Sternal cleft (SC) is a rare form of chest wall deformity with an incidence of <0.15%. It occurs because of failure of fusion of the sternal bars about the 7-9th week of intrauterine life. It could occur in isolation or as a part of a syndromic complex. This condition exposes the vital mediastinal structures to a huge risk of injury, aside from cosmetic issues. Treatment in the neonatal period is most favourable, though other modalities are available in the later stages of life, but it can be challenging. We present the case of a 2-month-old female infant with a superior SC with a single association of secundum atrial septal defect. She was asymptomatic. She was treated by primary repair to protect the underlying mediastinal structures as well as for cosmetic reasons. Such a repair resulted in good clinical outcome.

Isolated sternal cleft in a patient with atrial septal defect: A rare sole association.

Context: An upper gastrointestinal endoscopy (UGIE) is now a routine procedure and is a guide to the prevalence and nature of gastrointestinal tract diseases in an area. Aim: To report indications and findings for UGIE in a tertiary hospital in Kaduna, Nigeria, and compare with past reports in the region and from the rest of Nigeria and Africa. Settings and Design: A retrospective review of endoscopy records (2014–2021) of consecutive patients referred to the endoscopy unit of Barau Dikko Teaching Hospital, Kaduna, Nigeria. Statistical Analysis: The data were analyzed using IBM SPSS version 22. Results: Over seven years, 1,525 patients had diagnostic UGIE: mean age = 44.8 years (range 8–100), 61% ≥ 40 years, and 55.7% females. Dyspepsia (70%) and hematemesis/melena (14%) were the most common indications. Superficial gastritis (60%) was the most common endoscopic finding. Peptic ulcer disease (PUD) was diagnosed in 9.6% of patients: Gastric ulcer (6.6%) was more common than duodenal ulcer (3.6%) and more frequent in males than females (9.5% vs. 4.3%, P = 0.000) and in those ≥ 40 years compared with < 40 years (7.8% vs 5%, P = 0.032). Duodenal ulcer was also more common in males (6% vs 1.8%, P = 0.000). Erosive gastritis (20.5%), hiatus hernia (14.4%), esophagitis (13.7%), atrophic gastritis (8.3%), nodular gastritis (6.6%), esophageal varices (6.1%), and gastric carcinoma (1.2%) were other findings. There was no abnormality detected in 6% of patients. Conclusion: We reported a marked change in the pattern of some gastroduodenal diseases in our region. The patients are older and predominantly female. The prevalence of PUD has markedly declined with gastric ulcer now almost twice as common as duodenal ulcer.

Diagnostic upper gastrointestinal endoscopy in Kaduna, Northwest Nigeria: Indications and findings

Background: Endoscopy has a great role in the diagnosis, surveillance, and management of various gastrointestinal (GI) ailments. Aims: This study aimed to evaluate the spectrum of upper GI (UGI) symptoms and correlate them with the findings on UGI endoscopic examination. Patients and Methods: This observational cross-sectional study was carried out from August 2019 to December 2020 in the adult patients presenting with UGI complaints. The patients underwent UGI endoscopy at Yenepoya Medical College Hospital, Mangalore, a tertiary care centre in southern Indian state of Karnataka. Endoscopies were performed as per the standard protocol with diagnosis based on accepted criteria. Results: A total of 450 subjects (mean age: 49.14 ± 13.9; range, 19–89; 322 [71.5%] men) were included. Among the diagnostic indications, dyspeptic symptom seen in 176 (39.1%) patients was the most frequent indication in this study cohort, followed by reflux in 73 (16.2%) patients, UGI bleeding in 69 (15.34%) patients (portal hypertensive bleeding was found to be more common than nonvariceal bleed (49:20). Antral gastritis was seen in 112 (24.9%) patients. Ninety (20%) patients were found to have esophageal varices and 47 (10.4%) had esophagitis. Biopsy showed 25.3% to be positive for Helicobacter pylori. Forty-seven (10.45%) patients with a mean age 32 ± 6.8 years with dyspeptic symptoms but no alarming symptoms had normal endoscopic examination. Conclusion: Antral gastritis was the most common endoscopic finding in patients with dyspeptic symptoms. Portal hypertension was a more common cause of UGI bleeding compared to duodenal ulcers. While the majority of the patients presenting with heartburn had esophagitis, nonerosive esophagitis was observed in 3.2% of patients.

The Spectrum of Upper Gastrointestinal Endoscopic Findings and Therapeutic Interventions in Patients Presenting with Upper Gastrointestinal Complaints: A Tertiary Care Study

Sternal cleft is a rare congenital abnormality with an incidence of 2:100,000 live births. It could occur in isolation or along with defects of the abdominal wall, diaphragm, pericardium, and heart. Surgical correction in the neonatal period is required to protect the underlying structures as the risk of cardiac compression at this period is still minimal. We report a case of an 8-day-old term male neonate with congenital superior sternal cleft associated with a ventricular septal defect. He was evaluated and referred to a facility where he could access surgical reconstruction. 

Congenital sternal cleft with ventricular septal defect: A case report of a rare condition

Sternal cleft is a rare congenital anomaly and very few cases have been described especially in Africa. This is a case of an isolated superior sternal cleft in a term neonate in Western Kenya.

/pdf/an-isolated-superior-sternal-cleft-in-a-neonate-in-western-1ojceegmdi.pdf

An isolated superior sternal cleft in a neonate in western Kenya: case report

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An isolated superior sternal cleft in a neonate in western Kenya: case report