Schistosomiasis is an important communicable disease in the developing world. However, testicular schistosomiasis is an extremely rare condition. We report a case of testicular schistosomiasis mimicking testicular tumour in a 13 year old who presented with huge unilateral testicular mass. The dilemma encountered in the diagnosis and treatment of this child is presented to highlight the need for high index of suspicion of this pathology in children with testicular mass presenting from schistosomiasis-endemic areas.

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Introduction: Acute appendicitis is one of the most common abdominal emergencies globally. Etiologyremains poorly understood with few advances over the past decades. Obtaining a confident pre-operativediagnosis remains a challenge, as appendicitis must be entertained in any patient presenting with an acuteabdomen. A clinical classification is used to stratify management based on simple (non-perforated) andcomplex (gangrenous or perforated) inflammation, although many patients remain with an equivocaldiagnosis, which remains one of the most challenging dilemmas. The aim of the study is to evaluate themanagement and outcome of complicated appendicitis at the Abia State University Teaching HospitalAba Nigeria. Methodology: A prospective analysis of all children treated for appendicitis at the AbiaState University Teaching Hospital Aba between 2016 and December 2018. Proforma was opened fordemographic data, clinical presentation, diagnosis, treatment, complication and outcome. Results: A totalof 100 children aged between 2 and 15 (mean 8.7 ± 2.8) years, comprising 60males and 40 females withmale/female ratio 3:2 had appendectomy which accounted for 8% of total pediatric operations and 40% ofpediatric abdominal operations. Only 40 (40%) children presented during the first episode of symptomsand in clinically stable state while 60 (60%) were referred after wrong diagnosis and treatment by generalpractitioners which resulted in different complications ranging from appendix abscess 10 (10%), appendixmass 15 (15%), perforated appendix 30 (30%), gangrenous appendix 5 (5%) . These influenced postoperative outcome with wound infection recorded in 20 (20%), wound break down 10 (10%), septicemia15 (15%), pelvic abscess 5 (5%) and death 1 (1%). These were not recorded among those who presentedearly who also had significantly lower duration of hospitalization and cost of treatment. Conclusion: Latereferral due to paucity of knowledge, long referral chain and low index of suspicion was rampant whichsignificantly increased associated morbidities and mortality among children managed with appendicitisKeywords: Appendicitis, children, complicated

Background: Neonatal surgery is still a challenge in developing country due to lack of appropriate equipment, inadequate work force and lack of political will by hospital management. However, there has been significant improvement in outcome over the last century. Objective: This study evaluates neonatal surgery in commercial city of Aba South East Nigeria with emphasis on challenges and management outcome. Methods: Prospective analysis of sixty neonates who had operative treatment at Abia State University Teaching Hospital Aba from October 2016 to July 2018. Proforma was opened for sex, weight, prenatal care, age at presentation, duration of symptoms prior to presentation, surgical pathology, treatment offered, associated congenital anomaly, evidence of prenatal diagnosis, complications and outcome. Results: There were 40 males and 20 females, male to female ratio of 2:1. The mean weight of the neonates was 2.5kg (range1.1-4.3kg). The average age at operation was 3 days (1-15days), the mean duration of symptoms before presentation was 3.5days. The major indication for operation was anorectal malformation 32 patients {53.3%} anterior abdominal wall defect 8 patients {13.3%}, Intestinal atresia 8 patients {13.3%}, intestinal perforation 8 patients {13.3%}, obstructed hernia 4 patient {6.6%}/There was associated congenital abnormality in 5 patients {8.3%} and prenatal diagnoses was made in 10 cases {16.6%}. During a mean follow up of 3months {1week to 9months, procedure related complications in 16 patients {26.6%} and 8patients died {mortality of 13.3%}. Conclusion: Surgical care of the neonate with a wide range of pathologies is still major challenge in our setting. Good political will, capacity building in form of manpower development and procurement of appropriate equipment will enhance the outcome.