Background: Although uncommon, incisional hernia is a well-known complication of abdominal surgery in children and data on incisional hernia in the pediatric age group are sparse. The aim of this study was to evaluate a single center’s experience with regards to the incidence and outcome of incisional hernia in children. Materials and Methods: This was a retrospective study of children aged 15 years and younger who developed incisional hernia following abdominal surgery, between January 2013 and December 2017, at the pediatric surgery unit of a tertiary hospital in Enugu, Nigeria. Results: During the study period, a total of 1004 pediatric abdominal surgeries were performed. Out of this number, 31 patients developed incisional hernia: This accounted for an incidence rate of 3.1%. There was male predominance and the mean age at diagnosis of incisional hernia was 24 months. All the patients presented with a protrusion at or around the site of a previous surgical scar. Non-operative treatment (serial bandaging) was effective in most of the patients. There was no mortality. Conclusion: Incisional hernia is a well-known complication of abdominal surgery. This study recorded the incisional hernia incidence rate of 3.1%. Non-operative treatment was successful in majority of the patients. Future studies should emphasis on the specific risk factors (surgeon/patient) that may predispose to incisional hernia.

Background: A reduction in testicular mass (testicular atrophy) may occur as a complication of hydrocele/hernia repair in children (herniotomy). The aim of this study was to evaluate for testicular atrophy in children who underwent herniotomy for hernia or hydrocele repair. Materials and Methods: This was a prospective study of children aged 15 years and younger who had unilateral herniotomy at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Preoperatively and postoperatively (at least 6 months apart), the volumes of both testes were assessed using ultrasound. These specific testicular volumes were compared to determine the degree of change in unilateral testicular volumes relative to the contralateral testis. For the index study, any reduction in testicular volume of more than 20 percent is considered testicular atrophy. Results: A total of 258 cases of herniotomies were seen during the study period. The mean age of the patients, at diagnosis of testicular atrophy, was 2 years, range of 1 to 3 years. About one-fifth (53) of the patient showed more than 20% reduction in testicular volume relative to the contralateral testis. There were more hydroceles than hernias and all the patients had herniotomy. Stitch related complications were the most common post-operative complication. Conclusion: Herniotomy for pediatric inguinal hernia and hydrocele is one of the most commonly performed surgical procedures in children. However, this procedure is not without complications, testicular atrophy may occur. This study has shown that up to 20% of the children who underwent herniotomy may come down with testicular atrophy.

Background: The incidence of intussusception may vary from one season to another and from one country to another. The aim of this study was to evaluate the seasonality of childhood intussusception. Materials and Methods: This was a retrospective study of infants, aged one year and below, who presented with intussusception (ultrasound confirmed) between January 2016 and December 2020 at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Results: A total of 378 cases of intussusception in infants were seen during the study period. There were 236 (62.4%) and 142 (37.6%) females. The median age of the patients was 6 months with a range of 3 to 12 months. Abdominal pain was the most common presenting symptom and most of the intussusceptions occurred during the dry season. Majority of the patients had operative treatment and surgical site infection was the most common postoperative complication. The overall outcome was good. However, 34 (9%) infants expired. Conclusion: Although intussusception can occur at any time of the year, this study has shown that more cases of intussusception are seen during the dry season in our centre. This spans over a period of October to March.

Background: The surgical removal of the kidney, nephrectomy, is not a minor surgical procedure. It is a major endeavor. Indications for nephrectomy range from benign to malignant pathological conditions. Materials and Methods: This was a retrospective study of children aged 15 years and below who had nephrectomy between January 2016 and December 2020 at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. The information extracted included the age of the patient at presentation, gender, and predominant presenting symptom and the pathology (indication), duration of symptoms before presentation to the hospital, time interval between presentation and nephrectomy, operative procedure performed complications of treatment, duration of hospital stay and outcome of treatment. Results: Eighteen (18) pediatric nephrectomies were performed during the study period. There were 14 (77.8%) males and 4 (22.2%) females. The mean age of the patients was 6 years with a range of 3 years to 9 years. Nephroblastoma was the most common indication (pathology) for nephrectomy. Nephrectomies were performed more on the left side than on the right. Simple nephrectomy was performed in all the patients. However, children with nephroblastoma had nephroureterectomy. Surgical site infection was the most common post-operative complication. About one-quarter of the patients expired due to tumor metastasis. Conclusion: Nephrectomy is the optimal procedure for neoplasm of the kidney or non-functional kidney. Malignant kidney tumour (nephroblastoma) was the most common indication for nephrectomy in the present study.