Browsing by Author "Pun, MS"
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Publication Clinical Analysis, Management and Outcome of Intussusception in Children(Nepal Paediatric Society (JNPS), 2012) Thapa, B; Chaudhary, RP; Pun, MS; Ral, GKAbstract: Introduction: Intussusception is the commonest cause of bowel obstruction in infancy and childhood. Early diagnosis and management is essential to reduce morbidity and mortality. The objective was to To review the diagnostic criteria of intussusception in infants and children to increase awareness of attending personnel for effective management decrease the rate of operative treatment and complications. Materials and Methods: The data collected of all 38 patients admitted in Kanti Childrens Hospital between 2008 September to 2009 September were studied prospectively. Each patient was evaluated in regard to age at presentation, sex, signs and symptoms, diagnostic method, treatment (operative, non-operative). Results: During study period of one year there were a total of 20 (52%) males and 18 (48%) females of age 3 months to 6 years. Pain abdomen was seen in 25(66%), vomiting 16(42%), diarrhea 15(40%), blood mixed with stool 10(26%). These symptoms were seen in different combination. X-ray erect abdomen was done in 15 and ultrasound in all 38 cases. Ten out of 15 (66.6%) patients with early presentation and diagnosis had successful barium enema reduction.10 (66.6%) had successful reduction and admitted to our hospital. 28(74%) patients were undergone laparatomy. Among 28 (74%) patents that had lapartotomy, manual reduction was successful in 18 and 10 required bowel resection and anastomosis. Conclusion: The awareness of early features of intussusception is important for early referral to tertiary centers for successful non-operative barium reduction and reduce the need of laparotomies in children.Publication Patent Urachus with Bladder Prolapse(Nepal Paediatric Society (JNPS), 2014) Thapa, B; Pun, MSAbstract: We report a case of bladder prolapse through a patent urachus in a term male neonate with a large, red, tubular, mucosa lined mass inferior to the umbilical cord. A cystic mass communicating with fetal urinary bladder was detected in an antenatal ultrasound in a 26 years primigravida at 18 and 26 weeks gestation. The cyst disappeared at 35 weeks and a new solid mass was noted at the fetal abdominal wall. After birth a protruded mucosal mass inferior to the umbilical cord was noted. Urethral catherisation confirmed communication with bladder. On the second day of life excision of urachus, repair, reduction of bladder and reconstruction of abdominal wall was performed. The patient voided well and was discharged on ninth day without any complication.