Outcomes of intestinal obstruction are still poor in our setting; late presentation, financial constraints, poor parental motivation and lack of basic facilities were the major determinants of mortality.

Many neck masses in otherwise healthy children in our setting were malignant. We advocate early surgical consultation and thorough histopathologic analysis of neck masses in children in our subregion.

Background/Objective: Circumcision may be associated with complications which are usually minor but could be life threatening on certain occasions. This study determined contributory factors, pattern of presentation, challenges of management and outcome of circumcision mishaps in Benin City, Nigeria. Methods: A retrospective analysis of all male children managed for circumcision mishaps between January 1998 and December 2007 at the University of Benin Teaching Hospital, Benin City, Nigeria. Results: There were 346 male children aged between 6 days and 12 years. Period of presentation to the unit ranged between 1 hour and 12 years. Redundant prepuce, 51 (14.7%); glandulopenile adhesions, 30 (8.7%); implantation cyst, 10 (2.9%); penile chordee, 11 (3.2%); local wound infection, 17 (4.9%); and proximal migration of plastibell ring, 11 (3.2%), were common mishaps treated with good outcome. On the other hand, urethrocutaneous fi stula, 73 (21.1%); hemorrhage, 46 (13.3%); glandular amputation, 9 (2.6%); penile tissue avulsion, 24 (7.0%); and transmission of infections, 4 (1.2%), were challenging mishaps to manage. These resulted in 18 children with residual penile deformity and 4 deaths. Challenging mishaps and late referrals were common among children circumcised by traditional circumcisionists (P Ͻ 0.0001). Inadequate training of circumcisionists; circumcision in unhygienic environment; circumcision with unsterilized instruments; circumcision without the use of anesthesia, analgesia and antibioticswhich were compounded by late referrals -infl uenced the development and fi nal outcome of circumcision mishaps. Conclusion: Circumcision mishaps presenting very late with resultant poor outcome are still common in our setting. Hospital circumcision by experts, health awareness campaigns, adequate training of circumcisionists and early referrals of affected children should be encouraged.

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These outcomes showed that with meticulous selection, primary PSARP in neonates was feasible and safe in a developing country. Multicenter studies and long-term follow-up are advocated World-wide.