Isolated hydatid cyst of kidney is very rare. Hydatid cyst of a duplex renal system is even more rare. We report a 13-year old girl with duplex system of right kidney with isolated hydatid cyst in upper moiety. Right nephrectomy was done to cure the condition.
Hydatid cyst; Echinococcosis; Duplex kidney
Congenital lung malformations can result in significant morbidity and mortality in children. Pulmonary sequestration is an uncommon congenital malformation of the lung that can cause complications even in fetal life. We herein present a newborn with extra-lobar sequestration (ELS) that lead to hydrops fetalis necessitating fetal intervention.
Extra-lobar pulmonary sequestration; Fetal pleural effusion; Congenital lung malformations
Pancreatic pseudocysts in children are not uncommon. Non-resolving pseudocysts often require surgical intervention. Endoscopic cystogastrostomy is a minimally invasive procedure which is recommended for this condition. We report a large pancreatic pseudocyst in a 4-year old child, which developed following therapy with PEG-Asparaginase for acute lymphoblastic leukemia. It was managed with minimally invasive procedure.
Pancreatic pseudocyst; Paediatric patients; Endoscopic cystogastrostomy
Segmental dilatation of ileum (SDI) is a rare clinical entity and so is anterior thoracic meningomyelocele (AMC). There has been no reported association between these two clinical entities. We hereby report a very rare presentation of these two in a 4 year old boy who presented with swelling in the right lower abdomen. Preoperative diagnoses were partial cecal volvulus and duplication cyst. At operation, SDI along with AMC was found.
Segmental dilatation of ileum; Anterior meningomyelocele; Undescended testes
Actinomycosis is a rare chronic bacterial infectious disease in childhood. A 14-year-old boy admitted with cramping abdominal pain and vomiting. Physical examination revealed right lower quadrant tenderness. Appendectomy was performed. On the histological section, typical actinomycotic (sulfur) granules in the appendiceal lumen were observed.
Appendicitis; Actinomycosis; Diagnosis
Giant omphalocele is difficult to manage and is associated with a poor outcome. A male newborn presented to our hospital with a giant omphalocele. We performed a staged closure of giant omphalocele using synthetic mesh to construct a silo and then mesh abdominoplasty in the neonatal period that led to a successful outcome within a reasonable period of hospital stay.
Giant omphalocele; Staged closure; Silo; Synthetic mesh
Fetus-in-fetu (FIF) is a rare and interesting entity characterized byincorporation of a malformed, monozygotic, diamnionic parasitic twin into the body of other normal twin partner. FIF is differentiated from teratoma by its embryological origin, its unusual location in the retroperitoneal space and the presence of vertebral column (axis) often with appropriate arrangement of other organs or limbs around this axis. We report two cases of FIF. Our first case presented at 18 months, while second at 9 year of age. FIF derived their blood supply directly from aorta in both the cases.Our FIF had distinct fetoid features, well developed axial skeleton with a complete spinal column, trunk, intestinal loops, four limbs, well developed fingers and toes, male external genitalia and abundant scalp hairs. Their weightwas 600 grams and 800 grams, respectively. Postoperative period was smooth and on long-term follow up no evidence of recurrence was seen in both the patients.
Fetus-in-fetu; Monozygotic diamnionic twinning; Teratoma
Appendicular band syndrome is an exceedingly rare surgical emergency that may lead to intestinal obstruction and strangulation. We report a case of 2-year-old boy who presented with acute intestinal obstruction with a mass in right iliac fossa (RIF). At exploration, an inflamed appendix had entrapped a loop of terminal ileum leading to its strangulation and gangrene. The appendectomy and resection of gangrenous gut were done with formation of an ileostomy.
Appendicular Band; Knot; Appendicular Mass; Strangulation
Sternal cleft is a very rare congenital anomaly, which can occur as an isolated or associated with other anomalies. We report a patient with a mesh-repaired complete sternal cleft complicated by infection with a multi-resistant Pseudomonas aeruginosa. The patch was surgically removed.
Sternal cleft; Mesh; Infection
Pneumothorax, though rare, is a recognized cause of respiratory distress in the immediate newborn period. It may occur spontaneously or secondary to various underlying lung diseases. Here we share our experience of a neonate with spontaneous pneumothorax with mild to moderate respiratory distress, who recovered completely with conservative management with an oxygen-enriched atmosphere and no surgical intervention.
Intercostal drain; Newborn; Oxygen supplementation; Spontaneous pneumothorax
Clear cell sarcoma of kidney (CCSK) is an aggressive renal neoplasm. We report two boys aged three and half, and three years with CCSK, one of whom had a disease free survival of four years and eight months. These patients were managed with surgery, chemotherapy and radiotherapy. One of the patients discontinued treatment early and lost to follow up. Aggressive multimodality therapy is the keystone to improved outcome.
Clear cell sarcoma; Kidney; Wilm's tumor
Lipomas can occur almost anywhere in the body, but retroperitoneal lipomas are extremely rare. They are slowly growing benign tumors and can attain an enormous size due to silent course of the disease. Total excision of the mass is the treatment of choice and is curative for benign retroperitoneal lipomas. We treated an 11-month-old female patient with giant retroperitoneal lipomas by surgical excision. Histopathology confirmed it as fibrolipoma.
Retroperitoneal lipomas; Liposarcoma; Infant
A neonate with patent urachus (PU) who later developed hypertrophic pyloric stenosis (HPS) is being reported. The newborn was first operated for PU; post-operatively he developed persistent vomiting and radiological workup confirmed HPS. Pyloromyotomy was performed with an uneventful recovery.
Patent urachus; Hypertrophic pyloric stenosis; Neonate
Ureteral tumors are rare and benign tumors are even rarer. Most of such tumors are diagnosed after nephroureterectomy assuming a malignant lesion, but with modern technological advancements like contrast enhanced CT scan or MR urography and ureteroscopic biopsy, benign nature of such tumors can be established preoperatively with an aim to preserve the renal unit. Here we report a case of 10-year old boy who presented with chronic right loin pain. DTPA scan showed complete loss of function of the right kidney. He was diagnosed to have an inflammatory myofibroepithelial polyp of right lower ureter and treated by nephroureterectomy.
Ureteral tumors; Fibroepithelial polyp; Myofibroepithelial polyp; Ureteroscopy
Ingestion of foreign bodies is a common presenting complaint in the pediatric emergency department. We present a case of a child in whom disc battery ingestion was suspected initially. The immobility of the foreign body on few days of conservative management raised the suspicion of two magnets. At operation, two magnets were found in the bowel causing a transmesenteric entero-enteric fistula.
Intestinal perforation; Magnets; Enteric fistula
Gastro-esophageal reflux (GER) is one of the common problems of neonatal intensive care units. Although this condition does not always need to be treated, it occasionally causes clinically serious consequences. Initial management is medical; however, in some cases surgery might be required. A premature neonate with birth weight of 1370 grams was managed in our ICU. The patient was mechanical ventilator dependent due to GER. The patient needed Nissen fundoplication for successfully weaning off the ventilator.
Nissen fundoplication; Gastro-esophageal reflux; Premature