Spontaneous intracerebral haemorrhage (SICH) is a rare occurrence in children, with different aetiological factors, clinical characteristics and prognosis. A 14 year male child had sudden onset of headache associated with multiple vomiting. Magnetic resonance imaging showed deep seated intracerebral haematoma. Haematoma was evacuated successfully and child recovered without deficits. A high index of suspicion is necessary for the diagnosis of spontaneous intracerebral haemorrhage in children.

Retroperitoneal teratomas are usually asymptomatic, though there have been isolated reports of retroperitoneal teratomas presenting as intra-abdominal abscesses and peritonitis in adults. A 7-year-old girl who had presented with acute abdomen due to ruptured retroperitoneal teratoma is reported.

Tracheoesophageal fistula (TEF) without associated esophageal atresia (EA) is a rare congenital anomaly. Diagnosis in neonatal period is usually not made and most of the patients are treated as cases of pneumonia. A case of H-type of tracheoesophageal fistula, diagnosed within 24 hours of delivery based upon choking and cyanosis on first trial of feed, is being reported. Diagnosis was confirmed with contrast esophagram. Through cervical approach fistula was repaired and baby had uneventful post operative outcome.

The popliteal pterygium syndrome is a congenital malformation that includes orofacial, musculoskeletal and genitourinary anomalies. It is a rare autosomal dominant disorder. We report one family with popliteal pterygium syndrome affecting father and his two daughters, who underwent surgical corrections for multiple congenital malformations.

Ewing's sarcoma (ES) primarily affects bones and commonly presents in adolescents and young adults. This paper reports a rare case of extra osseous ES of the scapular region in a 9 years old girl. She was treated by a multidisciplinary approach including surgery, chemotherapy and radiotherapy. She was followed up for two years and remained well.

Infant feeding tubes (IFT) have been universally used as urethral catheters in neonates and children for several decades. Though generally a safe procedure, it may cause significant morbidity if the catheter spontaneously knots inside the bladder. We report this complication in three children including a neonate.

Foreign body ingestion is common in children. Sharp foreign bodies are potentially harmful and can result various complications. An 8-month-old infant presented with incarcerated umbilical hernia. With a suspicion of strangulation, operation was performed that revealed a loop of ileum being stuck in the umbilical defect. The loop of ileum was freed from the umbilicus which demonstrated open ends of safety pin piercing out of bowel lumen. The enterotomy followed by removal of safety pin was performed.

Parasitic twining is a rare type of monozygotic monochorionic monoamniotic asymmetrical conjoined twin. We report a case of epigastric heteropagus twin. An ultrasound scan showed a defect of 1.5 cm in the epigastrium. CT showed soft tissue lobulated mass with fat and air components coming out of the epigastric defect. At operation rudimentary alimentary canal with no viscera, was found in the parasite. The parasite was easily separated from the host.

Cloacal malformations are challenging as to the surgical correction. A case of cloacal malformation who underwent reconstructive surgery is being reported. The patient had colostomy in the neonatal period and reconstruction was performed at the age of 6 year. The surgical management included abdomino-perineal anorecto-urethro-colo-vaginoplasty. The patient is fully continent of urine and achieved fair continence of feces at 9 months of follow up.

Acute gastric volvulus secondary to malrotation of gut is a rare surgical emergency. We report a case of an eight years old cerebral palsy (CP) child who presented to us with sudden upper abdominal distension and non productive retching. X-ray abdomen revealed a huge gas shadow on left side of abdomen with paucity of distal gas shadows. On exploration organoaxial gastric volvulus with gastric ischemia, secondary to malrotation of gut, was found. Volvulus derotated and Ladd’s procedure was done. Gastropexy and fundoplication was not done due to gastric ischemia. Early diagnosis and surgical management can save the patient from fatal complications of gastric perforation due to gastric ischemia.

A number of diseases can present as acute right iliac region pain. Lymph node infarction, located adjacent to the cecum, mimicking acute appendicitis in a 13-year-old boy is presented here.

True hermaphrodite is one of the rarest variety of disorders of sexual differentiation (DSD) and represents only 5% cases of all. A 3-year-old child presented with left sided undescended testis and penoscrotal hypospadias. Chordee correction was performed 18 months back, elsewhere. At laparotomy Mullerian structures were present on left side. On right side testis was normally descended into the scrotum.

Gastric teratomas are extremely rare tumors. A 15-day-old neonate presented with abdominal mass. Ultrasound of abdomen showed mixed echogenicity lesion. CT scan showed a mass with solid and cystic components and internal calcifications. At operation a tumor arising from the posterior wall of the stomach found. It was exogastric as well as endogastric in location. Biopsy report was suggestive of mature teratoma.

Mitrofanoff appendicovesicostomy has been the method of choice for dealing with urinary incontinence. However, there may be some cases where some alternate conduits have to be used. Yang-Monti ileovesicostomy is an alternative to Mitrofanoff appendicovesicostomy. Three boys who underwent successful Yang-Monti continent ileovesicostomy are reported in this manuscript. In the first case, Mitrofanoff procedure was done for traumatic anorectal and urethral disruption after attempting ureterosigmoidostomy. Later on, on the request of the patient the appendicovesicostomy was excised. The patient presented later with chronic renal failure and bilateral hydroureteronephrosis thus an ileovesicostomy was fashioned. The patient could not be survived due to chronic renal failure related complications. In the second patient with exstrophy of bladder, the ileocecal junction along with appendix had to be resected on account of strangulated inguinal hernia; later on, an ileovesicostomy was performed for small capacity bladder and major degree of vesicoureteric reflux. The third patient with exstrophy of bladder, in whom Mitrofanoff procedure had been performed, presented with stenosis of the appendicovesicostomy. On re-operation the entire channel had disappeared thus necessitated ileovesicostomy. Both of these patients were doing well on follow-up.

A conjoined twin is one of the rare congenital defects. Ischiopagus variety is even rarer. We present a case of ischiopagus-tripus conjoined twins. They were fused at the lower halves of the bodies. One of the twins was apparently normal looking, active and pink. The other twin was small, ill looking, sluggish and cyanosed. There were two well formed separate lower limbs on one side and a fused limb at the other side. The twins had an imperforate anus and two small orifices draining urine with incompletely developed external genitalia. Pre-operative workup was in progress when the twins passed away.

Small bowel obstruction is a common surgical emergency but trichobezoar as an etiology, rarely reported. A seven year old school going female child presented with acute intestinal obstruction with a palpable and mobile mass in the abdomen. At exploration, a 10 cm long trichobezoar was found in the distal ileum which was removed through enterotomy. Postoperative course remained uneventful. Further probing revealed that child used to eat her own scalp hairs at the age of 2 years and the habit persisted for about 18 months which resulted in alopecia at that time. Later on she started showing normal behavior.