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   Table of Contents - Current issue
Coverpage
January-June 2018
Volume 28 | Issue 1
Page Nos. 1-21

Online since Monday, January 20, 2020

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ORIGINAL ARTICLES  

Impact of suturing of stoma edges directly to skin without peritoneal fixation p. 1
Sandhya Padmanabhan Iyer, Pranal Sahare, Prabhakar Subramaniyan
DOI:10.4103/njss.njss_7_18  
Introduction: Enterostomies are one of the common surgical procedures performed in a general surgery unit. Enterostomies are fixed to the peritoneum/abdominal wall, before being sutured to the skin. This results in prolongation of operative time and dense adhesions between the bowel wall and the abdomen at the site of stoma. This is a comparative study between the commonly followed methods of maturation with our method of direct suturing of the stoma to the skin. Materials and Methods: A prospective randomized study to compare the traditional method of maturation of stoma with direct suturing of the stoma edges to the skin without a peritoneal fixation was carried out in a tertiary health-care hospital. Results: Skin complications and stomal prolapse were the most common type of complication seen. Most of the stoma-related complications were managed conservatively. There was no difference in stoma-related complications between the two methods of stoma construction in our study. However, during stoma closure, dense adhesions were seen in 90% of cases in Group A (peritoneal hitch) as compared to 7% in Group B (direct skin fixation). There was a significantly high 16.7% incidence of iatrogenic perforation of bowel in Group A during stoma closure. Conclusions: Thus, additional rectus and/or peritoneum fixation does not add any benefit in preventing stoma-related complications over intestinal stomas, which are constructed with fixation only to skin. In the group, where the stoma was fixed to abdominal wall, the higher incidence of dense adhesions between the stoma and the abdominal wall resulted in longer operative time during stoma closure and increased risk of iatrogenic bowel trauma.
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Pattern of congenital musculoskeletal anomalies in a suburban Nigerian tertiary hospital p. 7
Edwin Omon Edomwonyi, Roy Enemudo, Eghosa Morgan, Tope Johnson Omokehinde
DOI:10.4103/njss.njss_5_18  
Introduction: Available data in congenital musculoskeletal anomalies (MSAs) in Africa are sparse; hence, we decided to evaluate the pattern of congenital MSA as seen in Irrua Specialist Teaching Hospital (ISTH), Irrua, Edo state of Nigeria. Materials and Methods: The clinical records of patients who presented to ISTH with congenital MSA over 10 years (January 2005–December 2014) were extracted and reviewed. Demographic data, diagnosis, description of abnormalities, associated congenital deformities, side of the body involved, and bilaterality were noted. Results: Seventy-five patients met the criteria. Fifty patients were male and 25 were female. Male: female ratio was 2:1. Congenital talipes equinovarus (CTEV) deformity was the most common MSA in 46 (61.33%) patients. Others were syndactyly in 20 (26.7%) patients and congenital constriction band syndrome in 4 (5.3%) patients. Among patients with clubfoot were a predominance of bilaterality involved with 44.7% in the idiopathic group and 62.5% of those in the nonidiopathic group. The idiopathic variety constituted 82.5% of clubfoot deformity. Spina bifida cystica was the most common associated deformity among patients with nonidiopathic clubfoot. Conclusion: CTEV was the most common congenital MSA seen in ISTH, Irrua, with a high incidence of bilaterality. Spina bifida cystica was the most associated anomaly in the nonidiopathic clubfoot in this center.
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Changing pattern of intestinal obstruction at Nnewi, South-Eastern Nigeria p. 11
Chiemelu D Emegoakor, Ikechukwu C Iloabachie, Henry C Nzeako, Stanley N C Anyanwu
DOI:10.4103/njss.njss_12_18  
Background: Intestinal obstruction is a common surgical emergency. Its pattern and causes vary between communities. Previous reports, including a study from Nnewi, showed obstructed external hernias to be the most common cause. Objective: The objective of the study is to determine the current pattern of intestinal obstruction at Nnewi. Materials and Methods: All case notes of intestinal obstruction managed at Nnewi between January 1, 2000, and December 31, 2009, were retrieved and analyzed. Results: It was found that adhesions caused 62.1% of cases of intestinal obstruction, while obstructed external hernias caused 21.4%. The rest were from other causes. Furthermore, 62.5% of intestinal obstruction from adhesions were managed nonoperatively. Conclusion: Adhesion has emerged as the most common cause of intestinal obstruction at Nnewi.
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CASE REPORTS Top

Parapharyngeal space lipoma mimicking cystic hygroma p. 15
Aditya Pratap Singh, Ramesh Tanger, Arun Kumar Gupta
DOI:10.4103/njss.njss_22_16  
Parapharyngeal space (PPS) tumors constitute only 0.5%–0.8% of all tumors of which lipoma is the rarest. In general, lipoma is found just beneath the subcutaneous tissues. Here, we present a case of a 2-year-old female child with lipoma of the right PPS extending into the neck mimicking cystic hygroma on presentation.
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Parosteal osteosarcoma of the maxilla: A case report and review of the literature p. 18
Osawe Felix Omoregie, Anthony Osaguona, Ehimwenma Ogbeide
DOI:10.4103/njss.njss_23_13  
This study reports a rare case of parosteal osteosarcoma, a low-grade malignant lesion diagnosed in a 67-year-old female who presented with a slow growing oval-shaped, well circumscribed, bony hard, left maxillary swelling of 4 months' duration; extending from the region of the left upper lateral incisor tooth (22) to the left upper first molar tooth (26) and fixed to the overlying gingival. Oblique lateral radiograph showed the left maxillary alveolar ridge with lobulated ossified mass. The clinical differential diagnoses of the lesion were osteoma, and fibrous dysplasia histopathological diagnosis of parosteal osteosarcoma was made after incisional biopsy of the lesion. Surgical resection (with a wide margin) of the affected maxillary segment and the associated teeth was performed, and postsurgical biopsy confirmed the diagnosis of parosteal osteosarcoma. Parosteal osteosarcoma shares similar clinicopathological characteristics with some periosteal lesions. However, special imaging techniques and histopathological evaluation remain the most reliable tools for definitive diagnosis of these lesions.
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