| ORIGINAL ARTICLE |
|
| Year : 2013 | Volume
: 12
| Issue : 4 | Page : 212-216 |
|
|
Exstrophy anomalies: Preliminary review of 18 cases in Maiduguri, North-eastern Nigeria
JY Chinda1, AM Abubakar1, TM Dabkana2, D Kwari3, Y Mava4, KJ Bwala1, S Wabada1
1 Department of Surgery, Paediatric Surgical Unit, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
2 Department of Orthopaedic and Traumatology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
3 Department of Anaesthesia, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
4 Department of Paediatrics, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
Correspondence Address:
J Y Chinda
Deeper Life Bible Church, PMB 516, Maiduguri, Borno State
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1596-3519.122688
|
|
|
Background: Exstrophy anomalies, although rare, pose a tremendous challenge to both surgeons and surrogates. Management is intricate and experience with large members is restricted to a few centres worldwide. This report is a review of 18 cases of these anomalies managed in University of Maiduguri Teaching Hospital (UMTH) over 8 years, highlighting the intricacies of management, and contributes to the existing data bank on this subject matter in our environment.
Materials and Methods: We reviewed the records of all cases of anomalies that were managed in the index hospital from December 2002 to December 2010.
Results: Eighteen cases were studied. The youngest was a 2-day-old neonate and the oldest was 6 years at repair, with a median age of 4 months. There were 7 boys and 9 girls with bladder exstrophy, and the remaining two were girls with cloacal exstrophy, giving a male-female ratio of 7:11 for the exstrophy anomalies. Eight patients (33.5%) had associated congenital anomalies; 16.7% had undescended testes (UDT), anorectal malformation (ARM) and patent processus vaginalis (PPV); and duplicate bladder occurred in 5.6% of the patients. All but one patient had bilateral posterior iliac osteotomy at bladder closure. Out of the 17 patients that had osteotomy, 76.5% had satisfactory bladder closure (no complication), 5.9% had superficial wound dehiscence, 11.8% had bladder neck dehiscence and 5.9% had complete disruption. The lone patient that did not undergo osteotomy had complete bladder dehiscence. Postoperative immobilization was done for 3 weeks for 16 cases; one was discontinued after 1 week because of complication. The longest follow-up was for 2 years and the shortest for 2 weeks. Four patients (22.2%) did not turn up for follow-up.
Conclusion: Exstrophy anomalies although rare remain a major challenge in paediatric surgery. Iliac osteotomy, among other technical considerations, remains a cornerstone for successful bladder closure. |
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
