the only deaths in the series, and an operative mortality of 20.8%. A striking feature of this study is the observation that some recurrences occurred at sites which were normal at the initial or previous excision. Such recurrences led to 4 surgical operations at different times in one child. The term 'Progressive Infilterating cystic Hygroma' (PICH) is being suggested to distinguish this type from the ordinary cystic hygroma.

Airway Obstruction↗
PubMed1988

Combination of annular pancreas and partial situs inversus: a multiple organ malrotation syndrome associated with duodenal obstruction.

A combination of annular pancreas and partial situs inversus has been encountered in three babies who presented as duodenal obstruction. All the abnormalities can be explained on the basis of multiple organ malrotation involving the duodenum, pancreas, liver, stomach, and indirectly, the spleen; hence, the term multiple organ malrotation syndrome (MOMS). The heart maintains its normal left side location in this condition. Similarly the remaining small bowel, large bowel, and appendix are normally located. It is proposed that the triad of intestinal obstruction as suggested by vomiting and visible peristalsis, left-sided liver in the presence of laevocardia, and radiographic appearance of reversed double bubble, be considered as indicating MOMS.

Abnormalities, Multiple↗
PubMed1988

Prognostic factors in neonatal intestinal obstruction: a prospective study of Nigerian newborns with bowel obstruction.

The management of neonatal intestinal obstruction in developing countries remains challenging, but the results are relatively less rewarding compared with results of treatment of this condition in industrialized countries. This study is an attempt to evaluate, using acceptable scientific methods, some of the factors that are believed to influence survival in neonatal intestinal obstruction, including those that are not peculiar to developing countries alone. Sixty-five babies treated for intestinal obstruction at the Lagos University Teaching Hospital, Lagos, Nigeria, formed the subjects for the study. The levels of obstruction, which were congenital in all cases, spanned the entire intestinal tract from the duodenum to the anus. Forty-one babies survived and 24 died, a survival rate of 63%. Employing Student's t test, there were no significant differences in the gestational age and birth weight between survivors and nonsurvivors, whereas significant differences do exist with respect to the age at operation and admission serum bicarbonate levels, P less than .05 and P less than .001, respectively. Analysis of the levels of obstruction and nature of operative procedure using the chi-square test shows no significant differences between the two groups. However, there is significant difference in the percentage of major associated congenital problems, P less than .01, which was higher in nonsurvivors.

Abnormalities, Multiple↗
PubMed1986

Adrenal rest tumour of the ovary associated with isosexual precocious pseudopuberty and cushingoid features.

A 2-year-old girl who presented with blindness, aphasia and inability to move the right arm and leg following a convulsive episode was found to have hypertension, precocious pseudopuberty, features of Cushing syndrome and an ovarian tumour. The hormonal profile suggested an adrenal cortical tumour, which turned out to be located in the ovary and the cause of the ovarian enlargement. Following removal of the mass, all the abnormal features regressed and the blood pressure returned to normal.

Adrenal Rest Tumor↗
PubMed1986

Neonatal necrotizing enterocolitis in Lagos.

The records of 14 infants in whom the diagnosis of Neonatal Necrotizing Enterocolitis was made between 1978 and 1984 were studied. The distance appeared in the second week of life of the majority (57%) of the babies, and was equally prevalent in preterm and term babies. Infections seemed to be the predisposing factor in all cases although no transmissable pathogens were identified. Abdominal distention (57%), rectal bleeding (21%) and bowel perforation (14%) were the main presenting features. The only three survivors were among the babies treated medically including intravenous metronidazole. The only baby that survived bowel resection succumbed three months later to jejunostomy diarrhoea. Extended medical management including intravenous metronidazole is being suggested as the treatment for acute NNEC in developing countries while surgical treatment is reserved only for perforation and uncontrollable rectal bleeding.

Enterocolitis, Pseudomembranous↗
PubMed1986

Duodenal obstruction in Nigerian newborns and infants.

Experience with the management of congenital duodenal obstruction in a tropical environment is analysed with a view to highlighting some of the problems and suggesting solutions. 30 infants with duodenal obstruction were treated at the Lagos University Teaching Hospital between 1978 and 1985. 15 (50%) infants had duodenal atersia. 7 (23%) had Ladd's bands, 6 (20%) had duodenal diaphragm and there was one bay with partial duodenal obstruction caused by a duplication cyst. The associated abnormalities encountered in 7 infants are distal bowel atresia (3), partial situs inversus (3) and Trisomy 21 (1). Delay in presentation and inadequate facilities constituted the major constraints. 7 of the 25 infants that had corrective surgery died, a mortality of 28%. All the infants that were treated within the first 8 days of life survived. After this period survival was restricted to those with incomplete obstruction. Mortality can be reduced by the provision of adequate facilities and health education.

Duodenal Obstruction↗
PubMed1985

Malignant sacrococcygeal teratoma--endodermal sinus, yolk sac tumor--in infants and children: a 32-year review.

Fifteen cases of malignant sacrococcygeal teratoma were treated at our hospital over the last 32 years. These included five cases of endodermal sinus (yolk sac) tumor that arose in otherwise benign or immature teratoma, and ten cases of pure endodermal sinus (yolk sac) tumor. Most were females, and only one was a neonate. The presence of symptoms almost always indicated local extension or distant metastases. According to Altman's classification, all but two of these malignant tumors were Types III and IV. The resectability was low, but with aggressive radiotherapy and chemotherapy, second look operations in five have been possible with increasing optimism for survival. Two of five patients with secondary resections are alive and tumor-free almost two years after therapy was discontinued. So far, only the newborn is a long-term (14 years) cure.

Child, Preschool↗
PubMed1984

A comparative study of the traditional long case with the objective structured clinical examination in Lagos, Nigeria.

An apparent difference in the results of the clinical examination of the final M.B., B.S. was observed following replacement of the traditional long case (TLC) with the Objective Structured Clinical Examination (OSCE) in 1979. This led to a study of the results of two consecutive years of each method, 1976 and 1978 (TLC), and 1979 and 1980 (OSCE). The OSCE pass rate of 61% was found to be significantly lower than TLC pass rate of 93% (P less than 0.05). Using the analysis of variance and the critical difference (CD) of the mean scores of the different types of examination, no significant difference was found to exist between the two TLC examinations or between the two OSCE examinations. However, significant difference exists between the TLC of 1978 and the OSCE of 1979, P less than 0.05. A comparison of the CD of MCQ to those of TLC and OSCE suggests that less differences exist between MCQ and OSCE scores compared to MCQ and TLC scores, and by 1980 no significant difference exists between MCQ and OSCE. OSCE, like MCQ, will therefore appear an acceptable method of examination and perhaps a more effective method of clinical examination than TLC.

Clinical Competence↗
PubMed1982

Management of imperforate anus at the Lagos University Teaching Hospital, Nigeria: a review of ten years' experience.

Sixty cases of imperforate anus treated at the Lagos University Teaching Hospital, Nigeria between 1969 and 1979 are reviewed. Late presentation at our hospital was a remarkable feature. Although there were only 18 attempts at Wangensteen-Rice (Wangensteen and Rice 1930) inversion radiograms using all the information available, it was possible to categorize 27 children as having high and 17 as having a low-type imperforate anus. Only 16 of the children with high lesions have had abdominoperineal pull-through procedures with an operative mortality of 31%. Eleven definite procedures for low lesions were carried out in newborn infants. The rest were decompressed either by a colostomy or a congenital fistula and are waiting for definite surgery. One child died before any surgical treatment. Some of the problems related to the outcome of treatment of this disease in our hospital are late presentation, inadequate facilities and shortage of specialized personnel, problems peculiar to a developing country. We suggest an urgent colostomy performed under local anaesthesia as a safe and expedient treatment for babies with obstruction and in whom the presence of a translevator anomaly cannot be immediately verified.

Anus, Imperforate↗
PubMed1981

Traumatic diaphragmatic hernia in children.

Because of its rarity in children the diagnosis of diaphragmatic hernia due to trauma is often delayed, sometimes resulting in gastrointestinal or respiratory complaints or obstruction of the small intestine. Eleven children with rupture of the diaphragm were seen between 1950 and 1977. All injuries were due to blunt trauma sustained in automobile-related accidents; all involved the left hemidiaphragm. Nine children had associated injuries, most commonly fractures, and injury to the head and spleen. In six children the diaphragmatic rupture was recognized and treated at the time of injury. The other five presented with gastrointestinal or respiratory symptoms from 2 months to 3 years after the trauma. Repair was through the abdomen in 10 patients and the chest in 1. There was only one death from an associated severe craniocerebral injury. Complications developed in five surviving patients but were relatively minor.

Accidents, Traffic↗
PubMed1980

Benign sacrococcygeal teratomas in infants and children: a 25 year review.

A review of 33 infants treated over 25 years for benign sacrococcygeal teratoma shows that this is predominantly a newborn tumour presenting mostly as an external mass and carrying an excellent prognosis provided surgical treatment is prompt and complete excision accomplished. Resectability was 100% in this series as is usually the case. This tumour must however, be differentiated from other masses presenting in the sacrococcygeal area by a careful histologic study since these other lesions generally require a different therapeutic approach.

Female↗
PubMed1979

The value of emergency open lung biopsy in infants and children.

The records of 36 infants and children who underwent emergency open lung biopsy at the Hospital for Sick Children, Toronto, between 1969 and 1976 were studied in order to assess the safety and value of performing this procedure in patients with failing respiratory function. Prior to their respiratory illness, 14 of these patients were receiving steroids, chemotherapy, and radiotherapy singly or in combination as treatment for various sytemic diseases of which leukemia was the most prominent. In all cases the biopsy was performed under general anesthesia and lasted about 1 hour. The biopsy was diagnostic in all but one of these children, permitting the institution of appropriate therapy. Six preventible postoperative complications required treatment but there were no deaths attributable to operation in this series. Emergency open lung biopsy is strongly recommended even in patients in severe respiratory failure when all routine investigations fail to yield a diagnosis.

Adolescent↗
PubMed1979

Perforated stress ulcer in infants: a silent threat.

Stress ulcer has become an important clinical entity and its two major complications--bleeding and perforation--are among the most baffling problems, in terms of management, in clinical practice. Perforation, though the less common of the two, is perhaps the most formidable particularly when this occurs in a very sick infant. Four such infants (cyanotic heart disease, gastroenteritis and two severe pneumonias) all developed this severe complication of their illness and after surgery two survived. Two of these infants presented with bleeding prior to perforation of their stress ulcer. The perforation diagnosis was initially not apparent and was first made after radiological examination. Clinical signs of peritonitis were absent as these infants were too sick for such signs to be elicited. All four ulcers were situated in the posterior wall of the duodenum. Two of these infants developed cardiac complications on the operating table, the cause of which was not very clear. It may have been due to the debilitation of these babies with the additional effect of anesthesia perhaps leading to myocardial toxicity. It is therefore recommended that: all sick infants on steroid therapy be placed on prophylactic antacids; abdominal girth measurements be taken frequently in sick infants to appreciate any unexplained increase in girth; such increase in abdominal girth must be evaluated with an upright abdominal x-ray; operative closure of the perforation must be simple and expedient.

Duodenal Ulcer↗