Browsing by Author "Lawal, T. A."

Now showing 1 - 4 of 4

Experience with sonogram-guided hydrostatic reduction of intussusception children in South-West Nigeria
(The West African College of Surgeons, 2013) Ogundoyin, O. O.; Atalabi, O. M.; Lawal, T. A.; Olulana, D. I.
"Background Intussusception is a common cause of intestinal obstruction in young children. The diagnosis and treatment of intussusception has evolved over the years with ultrasound being the first choice imaging technique and a major player in the non-operative reduction of intussusception owing to its advantage of reduced morbidity and non-exposure to ionizing radiation when compared to other modalities of treatment.Aim & Objectives: The aim of this study was to evaluate the efficiency of ultrasound guided hydrostatic reduction in the management of intussusception in children and assess the predictors of reducibility.Methods: A prospective study of all infants and children who presented with uncomplicated intussusception was conducted between January, 2005 and September, 2013. The diagnosis of intussusception was made clinically and this was confirmed by an abdominal ultrasonography. Ultrasound guided hydrostatic reduction of intussusception was performed on the selected patients after they were adequately resuscitated. Failed was abandoned in favour of operative reduction in some patients. Data collected included the age of the patient, duration of symptoms and the outcomes of the procedure and these were analyzed. Results: Eighty-four patients with intussusception were treated over this period, 36(42,9%) patients were found suitable for hydrostatic reduction of intussusception. Twenty-four(66.7%) patients presented within 48 hours of onset of symptoms. Twenty-one(58.3%) patients had successful hydrostatic reduction of intussusceptions while 15 (41.7%) patients had failed reduction. The procedure was successful in majority (58%) of the patients age of 1 year and one of the three (33%) patients older than one year. Hydrostatic reduction of intussusceptions was successful in 14 out of 24 patients (58.3%) who presented within 48 hours of onset of symptoms. Conclusion: Hydrostatic reduction of intussusception under ultrasound guidance is an effective and use conservative method of management in carefidly selected children with intussusception. Overall, this modality treatment is cost effective and could readily be used for patients in resource poor environment. It also monitors the reduction process and visualizes the components of the intussusception including the lead points. "
Factors influencing the pratcie of hydrostatic reduction of intussusception amongst radiologists in a developing country
(2009) Lawal, T. A.; Atalabi, O. M.; Adekanmi, A. J.; Ogundoyin, O. O
Background: Intussesception is a mojor cuase of intestinal obstruction in children and can be treated operatively or non-operatively. Surgery is associated with mortality rates, in dveloping countries of 8.5% to 18%. Hydrostatic reduction is a cost effective treatment that can lower the mortality rate in resource poor settings. However, the teachnique is not widely performed inspite of the advantages. Objectives: We reviewed factors influencing the current practice of hydrostatic reduction of intussusception by radiologists in Nigeria. Materials and Methods: A survey of radiologists was conducted using structured self adminsitered questionnaires. Strenght of assocition between the practice of hydrostatic reduction and variables related to the workforce was evaluated using Fisher's exact test. Result: Fifty-one participants were studied. Three (18.8%) hospitals have at least one consultant radiologist focusing on pediatric surgeon or more. Hydrostatic reduction is practiced in hospitals with a radiologist with interest in pediatric radiology, (p=0.002). Lack of expertise was given as the main reason why hte other hospitals have not commenced the procedure.
Hydrostatic reduction of intussusception under ultrasound guidance: an initial experience in a developing country
(2007-07) Atalabi, O. M; Ogundoyin, O. O,; Ogunlana, D. I,; Onasanya, O. M.; Lawal, T. A.; Olarinoye, A. S.
Background: Intussusception is one of the most common causes of acute intestinal obstruction in children. Hydrostatic reduction with barium enema is the widely accepted and preferred mode of treatment of uncomplicated intussuception. The aim of this study was to report our initial experience with hydrostatic reduction of intussusception. Patients and methods: We present our initial experience in which 8 patients had ultrasound guided hydrostatic reduction of intussusception over a period of 2 years. All patients that presented within 48hours of onset of symptoms were recruited into the study. Clinical diagnosis of intussusceptions was made in all of them while abdominal ultrasound was used to confirm the diagnosis. Results: Half of the patients presented after 24 hours of onset of symptoms. Five patients (62.5%) had a successful reduction of thier instussusception while was completed by surgery. There was only one (12.5%) recurrence and there was no peritonitis. Conclusion: Ultrasound guided hydrostatic reduction of intussusceptions in this environment is possible when patients present early with low risk of complication and low recurrence rate.
Routine prenatal ultrasound anomaly screening program in a Nigerian university hospital: redefining obstetrics practice in a developing African country
(2015-08) Akinmoladun, J. A.; Ogbole, G. I.; Lawal, T. A.; Adesina, O. A.
Background: Congenital anomalies are among the leading causes of fetal and infant morbidity and mortality worldwide. Prenatal ultrasound (US) screening has become an essential part of antenatal care in the developed world. Such practice is just evolving in die developing countries such as Nigeria. The aim of this article is to present our initial experience and demonstrate the effectiveness of a prenatal US screening program in detecting congenital malformation in a developing country. Materials and Methods: This was a prospective evaluation of the prenatal .US screenings conducted at a major referral hospital in Southwestern Nigeria All pregnant women referred to the antenatal clinic for mid-trimester screening during the period of study were assessed. Results: Two hundred and eighty-seven pregnant women (5 with twin gestations) were presented for fetal anomaly scan during the study period. Twenty-nine anomalies (9.9%) were detected among the scanned population. Sixteen of the anomalies were followed to delivery/termination with a specificity of 93.5%. The commonest malformations were demonstrated in the genitourinary tract (34.5%) followed by malformations within the central nervous system (27.6%). Six (20.6%) of the anomalies were lethal. Five of the anomalies were surgically collectable. Conclusion: Institutions and hospitals across Nigeria and other low- and middle-income countries need to develop policies and programs that would incorporate a standardized routine screening prenatal US in order to improve feto-maternal well-being and reduce the high perinatal mortality and morbidity in developing nations.