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Data on pediatric endoscopy in Nigeria is almost non-existent. This may be due to lack of trained pediatric endoscopist or lack of facilities. Upper gastrointestinal(GI) endoscopy is thegold standard for evaluating upper GI symptoms/diseases. The majority of gastroscopies in Nigeria are done in adults but children also present with symptoms that require it,hence the need to develop pediatric endoscopy in Nigeria. This is a report of two cases done in the only private high definition video endoscopy facility in Calabar (JIL ENDOSCOPY), Nigeria. Two female children aged 10 years and 8 years had gastroscopy for swallowed foreign body (an office pin) and upper GI bleeding respectively. These patients were referred to JIL endoscopy by Pediatricians from the University of Calabar Teaching Hospital,Calabar. Conscious sedation was administered by the same anesthetist in the two cases. In the first patient, no foreign body was seen at gastroscopy while marked duodenitis was found to be responsible for the upper GI bleed in the second child. The choice of anesthesia for pediatric endoscopy has remained a topic of debate in many fora. A lot needs to be done to develop pediatric endoscopy in Nigeria.

Introduction: Paediatric gastroenterology has become an established subspecialty in the last five decades in developed and some developing countries. Endoscopy is the cornerstone of this sub-specialty. In Nigeria, it is still at its infancy stage, though with increasing local interest. This is a report of the first Paediatric Endoscopy Workshop in Nigeria organized as a pre -conference by the Paediatric Association of Nigeria (PAN) and the Nigerian Society of Paediatric Gastroenterology, Hepatology and Nutrition (NISPGHAN).Aim: The aim of the conference was to promote and create awareness on paediatric gastroenterology as a subspecialty and introduce participants to the practice of paediatric endoscopy.Method: This was a two day preconference workshop. Paediatricians, paediatric resisdents and nurses were in attendance. One International and three National resource persons were on ground to impart the needed knowledge and skills. Training involved didactic lectures, hands-on sessions using manikins and three live sessions involving the upper gastrointestinal tract.Results: There were 40 attendees on day 1: 22 (55%) paediatric residents, 12 (30%) consultant paediatricians and six (15%) nurses. Day 2: 22 (52%) paediatric residents, 12 (29%) consultant paediatricians and eight (19%) nurses. Three children (two females and one male) had upper GI endoscopy (with biopsy done in two cases) during the pre-conference workshop as live sessions. They were aged eight, nine and 16 years. Indications for endoscopy were recurrent haematemesis in an eight year old female patient and recurrent upper abdominal pain in the other two patients (a male and a female). Gastritis was found in the two patients and this was confirmed histologically in one of the patients.Conclusion: The training stirred up participant’s interest in this subspecialty of paediatrics. It brought to fore the need for paediatric endoscopy to be developed in Nigeria. The procedure should be performed at tertiary centres at this stage of our development and the cost of it covered by the National Health Insurance Scheme. Four training centres to aid interested paediatricians and paediatric trained nurses acquire the needed skills are recommended.Keywords: Paediatric endoscopy, Calabar, Nigeria.

Enema is largely used and widely abused in our community for various ailments including fever, constipation; abdominal pains vomiting and even diarrhoea. Objectives: To describe the abuse of enema at home in the Calabar area, and the associated findings among children who received enema. Method: Children admitted to the Children Emergency Unit of the University of Calabar Teaching Hospital with history of enema use at home were recruited into the study. The presenting symptoms, type of enema used and associated findings were documented. Relevant investigations were carried out where necessary. Tables and simple proportions were used to analyze the data. Results: Twenty two children were seen with enema abuse over a six months period. Diarrhoea diseases and fever were the predominant reasons why enema was given. Types of enema given were herbal concoctions in 13(59.1%) plain water enema in 8(36.4%) and salt water enema in one (4.5%) child. Electrolytes derangements were the commonest associated findings. Others were convulsions/coma, intestinal perforation, acute renal failure and severe dehydration from diarrhoea. Conclusion: Enema abuse is a continuing cultural phenomenon in the Calabar area. It is associated with severe consequences including intestinal perforation. Enema abuse should form part of history taking in this environment and child care practitioners should actively search for possible complications. Most importantly, health education to stem this widespread practice

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