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Published on: November 1, 2018
THE COMPLEX ANOMALY OF THORACO-ABDOMINAL ECTOPIA CORDIS IN IBADAN: MAKING A CASE FOR IMPROVED NHIA COVERAGE: A CASE
K I Egbuchulem1, J O Akpakwu2, P O Oyedeji1
1Division of Paediatric Surgery, Department of Surgery, University College Hospital, Ibadan.
Background:
Pentalogy of Cantrell (POC) is a collection of five congenital malformations involving the heart, pericardium, diaphragm, sternum, and anterior abdominal wall. This is a spectrum, and could be incomplete or complete; naked or covered cordis or can be classified based on the location of the heart, and in this index patient-thoraco-abdominal ectopia cordis. We aim to highlight this finding of covered incomplete pentalogy of Cantrell and the peculiarities of management in our sub-region that relies solely on out of pocket payment.
Case Presentation:
A 30-hour old female admitted with history and clinical examination findings in keeping with a covered pentalogy of Cantrell (Thoraco-abdominal ectopia cordis) in a term neonate. Attached is a video link at presentation https://youtu.be/0vQuzq14G9Q.
Conclusion:
Pentalogy of Cantrell is a complex anomaly. The constraints we encountered in the initial management of this neonate is not uncommon in surgical practice within Nigeria, and other resource constrained countries especially amongst carers of paediatric patients. Other factors at play in our sub-region are ignorance, high rate of illiteracy, superstitious beliefs, and varied cultural practices, and this partly hindered further evaluation of this vulnerable neonate in our sub-region.
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