AbstractsBasidiobolomycosis is a fungal infection caused by Basidiobolus ranarum which affects the skin and subcutaneous tissue and rarely the gastrointestinal tract. We report seven cases of gastrointestinal basidiobolomycosis with interesting clinical, radiological, and histological presentations. To our knowledge, this is the first case series of abdominal basidiobolomycosis to be reported from Sudan.

a valuable data for health authorities. The aim of this study was to reflect the burden and outcomeof one pediatric surgery unit at Sinnar Teaching Hospital (STH). It also throws some light intochallenges and obstacles that face running of pediatric surgery services outside of the capital.Methods: This was a retrospective, descriptive review. It included all the patients who presentedto the Pediatric Surgery Unit at Sinnar Teaching Hospital (STH) and underwent emergency orelective operations during the period from January 2009 to December 2012.Results: A total number of 2400 patients were seen at the unit over four years. About half of them(1210) (50.4%) underwent emergency or elective operations. Inguinoscrotal conditions were themost frequently performed elective operations 450 (37%). Appendectomy was the commonest emergency operation: 169 (14%). Forty four (2%) were referred to Al-Jazeera or KhartoumStates for further work-up or advanced care. The majority of the referred cases were those whorequired more specialized oncological or neurosurgical services, in addition to some patients whoneeded non-invasive interventions (like ESWL for instance) or multidisciplinary management (bladder exostrophy and proximal hypospadias). The overall mortality rate was 2.4% (n=52) withhigher mortality rate noticed among neonatal conditions: 20% of it (n=10) due to lack of trainedanesthetists, pediatric intensive care unit facilities, and delayed presentation.Conclusion: Conduction of a pediatric surgery service outside of the capital is challenging andfaces various obstacles, but it is possible with a reasonable outcome. A wide variety of emergencyand elective pediatric surgical conditions are seen and the majority of them could be managedproperly at a state hospital level. Availability of well-established anesthetic and pediatric intensivecare facilities, with trained nursing staff is the cornerstone for better quality services with minimummorbidity and mortality rates. Establishment of pediatric surgery services in the states wouldinvariably decrease the central congestion and referral to capital hospitals. It can also minimizethe unnecessary, and indeed, costly expenditure on referral,especially for low-and middle- incomefamilies.

BackgroundWe report a case of right adrenocortical adenoma in a girl with features suggestive of Beckwith Wiedemann syndrome to show the importance of tumor surveillance in patients with Beckwith Wiedemann syndrome.Case presentationA 4-years-old female with features suggestive of Beckwith-Wiedemann syndrome presented with 9 months history of virilization. Hormonal investigations results showed high levels of testosterone (2.3 ng/ml, normal values 0.1–0.4 ng/ml), and DHEAS (73 ng/ml normal values 1-6 ng/ml) with normal cortisol level. Computed tomography revealed a right adrenal mass. She underwent right adrenalectomy. Histopathological examination of the resected adrenal gland showed adrenocortical adenoma. Her postoperative evaluation showed a normal testosterone level.ConclusionAdrenocortical neoplasms though rare in children are well documented in Beckwith-Wiedemann syndrome patients. So tumor surveillance protocol should be employed, even in a resource-limited setting for early tumor detection and a better outcome.

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