Anorectal malformations are associated with other anomalies among which vaginal malformations are occasionally encountered and may go unnoticed by the primary physician. Between January 1998 and December 2003, 563 cases of anorectal malformations were managed in Pediatric Surgery Department, Chittagong Medical College & Hospital, Chittagong, Bangladesh. Among these, five cases of rectovestibular fistula were associated with vaginal malformations. In this retrospective study age, physical findings, operative findings and procedures, outcome of operation and postoperative follow-up were evaluated. Mean age at presentation was 8.67 years (range 2 months to 17 years). All cases referred as rectovaginal fistula and vaginal anomalies (atresia to agenesis) were detected after thorough examination. Initial pelvic colostomy was done in all patients. Cases 1, 3 and 4 had distal vaginal agenesis and underwent posterior sagittal anorectovaginoplasty. In case 5, atretic vaginal duplication was found with didelphic hypoplastic uterus and absent left kidney. Case 2 (vaginal atresia) operated elsewhere is waiting for definitive surgery. Colostomy closure was done in four cases. The third patient had already married and conceived. Bowel habits are regular in all except the second patient. In females, a thorough understanding of anorectal malformations is necessary to identify the association with vaginal anomalies and awareness of this association will lead to earlier diagnosis and appropriate operative measures.
Thorough clinical examination may identify the anatomical variations of male H-type ARM, and for the treatment of which primary ASAP or ASARP gives good results.
Background: Health care providers have given their efforts to reduce the rate of child mortality and morbidity, throughout the world. But inadequate amount of knowledge about the demand of pediatric surgical care lagging us behind to achieve our goal. The study was conducted to observe the distribution of pediatric surgical cases over five years in the study site. Materials and methods: It was a descriptive type of observational study. Data was extracted from record book of surgical procedures done in Department of Pediatric Surgery, Bangabandhu Memorial Hospital (BBMH) Chattogram, over a period of 5 years, from January 2013 to December 2017. Written permission was taken from the hospital authority prior to data collection. Descriptive data analysis was done by Microsoft Excel (Version 2013). Results: Out of total 2977 cases, 10-15 years age group had a predominance of 828 cases and the least was more than 15 years age group (672 cases). A male predominance was observed, with 65% of all cases (Total- 1935 cases) while female patients comprised rest of it. Male female ratio was 1.86: 1. Over 5 years period appendicectomy (497) circumcision (530) herniotomy (425) rectal polypectomy (255) showed abundant number covering majority of the surgical procedures. On the contrary, splenectomy with cholecystectomy was the least performed surgery (5) mostly done for haemolytic disease of newborn (Thalassemia). Conclusion: To deal with huge amount of surgical patients of pediatric age group an organized effort is required to ensure proper environment and resources to facilitate optimal implementation of surgical care to the future generations of a country.
JCMCTA 2018 ; 29 (2) : 47-52
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