The morbidity and mortality following surgical management of neonates is still very high in this hospital. Financial constraints, emergency surgery, delivery outside the hospital and tracheo-oesophageal/gastrointestinal anomalies were significant and contributory factors.
The incidence of infantile hypertrophic pyloric stenosis has steadily decreased in developing countries, and this study was designed to confirm this and establish any protection conferred by exclusive breastfeeding. A retrospective study was done between July 1978 and June 2008, at the University of Benin Teaching Hospital, Benin City, Nigeria. A total of 57 children aged between 2 and 6 weeks (mean 3.5 +/- 1.2 weeks) comprising of 49 males and 8 females with male female ratio 6.1 : 1 were treated. Following the introduction of exclusive breastfeeding in late 1980s and early 1990 s in Nigeria, a steady drop in incidence was noticed, with only five cases seen in the last decade and just one case seen in the past 5 years. All were babies who had artificial feeds, with none recorded among babies exclusively breastfed. This decrease in the incidence of infantile hypertrophic pyloric stenosis may have been due to exclusive breastfeeding.
The early surgical management of omphalocele major in Africa predisposes neonates to surgical complications which are often worsened by the presence of associated anomalies. Conservative management using available escharotics results in early skin cover by secondary wound healing. This delays the need for fascial closure and avoids neonatal surgical risks thus improving survival. We present a case of omphalocele major that underwent spontaneous closure during conservative management with honey dressing without surgical intervention.
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