Aims: Mini‑invasive adrenalectomy has been described by Gagner in 1991 and has become the approach of choice. In the pediatric population, laparoscopic adrenalectomy is more challenging because of the small body and pathology of adrenal masses which makes their removal difficult. Methods: We retrospectively reviewed medical records of 11 patients who had laparoscopic removel of adrenal masses, between January 2017 and June 2023. Demographic, clinical, and surgical data were described and compared to the literature. Result: Eleven patients were treated for adrenal masses laparoscopically. The mean age of our patients was 6.8 years. Computer tomodensitometry showed a solid mass with an average size between 2,5 to 6 cm. All patients were treated by transperitoneal approach, five patients had benign lesions and six malignant lesions. A Conversion was done in one patient; no complication had been noticed at o follow‑up of 25 months. Conclusion: LA has shown its safety and efficacy in the management of benign adrenal tumor and selective malignant lesions. Keywords: Adrenalectomy, conversion, laparoscopy, malignancy
Background: Disorder of sex development (DSD), previously known as ambiguous genitalia are group of Individuals who have a genital appearance that does not permit gender declaration at birth. Gender assignment in children with DSD must be done as early as possible and requires close correlation between the history and physical examination, appropriate genetic and laboratory studies and imaging studies. Objective: The objective of this study is to assess the sensitivity of the flush genitogram in the evaluation of children with DSD. Materials and Methods: A prospective study was done over 5 years; the flush genitogram findings of the children were compared with the laparotomy findings at mini lap. Results: Over 5 years, 39 children were evaluated using both a flush genitogram and mini laparotomy. The correct sex was identified by a flush genitogram in 18 children, with a sensitivity of 56% and a false positive in 6 children. Conclusion: The sensitivity of the flush genitogram is found to be low, other methods of assessment are necessary before gender assignment in children with DSD. Keywords: Diagnosis, disorder, flush genitogram, sex development
Background: A tourniquet is commonly used to achieve a clear operative field during corrective osteotomies for Blount’s disease in children. Excessive tourniquet pressures may, however, lead to complications that may threaten the child’s limb, causing avoidable morbidity. Determining the minimum effective cuff pressure required to achieve a bloodless field without causing any harm to the child’s limb becomes essential to good surgical practice. Objectives: To compare the effectiveness of and the complications arising from the tourniquet between fixed inflation pressure (FIP) and pressure determined by limb occlusion pressure (LOP) in children undergoing corrective osteotomy for Blount’s disease. Materials and Methods: Fifty lower limbs of 50 children aged 5–17 years who were undergoing corrective osteotomy for Blount’s disease were randomised into two groups (A and B) of 25 each. Group A is the LOP, whereas Group B is the FIP group. The tourniquet pressure, quality of the clear operative field, local tourniquet complications of pain, skin damage and nerve palsy were compared between the groups. Tourniquet pressure, effectiveness, complications, corrective osteotomy and Blount’s disease between the groups. Data were analysed using IBM SPSS statistic version 23. Results: The mean age of the population was 7.2 years. There was a significant mean decrease of pressure of 82 mmHg in Group A compared to Group B. Both groups had similar quality of the bloodless field; however, there were significantly less complications in Group A. Conclusions: LOP method performs better than the fixed pressure method. It achieves a comparable bloodless field while having a better safety profile. Keywords: Blount’s disease, complications, corrective osteotomy, effectiveness, tourniquet pressure
Background: Appendicitis is one of the most common surgical conditions in children. The appendix, a small pouch attached to the large intestine, may become inflamed or infected, requiring surgical removal. The standard treatment is appendectomy, which can be performed either laparoscopically or by an open technique. The choice of procedure often depends on multiple factors, and ongoing debate exists regarding which approach provides better outcomes. This study focuses on three important parameters: operative time, surgical site infection (SSI), and recovery. Objective: The aim of this study is to conduct a comparative analysis between laparoscopic and open appendectomy in children, specifically assessing operative time, SSI, and recovery. The findings are intended to identify the more effective approach for managing paediatric appendicitis. Method: A meta-analysis was performed to compare laparoscopic and open appendectomy. An inductive and exploratory research design was followed. Eligible studies published in English between 2019 and 2025 were included if they directly compared the two techniques in children. Review articles were excluded. Databases searched included PubMed, Google Scholar, and Mendeley. The PRISMA methodology guided study selection. Data were summarized in tables and charts, and central tendency analyses were performed using Excel and SPSS statistical tools. Results: The analysis showed no significant difference in operative time between the two procedures, although laparoscopic appendectomy tended to take longer. However, laparoscopic surgery demonstrated lower SSI rates and faster recovery compared to open appendectomy. Thus, operative time alone is not a decisive factor, whereas SSI and recovery highlight the advantages of the laparoscopic approach. Conclusion: Laparoscopic appendectomy is the more effective approach for paediatric appendicitis as it has significantly lower surgical site infection rates and faster recovery times despite a slightly longer operative duration in the current research. Keywords: Appendectomy, Appendicitis, Laparoscopic Appendectomy, Open appendectomy, Operative time, SSI, Recovery
Transverse testicular ectopia is a rare form of congenital urogenital anomalies. It is characterised by migration and descent of both testes through a single inguinal canal. Laparoscopy is useful for both diagnosis and management of transverse testicular ectopia. The surgical options for management are transseptal orchiopexy and transperitoneal orchiopexy. This article describes the case of a 2‑year‑old boy who had transseptal right orchiopexy for transverse testicular ectopia. Keywords: Cryptorchidism, transverse testicular ectopia, undescended testis
Adrenocortical adenoma is a rare tumour in children and even rarer in infancy. Most of these tumours in the paediatric age group are hormonally active and predominantly present with virilisation. Cortisol hypersecretion, presenting as Cushing syndrome, is extremely rare and seen in older age groups. We are reporting two cases of adrenal adenoma with different clinical presentations. The first case was of a 9‑month‑old female who presented with isolated features of Cushing’s syndrome (CS). The second case was of a 3‑year‑old male who presented with features of CS, virilisation and dyselectrolytemia. The clinical, biochemical and histological features are discussed. These cases are being reported because of their rarity. Early diagnosis, proper peri‑operative management, complete excision of the tumour and close follow‑up are crucial to improve survival and quality of life. Keywords: Adenoma, adrenocortical tumour, Cushing’s syndrome, dyselectrolytemia, infant, paediatric, virilisation
The pneumoperitoneum is usually a surgical emergency in neonates. It may be idiopathic in some cases like in pre‑term and low‑birth‑weight babies. These cases can be managed conservatively and surgery can be avoided. Prudent selection of cases can prevent surgical exploration of neonates. We present three neonatal cases, in which conservative management for pneumoperitoneum was done. Keywords: Conservative, peritoneal drain, pneumoperitoneum, positive airway ventilation, pre‑term
Introduction: Injury to the oesophagus due to ingestion of caustic substances is a common reason for presentation to paediatric surgical services worldwide. We report the experience of managing these injuries in a resource‑constrained environment. Methods: All patients presenting to specialist paediatric surgical services in The Gambia following ingestion of a caustic substance over 11 months (December 2021–November 2022) were identified and invited for surgical assessment including contrast swallow, endoscopy under general anaesthetic and oesophageal dilatation where indicated. Those who attended formed the study cohort. Data collected included age, time since caustic ingestion, oral intake using the International Dysphagia Diet Standardisation Initiative (IDDSI) dysphagia score, treatment given and outcome. Results: Twenty‑five patients presented in the 11 months, of these, 12 attended for further assessment and formed the study cohort. Of the 13 who did not, one is known to have died (cause unknown) and the remainder is lost to follow‑up. Median age was 4.5 years (range: 2–14 years); duration from injury was 7 months (2–144). The median IDDSI score at the presentation was 4 (0–6). Nine children underwent oesophageal dilatation with a median improvement in IDDSI score of 2 (0–3). Conclusion: Caustic injury of the oesophagus is a common presentation in The Gambia. Accessing specialist surgical care is challenging for patients. Oesophageal dilatation is feasible in most cases and has the potential to significantly improve oral intake. More severe cases not amenable to dilatation pose a significant challenge. A public health approach to try and prevent oesophageal injuries from occurring is needed. Keywords: Caustic, low‑ and middle‑income countries, oesophagus, stricture
Background: Both urinary flow characteristics and aesthetic appearance of the phallus determine the success of a procedure for hypospadias correction. Objectives: The objective of this study was to evaluate the outcomes of tubularized incised plate (TIP) urethroplasty on post‑operative uroflowmetry (UFM) and Hypospadias Objective Scoring Evaluation (HOSE) scores. Patients and Methods: A prospective study was conducted on all hypospadias patients who underwent TIP urethroplasty in the department of paediatric surgery at a tertiary centre from March 2020 to September 2021. Post‑operative HOSE and UFM were performed at 3, 6 and 9 months of surgery. Collected data were analysed. Results: A total of 30 children with hypospadias underwent TIP repair; 7 (23.33%) developed urethrocutaneous fistula; among the rest 23 patients, 7 (30.43%) had bell‑shaped (BS) curve at 3 months, which increased to 60.87% 6 months and 76% at 9 months. 60.87% patients at 3 months, 69.56% at 6 months and 60% at 9 months had normal flow rate. Type of curve, maximum flow rate and number of fistulae showed improvement with time. On objective assessment, the mean HOSE score was found to be 14.8, 14.8 and 14.49 at the end of 3, 6 and 9 months of surgery, respectively. Acceptable cosmetic results were obtained in 96.67% of the boys, with a HOSE score of ≥14. Conclusion: HOSE score, being an objective assessment tool, provided reliable and reproducible evaluation of post‑operative outcomes of hypospadias surgery. UFM must be done in every hypospadias patient who undergoes urethroplasty irrespective of the result of HOSE scoring, as it quantifies the urinary flow characteristics. Keywords: Hypospadias Objective Scoring Evaluation Score, hypospadias, tubularized incised plate urethroplasty, uroflowmetry
Background: Occlusion of the appendiceal lumen by faecolith results in appendicitis and its sequelae, including perforation and gangrenous alterations. A faecolith is believed to be the outcome of constipation. This study assessed the association between constipation faecolith, the occurrence of acute appendicitis and its complications. Methodology: This study examined the patients in the paediatric surgery department between the ages of 2 and 14 years who were diagnosed with acute appendicitis between January 2022 and January 2024. The study included 79 patients in total. The collected data were analysed using the SPSS software (IBM SPSS 25.0, Chicago, IL, USA.). AChi‑square test was used to find the association between the categorical variables. P < 0.05 was considered statistically significant with a 95% of confidence interval. Results: A total of 79 patients were admitted during the study period. In that male‑to‑female ratio was 2.3/1. In the present study, 34% (27/79) of patients had a history of constipation, of which 22.8% (18/79) were found to have faecolith in the appendiceal lumen intraoperatively. There was a statistically significant (P < 0.001) association between the history of constipation among patients with appendicitis, appendicitis with faecolith and appendicitis with complications. Patients with a history of constipation had an operational finding of faecolith in the appendiceal lumen that was statistically significant (P < 0.001). Conclusion: This retrospective study showed that one of the new risk factors for the development of faecolith, which leads to acute appendicitis and its sequelae, is constipation, which may be due to poor diet habits among children. Therefore, when it comes to planning surgery and post‑operative management, the presence of constipation histories and faecolith findings should be taken into consideration. Keywords: Appendicitis, constipation, faecolith
Background: Inguinal hernias are extremely common conditions in childhood and form a large part of the general paediatric surgical practice. While most hernias are unilateral, bilateral ones are usually recorded. In patients with bilateral hernias, the hernias on the contralateral side may not be clinically detectable at the time of the herniotomy. There has been the debate about the necessity and indications for exploring the apparently normal side during herniotomy. The aim of the study was to compare objectively the sensitivity of silk glove sign and ultrasound in detecting presence of a patent processus vaginalis (PPV). Materials and Methods: This is a prospective comparative study. A total of 79 patients with confirmed unilateral inguinal hernias were examined for the presence of patent contra‑lateral by checking for a positive silk‑glove sign. These patients subsequently had an ultrasound scan done on the same contralateral side by a different senior paediatric surgery resident trained in taking such scans with the supervision of a consultant radiologist (all blinded to the clinical findings). Patients who exhibited both positive clinical and ultrasound findings underwent herniotomies on the symptomatic side accompanied by contralateral exploration. Collated data were entered and analysed using the SPSS software version 27.0. P < 0.05 was considered statistically significant. Results: The hernias occurred more on the right − 52 (65.8%) and 25 (34.2%) on the left. A total of 53 (67.1%) had hernias, while 26 (32.9%) had hydroceles. The sensitivity, specificity and diagnostic accuracy of the silk glove sign were 100.0% respectively, for all 4 patients that were positive, while the ultrasound scan had a sensitivity of 98.7%, specificity of 100% and diagnostic accuracy of 98.7%. Conclusion: This study demonstrates that both the silk glove sign and ultrasound are equally effective in detecting the PPV in the contralateral groin of patients with unilateral inguinal hernia and hydrocele. The comparable sensitivities, specificities and diagnostic accuracies between the two methods suggest that either can be reliably used in clinical practice, depending on the availability of resources and the clinician’s expertise. Keywords: Hydrocele, Inguinal hernia, patent processus vaginalis, pediatric surgery, silk glove sign, ultrasound
Background: Idiopathic talipes equinovarus (clubfoot) is a congenital deformity treated initially by the Ponseti method, but in cases of relapse, tibialis anterior tendon transfer (TATT) is commonly used. A complication of TATT is the development of ‘Hallux extensus’ deformity, characterised by hyperextension of the great toe at the metatarsophalangeal joint (MTPJ). This deformity’s functional impact has not been systematically assessed. Objective: To measure and evaluate the occurrence of cock up great toe deformity following TATT surgery in recurrent talipes equinovarus patients. The study also aims to introduce a functional test, the ‘Newcastle test’, to identify this deformity reliably. Methods: This study involved four patients who had undergone TATT for relapsed clubfoot. Patients were assessed for active ankle dorsiflexion and MTPJ angles using goniometry. Measurements were taken with knees in extension and flexion to evaluate the impact of tendoachilles involvement. A functional ‘Newcastle test’ was also introduced to assess the deformity under weight-bearing conditions. The Newcastle sign was deemed positive if hyperextension at the MTPJ and a dorsal crease were observed during ankle dorsiflexion. Results: All patients with TATT demonstrated a positive Newcastle sign on the operated side. The average dorsiflexion in knee extension was lower on the TATT side (−0.75°) compared to the non‑TATT side (9°). The average MTPJ dorsiflexion angle was significantly greater on the TATT side (91.25°) compared to the non‑TATT side (45°). The Newcastle test consistently demonstrated the presence of the cock up deformity in the TATT-operated foot. Conclusion: The Newcastle test is a simple, reproducible functional test for identifying cock up great toe deformity following TATT in clubfoot patients. The study suggests that dorsiflexion weakness in the medial foot and posterior structural tightness may contribute to the deformity. Further biomechanical studies are recommended to refine tendon transfer techniques to prevent this complication and reduce the risk of long-term osteoarthritis in the MTPJ. Keywords: Clubfoot, cock up great toe, Newcastle sign, tibialis anterior tendon transfer
Introduction: Acute appendicitis is a common paediatric emergency, with higher risks of complications than in adults. Accurately distinguishing uncomplicated appendicitis (UA) from complicated appendicitis (CA) is essential for guiding appropriate management, particularly as non‑operative treatment for UA gains acceptance. However, existing scoring systems and single biomarkers lack sufficient specificity, especially in paediatric populations. This study assesses whether common inflammatory markers can predict UA and CA in children, providing a supplementary diagnostic tool for resource‑limited settings where imaging may be limited. Methods: We conducted a retrospective analysis of paediatric patients aged 16 years or younger who underwent appendectomy at two tertiary hospitals. Data included demographic information, symptoms and pre‑operative blood markers such as C‑reactive protein (CRP), total leucocyte count (TLC), neutrophil count and platelet count. Inflammatory marker values were incorporated into a multivariate logistic regression model to predict the likelihood of CA. Diagnostic accuracy was evaluated using the receiver operating characteristic curve analysis, reporting sensitivity, specificity and optimal cutoffs for the identified markers. Results: Of 247 paediatric appendectomy cases, 60.7% were UA and 39.2% were CA. Elevated CRP (≥76.8 mg/L) had a specificity of 78.7% and a sensitivity of 60.3% for CA. Combined markers (TLC, neutrophils, lymphocytes and platelets) improved sensitivity to 70.1%. The logistic regression model incorporating neutrophil count, lymphocyte count and platelet count achieved a sensitivity of 78.4% and specificity of 52.7% at a threshold score of 1.20. This model effectively stratified risk, providing diagnostic support when advanced imaging is limited. Conclusion: Our study introduces a logistic regression model using routine blood markers to differentiate between UA and CA in paediatric patients. While not a replacement for imaging or clinical evaluation, the model offers a valuable adjunct in settings with limited resources, improving sensitivity for detecting complicated cases. Prospective studies are warranted to validate these findings in the real‑time clinical applications. Keywords: Complicated appendicitis, inflammatory markers, paediatric appendicitis, predictive model
BACKGROUND:Acute appendicitis (AA) is a frequent and emergent surgical abdominal condition that presents some particularities and challenges in young children. PATIENTS AND METHODS:Data of 402 children aged <16 years with a confirmed diagnosis of AA were retrospectively reviewed. Included patients were divided into two groups: Group A (preschool children aged ≤5 years, n = 44) and Group B (school children aged >5 years, n = 358). Clinical presentation, biological findings, calculated diagnosis scores (paediatric appendicitis score [PAS] and Alvarado score), intraoperative findings and outcomes were comparatively analysed between the two groups. RESULTS:Children of Group A had more likely fever, bowel disorders, diffuse abdominal pain and diffuse tenderness than those of Group B (P = 0.001, P = 0.005, P = 0.006 and P = 0.001, respectively). Regarding biomarkers, the mean of white blood cell count and C-reactive protein levels was higher in Group A than in Group B (18,849 cell/mm3 and 162.8 mg/L in Group A versus 15,938 cell/mm3 and 86.7 mg/L in Group B, P = 0.003 and < 0.001, respectively). The mean of calculated PAS and Alvarado scores was higher in Group A than in Group B (8.2 ± 1.1 and 8.2 ± 1 vs. 7.5 ± 1.4 and 7.4 ± 1.5, P = 0.003 and P = 0.001, respectively). Most children with a calculated PAS and Alvarado score equal to or higher than 8 belonged to Group A (PAS: 84.1% vs. 58.4%, P = 0.001, Alvarado score: 84.1% vs. 55.6%, P < 0.001). The perforation of the appendix was seen in 77.3% of Group A patients and only in 41.5% of children in Group B (P < 0.0001). The mean length of stay was 5.1 ± 1.9 days in Group A and 4.3 ± 2.8 days in Group B but without any statistical difference between the two groups (P = 0.094). CONCLUSION:AA in preschool children is associated with atypical presentation and rapid progression of the disease making the early diagnosis mostly challenging in our settings.
ABSTRACT:Scrotoschisis (extracorporeal testicular ectopia) is a rare congenital defect of the scrotal sac associated with the extrusion of one or both testicles. The exact mechanism causing the anomaly is largely unknown. This is a report of two infants aged 3 and 4 days, respectively, presented with infected unilateral extracorporeal testicular ectopia. Both infants had orchidopexy and repair of the scrotal defect following debridement of the infected defects and administration of broad-spectrum parenteral antibiotics. The infants have remained well at 3 years of follow-up. The isolated unilateral disease was described by several authors. Delayed presentation in scrotoschisis results in superimposed infection which complicates surgical management resulting in a prolonged hospital stay.
ABSTRACT:A large number of congenital anomalies often involve the umbilicus. This is a report of two such anomalies together in an infant. The child had a mass protruding from the umbilicus since birth. The urachus was noted to be patent on voiding cystourethrogram. On exploration, a patent vitellointestinal duct was also noted. Resection and anastomosis was done for the vitellointestinal duct, and the urachus was excised close to the dome of the bladder. Histopathological examination confirmed a tube lined by intestinal epithelium and the urachal remnant showing a dense fibrous tube-like structure. The omphalo-mesenteric vessels are located between the urachus and the patent vitellointestinal duct, and care should be taken while incising or dissecting in this region to prevent bleeding.
INTRODUCTION:Adduction and medial rotation shoulder contracture are prevalent in unresolved neonatal brachial plexus palsy (NBPP). Various surgical options exist, including open anterior subscapularis release, to address this condition. This study assessed the outcomes of this procedure. MATERIALS AND METHODS:This cross-sectional, observational study focused on a cohort of children aged over 12 months who underwent open anterior subscapularis release to remedy residual shoulder contracture from upper or global NBPP over 11 years. The Mallet score was utilised to appraise deficits in shoulder function. RESULTS:The study included 32 patients. The sex ratio was 0.78. The median age at surgery was 36 months (25; 56). The right side was affected in 75% of cases. The median improvement in the Mallet score after subscapularis release was 4 (2; 6). This enhancement was statistically significant (P < 0.001), with a median follow-up duration of 78 months (72; 82). There was a substantial increase in shoulder abduction (P < 0.001) and lateral rotation (P < 0.001). Hand-to-mouth (P < 0.001) and hand-to-head (P < 0.001) manoeuvres exhibited significant enhancement. The hand-to-spine manoeuvre did not show a substantial alteration. A significant correlation was found between the injury severity and the enhancement of the Mallet score post-surgery (P = 0.009). CONCLUSION:Open anterior subscapularis release yielded significant mid-term functional enhancements in shoulder motion, with no modification in medial rotation. Improvements were observed even in children beyond 4 years of age, with those having more severe injuries showing greater functional recovery.
ABSTRACT:Tumours of the adrenal cortex are most commonly seen in adults but rare in children. The clinical manifestations depend on the age and sex of patients; about two-thirds of the cases virilisation is the predominant presentation, whereas many presents with both virilisation and cushingoid features. Diagnosis is confirmed by hormonal evaluation and radiological investigations. Surgical removal is the mainstay of treatment. Usually, there is a good prognosis in paediatric patients, whereas the high mortality rate reported in older literature may have been due to big tumour size, post-operative complications and inadequate steroid replacement. Here, we are presenting a series of three cases during childhood with virilising features due to adrenocortical tumours. All of them presented predominantly with features suggestive of virilisation. All patients underwent surgery and had a good outcome despite big tumour size in one of the patients. Histology revealed a benign lesion in the form of adrenal adenoma. Most virilisation and cushingoid features disappeared in the follow-up (median - 1 year). Although these tumours are rare, a high index of suspicion should be kept in children with cushingoid features, virilisation or a combination of both of them. Even if the tumour size is big, adequate steroid replacement and supportive management postoperatively have led to good prognosis in our patients.
BACKGROUND:Although congenital ureteropelvic junction (UPJ) obstruction is the most common cause of neonatal hydronephrosis, aetiopathogenesis is still inconclusive. Recently, the paucity of interstitial cells of Cajal (ICC) at the narrow adynamic part of UPJ has been implicated as a causative factor. MATERIALS AND METHODS:This prospective study was conducted between October 2019 and March 2022 to find out the density of ICC by the immunohistochemical method using CD117 (c-kit) antibody, in resected segments of UPJ in obstruction patients and in renal tumour patients as control. ICC/high power field (hpf) was also studied from the margins of the resected segment in the obstruction group. The pre-operative and post-operative sonographic and renal scintigraphic features were compared. RESULTS:The median age of patients in the study group (n = 25) was 36 months and in the control group was 39 months. The mean ICC/hpf at the stenotic part of UPJ in the study group was 3.56 ± 1.26 and in the control group was 12.56 ± 1.89 (P = 0.0001). ICC density from the proximal and distal margins of the resected segment was 11.12 ± 2.12 and 11.68 ± 1.62, respectively (P < 0.001). The post-operative antero-posterior diameter of the renal pelvis and differential renal function showed significant improvement in comparison to the pre-operative value (P = 0.0045 and 0.0005, respectively). CONCLUSIONS:The significant decrease in the density of ICC at the stenotic part of UPJ compared to controls suggests a pacemaker role of these cells in ureteral peristalsis and the aetiopathogenesis of UPJ obstruction. Histopathological analysis of ICC should not only be limited to the stenotic part of UPJ but also should focus on the anastomosed ends of the ureter, which reflects post-pyeloplasty outcome.
BACKGROUND:Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing. AIM:The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India. MATERIALS AND METHODS:This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre-hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed. RESULTS:Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%). CONCLUSION:The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country-made gun was the most common firearm causing injury in children.
