Francis Uba - Academia.edu (original) (raw)
Papers by Francis Uba
African Journal of Paediatric Surgery, 2009
Annals of Medical Research and Practice
Annals of African medicine
Background: Colostomy is a common procedure in children and may be attended by significant morbid... more Background: Colostomy is a common procedure in children and may be attended by significant morbidity. Method: This is a retrospective study of morbidity and mortality associated with the formation and closure of colostomy in children between 1991 and 2001, at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Results: There were 116 children with a median age of 3 weeks (range: one day 14 years). The male: female ratio was 2:1. The indications for colostomy were Hirschsprung's disease 68 (58.6%), anorectal malformations 44 (37.9%) and trauma to the rectum 4(3.5%). A total of 122 complications occurred in 62(53%) patients after colostomy formation. The commonest complication was excoriative dermatitis 46(74.2%), followed by prolapse 24(38.7%) and wound infection. Difference in complications between transverse and sigmoid colostomies was statistically significant (P Conclusion: Colostomy-related procedures in children are associated with high morbidity and mortality in our environment. Improved health care delivery may improve the present outcome. Colostomy-related operations should not be relegated to minor importance. Keywords: Colostomy, complications, children Vol.2(1) 2003: 9-12
Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.
Nigerian journal of clinical practice, 2008
Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagno... more Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and...
The Nigerian postgraduate medical journal, 2006
The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out t... more The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out to determine the pattern and outcome of management of anorectal malformations (ARM) in a Nigerian tertiary hospital. The clinical and operative records of consecutive children with anorectal anomaly managed between October 1990 and September 2000 at the Jos University Teaching Hospital, Jos, were reviewed. There were 82 patients, (57.3%) males and 35 (42.3%) females (m:f=1.3:1). There were 20 (24.4%) cases each of the high and intermediate types, 40 (48.8%) low variety and 2 (2.4%) cases of persistent cloaca. The high type was proportionately commoner in the males. Less than one-third presented within 24 hours. Eighty three percent of patients (mainly males) presented in acute intestinal obstruction. Passage of stools from abnormal sites and "imperforate" anus were complaints in 60 (73.1%) patients each. A total of 63 patients had definitive corrective procedure. Four patients w...
The Nigerian postgraduate medical journal, 2004
To compare post operative complications, rates of wound healing, and cost effectiveness between t... more To compare post operative complications, rates of wound healing, and cost effectiveness between the closed and open methods of haemorrhoidectomy. Prospective. Jos University Teaching Hospital (JUTH), Jos and Evangel Hospital, Jos. Consecutive patients who presented with second and third degree haemorrhoids were randomised into an open group A and a closed group B. Time taken for wound to heal, the postoperative complications and cost of management in each group were assessed. Each patient was followed up for at least three months. There were 59 males and 20 females, distributed between group A (n=39) and B (n=40). The average postoperative hospital stay was 5 days in group A and 3 days in group A. There were no differences in the complication rate between the two groups. Post operative retention of urine was the commonest complication and occurred in 12 patients: 7 in group A and 5 group B. This was followed by reactionary haemorrhage in 6. All of which occurred in group A. There we...
Tropical Doctor, 2007
The records of 168 children managed for burns in a teaching hospital in northwestern Nigeria, bet... more The records of 168 children managed for burns in a teaching hospital in northwestern Nigeria, between April 1998 and March 2003, were assessed to determine the factors that are responsible for high rates of morbidity and mortality in paediatric burns. The causes of burns were hot water in 86 cases (51.2%), flame in 45 (26.8%), hot soup in 32 (19%) and electricity in five (3%). The main complications were wound infections in 109 (64.9%) patients, anaemia in 68 (40.5%), malnutrition in 54 (32.1%), contracture in 50 (29.8%), persistent hypothermia in 27 (16.1%), tetanus in 14 (8.3%) and one case (0.6%) of massive upper gastrointestinal bleeding, possibly as a result of Curling's ulcer.
Pediatric Surgery International, 2007
Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctionin... more Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctioning colostomy. The purpose of this study was to examine the feasibility of single-stage resection and anastomosis without intraoperative colonic lavage for acute left-sided colonic obstruction in children. Between October 2000 and May 2006, nine consecutive patients who had a one-stage left-sided colon resection without preceding colonic lavage were evaluated. The main outcome measures were anastomotic leakage, wound infection and death. There were nine patients: six were males and three were females (M:F = 2:1). Their ages ranged from 2-10 years (mean age 6 years). The obstruction was due to irreducible colo-colic intussusceptions in two patients and colo-colic intussusceptions with colonic perforation in four patients, and colo-colic intussusceptions with gangrene in three. All the patients had resection and primary anastomosis without on-table colonic lavage. There were no anastomotic leakages or deaths. Postoperative complications included superficial wound infections in two patients and dry cough in four other patients. Three patients were lost to follow up after 3 years of follow up, but the remaining six are presently doing well. Primary anastomosis without colonic lavage is safe for resection of the left colon in children in an emergency setting.
Seminars in Pediatric Surgery, 2012
The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4... more The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4 distinct phases, starting from early 1920s till the present. The pace of development has been quite variable in different parts of Africa. Despite all recent developments, the practice of pediatric surgery in Africa continues to face multiple challenges, including limited facilities, manpower shortages, the large number of sick children, disease patterns specific to the region, late presentation and advanced pathology, lack of pediatric surgeons outside the tertiary hospitals, and inadequate governmental support. Standardization of pediatric surgery training across the continent is advocated. Collaboration with well-established pediatric surgical training centers in Africa and other developed countries is necessary. The problems of delivery of pediatric surgical services need to be addressed urgently, if the African child is to have access to essential pediatric surgical services like his or her counterpart in the high-income parts of the world.
Nigerian Journal of Medicine, 2006
The clinical diagnosis of intestinal malrotation in the older child is not always easy because of... more The clinical diagnosis of intestinal malrotation in the older child is not always easy because of its non-specific presentations. The aim of this study was to determine the pattern of presentation of malrotation in older Nigerian children. The clinical, radiological and operative records of all the children aged 2 years or above, managed for malrotation at the Jos University Teaching Hospital between March 1992 and December 2002 were retrospectively reviewed. There were 9 patients, with a median age of 5 years (range: 3-14 years). The commonest complaint was intermittent colicky abdominal pain in 9 (100%), followed by recurrent vomiting in 8 (88.9%), haematemesis and constipation each in 5 (55.6%) and repeated episodes of bloody stools and diarrhoea. Other features included abdominal distension in 5 (55.6%) and failure to thrive in 4 (44.4%). Preoperative diagnosis was possible only in 3 patients, through the use of barium meal. Operative findings included obstructing bands of Ladd, partial volvulus and mesocolic hernias. Surgery promptly and satisfactorily relieved the symptoms. The diagnosis of intestinal malrotation should be considered in any child with prolonged history of recurrent colicky abdominal pain, vomiting or diarrhoea, especially if there is associated history of failure to thrive. Surgical intervention provides satisfactory relief of symptoms and should be implemented as soon as the diagnosis is made.
West African Journal of Medicine, 2008
Nigerian Journal of Orthopaedics and Trauma, 2004
ABSTRACT OBJECTIVE: This article examines the effects of the September 2001 and May 2002 civil cr... more ABSTRACT OBJECTIVE: This article examines the effects of the September 2001 and May 2002 civil crises in Jos, Nigeria, on children and their health in order to make recommendations. METHODS: Between 7th and 12th September 2001, and on 2nd May 2002, Jos town and its environs experienced intense civil crises that were orchestrated by religious and ethnic grievances. The victims of those crises that were managed at the Jos University Teaching Hospital were studied. We retrospectively reviewed the victims' accident and emergency notes, operation registers and case files. Information extracted included demographic data, mechanism, nature and site of injury, type of weapons, treatment and outcome of management. RESULTS: A total of 463 patients were managed as a result of the crises, but complete data were available for analysis in 389. Out of the 389, 61 (15.7%) were children (<15 years) and adolescents (<19 years). Forty-five (73.8%) were males and 16 (26.2%) were females. (male: female ratio =3:1). Their ages ranged from 3 weeks to 19 years (median: 17 years). CONCLUSION: With the rising incidence of civil conflicts in Nigeria, governments should be concerned with the plights of the children. The effects of war on children are horrendous in many ways, but can be limited by providing timely and appropriate health care.Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 109-111
Nigerian Journal of Surgical Research, 2010
Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.
Nigerian Journal of Surgical Research, 2010
A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right... more A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right inguinal hernia is reported. He had necrotizing fasciitis of the right scrotum with sparing of the testis. He successfully had debridement, herniotomy and bowel resection with end-to-end anastomosis. This is a rare occurrence in infants and seems to result from late presentation. Health education coupled with early referral and prompt repair of inguinal hernia in neonates and infants would reduce this complication.
Nigerian Journal of Surgical Research, 2010
Background: While most cases of Hirschsprung's disease are diagnosed during the neonatal period i... more Background: While most cases of Hirschsprung's disease are diagnosed during the neonatal period in developed countries, majority of the cases present outside the neonatal period in developing countries. We reviewed our experience with Hirschsprung's disease presenting during the neonatal period to document the presentation and management. Patients/Methods: A retrospective analysis of the presentation and management of 31 neonates with Hirschsprung's disease over a nine year period in a Tertiary pediatric surgical centre in Nigeria was performed. Results: From January 1996-December 2004, 78 children were managed for Hirschsprung's disease in our unit. Thirty-one (39.7%) were aged 30 days or below. The median age at presentation was eight days (range 2-30 days). There were 23 boys and 8 girls. The median weight at presentation was 2.8kg (range 2.3-4.5kg). Fifteen weighed <2.5kg. Twenty-two presented with acute intestinal obstruction. Three presented with enterocolitis while in five there was delayed passage of meconium and recurrent constipation. Barium enema was done in 25 and rectal biopsy confirmed diagnosis in 29 babies. In two babies with total colonic aganglionosis (TCA), diagnosis was confirmed by colonic biopsy at laparotomy. Twenty nine had right transverse loop colostomy in the neonatal period; four were under local anesthesia, while the two children with TCA had ileostomy. Four children died before definitive surgery, two with TCA and two with enterocolitis. None had primary pull-through. Two children were lost to follow up after colostomy formation. Twenty two had definitive surgery between the ages of three months and five years. Fifteen had Boley's endorectal pull-through with a single mortality; while seven had Swenson's pull-through, one of whom died. Conclusion: Few cases of Hirschsprung's disease present during the neonatal period in our environment, many presenting with intestinal obstruction. A high index of suspicion is needed for the early diagnosis of Hirschsprung's disease in environment with limited diagnostic facilities.
African Journal of Paediatric Surgery, 2009
Annals of Medical Research and Practice
Annals of African medicine
Background: Colostomy is a common procedure in children and may be attended by significant morbid... more Background: Colostomy is a common procedure in children and may be attended by significant morbidity. Method: This is a retrospective study of morbidity and mortality associated with the formation and closure of colostomy in children between 1991 and 2001, at the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Results: There were 116 children with a median age of 3 weeks (range: one day 14 years). The male: female ratio was 2:1. The indications for colostomy were Hirschsprung's disease 68 (58.6%), anorectal malformations 44 (37.9%) and trauma to the rectum 4(3.5%). A total of 122 complications occurred in 62(53%) patients after colostomy formation. The commonest complication was excoriative dermatitis 46(74.2%), followed by prolapse 24(38.7%) and wound infection. Difference in complications between transverse and sigmoid colostomies was statistically significant (P Conclusion: Colostomy-related procedures in children are associated with high morbidity and mortality in our environment. Improved health care delivery may improve the present outcome. Colostomy-related operations should not be relegated to minor importance. Keywords: Colostomy, complications, children Vol.2(1) 2003: 9-12
Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.
Nigerian journal of clinical practice, 2008
Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagno... more Gastrointestinal (GI) injuries in children following blunt abdominal trauma is rare; early diagnosis and treatment is important for good outcome. The purpose of this report is to describe the management problems encountered in children with GI injuries following blunt abdominal trauma. From January 1996 June 2006, 168 children were treated at our centre for abdominal trauma. Twenty three had GI injuries, 19 were due to blunt trauma while four were due to penetrating trauma. We retrospectively reviewed the clinical data of the 19 children that had GI injuries as a result of blunt abdominal trauma to document the presentation, clinical features, diagnosis and outcome. There were 19 patients, 14 were boys, and five were girls. The median age at presentation was nine years (range 1.5 15 years). Road traffic accident was responsible for injuries in 10, fall from heights in six and assault in two children. In one child the cause of injury was not recorded. Most children presented late and...
The Nigerian postgraduate medical journal, 2006
The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out t... more The management of anorectal anomaly remains a challenge to Surgeons. This study was carried out to determine the pattern and outcome of management of anorectal malformations (ARM) in a Nigerian tertiary hospital. The clinical and operative records of consecutive children with anorectal anomaly managed between October 1990 and September 2000 at the Jos University Teaching Hospital, Jos, were reviewed. There were 82 patients, (57.3%) males and 35 (42.3%) females (m:f=1.3:1). There were 20 (24.4%) cases each of the high and intermediate types, 40 (48.8%) low variety and 2 (2.4%) cases of persistent cloaca. The high type was proportionately commoner in the males. Less than one-third presented within 24 hours. Eighty three percent of patients (mainly males) presented in acute intestinal obstruction. Passage of stools from abnormal sites and "imperforate" anus were complaints in 60 (73.1%) patients each. A total of 63 patients had definitive corrective procedure. Four patients w...
The Nigerian postgraduate medical journal, 2004
To compare post operative complications, rates of wound healing, and cost effectiveness between t... more To compare post operative complications, rates of wound healing, and cost effectiveness between the closed and open methods of haemorrhoidectomy. Prospective. Jos University Teaching Hospital (JUTH), Jos and Evangel Hospital, Jos. Consecutive patients who presented with second and third degree haemorrhoids were randomised into an open group A and a closed group B. Time taken for wound to heal, the postoperative complications and cost of management in each group were assessed. Each patient was followed up for at least three months. There were 59 males and 20 females, distributed between group A (n=39) and B (n=40). The average postoperative hospital stay was 5 days in group A and 3 days in group A. There were no differences in the complication rate between the two groups. Post operative retention of urine was the commonest complication and occurred in 12 patients: 7 in group A and 5 group B. This was followed by reactionary haemorrhage in 6. All of which occurred in group A. There we...
Tropical Doctor, 2007
The records of 168 children managed for burns in a teaching hospital in northwestern Nigeria, bet... more The records of 168 children managed for burns in a teaching hospital in northwestern Nigeria, between April 1998 and March 2003, were assessed to determine the factors that are responsible for high rates of morbidity and mortality in paediatric burns. The causes of burns were hot water in 86 cases (51.2%), flame in 45 (26.8%), hot soup in 32 (19%) and electricity in five (3%). The main complications were wound infections in 109 (64.9%) patients, anaemia in 68 (40.5%), malnutrition in 54 (32.1%), contracture in 50 (29.8%), persistent hypothermia in 27 (16.1%), tetanus in 14 (8.3%) and one case (0.6%) of massive upper gastrointestinal bleeding, possibly as a result of Curling&amp;amp;amp;#39;s ulcer.
Pediatric Surgery International, 2007
Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctionin... more Classically, left-sided colon obstruction is managed by a multi-staged resection and defunctioning colostomy. The purpose of this study was to examine the feasibility of single-stage resection and anastomosis without intraoperative colonic lavage for acute left-sided colonic obstruction in children. Between October 2000 and May 2006, nine consecutive patients who had a one-stage left-sided colon resection without preceding colonic lavage were evaluated. The main outcome measures were anastomotic leakage, wound infection and death. There were nine patients: six were males and three were females (M:F = 2:1). Their ages ranged from 2-10 years (mean age 6 years). The obstruction was due to irreducible colo-colic intussusceptions in two patients and colo-colic intussusceptions with colonic perforation in four patients, and colo-colic intussusceptions with gangrene in three. All the patients had resection and primary anastomosis without on-table colonic lavage. There were no anastomotic leakages or deaths. Postoperative complications included superficial wound infections in two patients and dry cough in four other patients. Three patients were lost to follow up after 3 years of follow up, but the remaining six are presently doing well. Primary anastomosis without colonic lavage is safe for resection of the left colon in children in an emergency setting.
Seminars in Pediatric Surgery, 2012
The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4... more The evolution and recognition of pediatric surgery as a specialty in Africa can be divided into 4 distinct phases, starting from early 1920s till the present. The pace of development has been quite variable in different parts of Africa. Despite all recent developments, the practice of pediatric surgery in Africa continues to face multiple challenges, including limited facilities, manpower shortages, the large number of sick children, disease patterns specific to the region, late presentation and advanced pathology, lack of pediatric surgeons outside the tertiary hospitals, and inadequate governmental support. Standardization of pediatric surgery training across the continent is advocated. Collaboration with well-established pediatric surgical training centers in Africa and other developed countries is necessary. The problems of delivery of pediatric surgical services need to be addressed urgently, if the African child is to have access to essential pediatric surgical services like his or her counterpart in the high-income parts of the world.
Nigerian Journal of Medicine, 2006
The clinical diagnosis of intestinal malrotation in the older child is not always easy because of... more The clinical diagnosis of intestinal malrotation in the older child is not always easy because of its non-specific presentations. The aim of this study was to determine the pattern of presentation of malrotation in older Nigerian children. The clinical, radiological and operative records of all the children aged 2 years or above, managed for malrotation at the Jos University Teaching Hospital between March 1992 and December 2002 were retrospectively reviewed. There were 9 patients, with a median age of 5 years (range: 3-14 years). The commonest complaint was intermittent colicky abdominal pain in 9 (100%), followed by recurrent vomiting in 8 (88.9%), haematemesis and constipation each in 5 (55.6%) and repeated episodes of bloody stools and diarrhoea. Other features included abdominal distension in 5 (55.6%) and failure to thrive in 4 (44.4%). Preoperative diagnosis was possible only in 3 patients, through the use of barium meal. Operative findings included obstructing bands of Ladd, partial volvulus and mesocolic hernias. Surgery promptly and satisfactorily relieved the symptoms. The diagnosis of intestinal malrotation should be considered in any child with prolonged history of recurrent colicky abdominal pain, vomiting or diarrhoea, especially if there is associated history of failure to thrive. Surgical intervention provides satisfactory relief of symptoms and should be implemented as soon as the diagnosis is made.
West African Journal of Medicine, 2008
Nigerian Journal of Orthopaedics and Trauma, 2004
ABSTRACT OBJECTIVE: This article examines the effects of the September 2001 and May 2002 civil cr... more ABSTRACT OBJECTIVE: This article examines the effects of the September 2001 and May 2002 civil crises in Jos, Nigeria, on children and their health in order to make recommendations. METHODS: Between 7th and 12th September 2001, and on 2nd May 2002, Jos town and its environs experienced intense civil crises that were orchestrated by religious and ethnic grievances. The victims of those crises that were managed at the Jos University Teaching Hospital were studied. We retrospectively reviewed the victims' accident and emergency notes, operation registers and case files. Information extracted included demographic data, mechanism, nature and site of injury, type of weapons, treatment and outcome of management. RESULTS: A total of 463 patients were managed as a result of the crises, but complete data were available for analysis in 389. Out of the 389, 61 (15.7%) were children (<15 years) and adolescents (<19 years). Forty-five (73.8%) were males and 16 (26.2%) were females. (male: female ratio =3:1). Their ages ranged from 3 weeks to 19 years (median: 17 years). CONCLUSION: With the rising incidence of civil conflicts in Nigeria, governments should be concerned with the plights of the children. The effects of war on children are horrendous in many ways, but can be limited by providing timely and appropriate health care.Nig Jnl Orthopaedics & Trauma Vol.2(2) 2003: 109-111
Nigerian Journal of Surgical Research, 2010
Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The ... more Infantile haemangioendothelioma is a rare tumour of infancy arising from mesenchymal tissue. The liver is the commonest site for this tumour in children. This is a report of a 3 month old boy who presented with hepatomegaly, hypertension, congestive cardiac failure and protracted diarrhea. Abdominal ultrasonography demonstrated diffuse hepatic nodules involving the whole liver. A diagnosis of infantile hepatic haemangioendothelioma was made on histologic examination of tissue following an open liver biopsy. The patient died 3 days after liver biopsy. We report this case to raise awareness of this rare tumour of infancy in our environment.
Nigerian Journal of Surgical Research, 2010
A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right... more A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right inguinal hernia is reported. He had necrotizing fasciitis of the right scrotum with sparing of the testis. He successfully had debridement, herniotomy and bowel resection with end-to-end anastomosis. This is a rare occurrence in infants and seems to result from late presentation. Health education coupled with early referral and prompt repair of inguinal hernia in neonates and infants would reduce this complication.
Nigerian Journal of Surgical Research, 2010
Background: While most cases of Hirschsprung's disease are diagnosed during the neonatal period i... more Background: While most cases of Hirschsprung's disease are diagnosed during the neonatal period in developed countries, majority of the cases present outside the neonatal period in developing countries. We reviewed our experience with Hirschsprung's disease presenting during the neonatal period to document the presentation and management. Patients/Methods: A retrospective analysis of the presentation and management of 31 neonates with Hirschsprung's disease over a nine year period in a Tertiary pediatric surgical centre in Nigeria was performed. Results: From January 1996-December 2004, 78 children were managed for Hirschsprung's disease in our unit. Thirty-one (39.7%) were aged 30 days or below. The median age at presentation was eight days (range 2-30 days). There were 23 boys and 8 girls. The median weight at presentation was 2.8kg (range 2.3-4.5kg). Fifteen weighed <2.5kg. Twenty-two presented with acute intestinal obstruction. Three presented with enterocolitis while in five there was delayed passage of meconium and recurrent constipation. Barium enema was done in 25 and rectal biopsy confirmed diagnosis in 29 babies. In two babies with total colonic aganglionosis (TCA), diagnosis was confirmed by colonic biopsy at laparotomy. Twenty nine had right transverse loop colostomy in the neonatal period; four were under local anesthesia, while the two children with TCA had ileostomy. Four children died before definitive surgery, two with TCA and two with enterocolitis. None had primary pull-through. Two children were lost to follow up after colostomy formation. Twenty two had definitive surgery between the ages of three months and five years. Fifteen had Boley's endorectal pull-through with a single mortality; while seven had Swenson's pull-through, one of whom died. Conclusion: Few cases of Hirschsprung's disease present during the neonatal period in our environment, many presenting with intestinal obstruction. A high index of suspicion is needed for the early diagnosis of Hirschsprung's disease in environment with limited diagnostic facilities.