Pyloroduodenal duplication is the rarest alimentary tract duplication known so far. A 1-year-old female patient presented with abdominal pain, lump in the epigastrium and occasional vomiting. On ultrasound and CT scan of abdomen suspicion of duplication cyst was made. Operation revealed a duplication cyst along pylorus and first part of the duodenum. Excision of free part and mucosal stripping of the attached part of the duplication was done.
Pyloroduodenal duplication; Vomiting; Abdominal mass
Fetus in fetu is a rare developmental aberration, characterized by encasement of partially developed monozygotic, diamniotic, and monochorionic fetus into the normally developing host. A 4-month-old boy presented with abdominal mass. Radiological investigations gave the suspicion of fetus in fetu. At surgery a fetus enclosed in an amnion like membrane at upper retroperitoneal location was found and excised. The patient is doing well after the operation.
Fetus in fetu; Teratoma; Abdominal mass
Congenital diaphragmatic hernia is a congenital defect of the diaphragm through which intestine and other viscera herniate into the chest. In extreme form of diaphragmatic maldevelopment, there might be a complete agenesis of diaphragm. A 45-day old male infant was presented with fever, cough and respiratory distress for a week. Chest radiograph showed right-sided congenital diaphragmatic hernia. The patient underwent surgical exploration and found to have an unusual and large defect of right hemidiaphragm. The diaphragm was absent on anterior and lateral aspects of the chest wall and only a small rim of diaphragm was present on posterior aspect. The defect was identified as agenesis of right hemidiaphragm and successfully managed by suturing the posterior rim of diaphragm to the intercostal muscles and ribs. This report describes successful management of hemidiaphragmatic agenesis without incorporating a prosthetic material.
Congenital diaphragmatic hernia; diaphragmatic agenesis; Prolene mesh; repair
Decorative crystal gel balls are used for decoration purpose. Due to their attractive appearance they may be ingested by children. This may result in grave complications. A case of decorative crystal ball ingestion is being reported in a 6 months old infant who presented with sub acute intestinal obstruction and was operated. Crystal gel balls were causing obstruction of jejunum. Enterotomy and removal of the mass of jelly balls was done with primary closure. The patient was re-operated for anastomotic disruption on 6th postoperative day. Baby developed septicemia, and succumbed after 2 days of second operation.
Crystal balls; Jelly balls; Mortality
We report a case of persistent cloaca and type I congenital pouch colon associated with ileovesical and colovesical fistulae. Such a malformation has not been reported so far.
Congenital pouch colon; Ileovesical fistula; persistent cloaca
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.
Safety pin ingestion; Strangulated umbilical hernia; Intestinal perforation
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.
Persistent cloaca; Urogenital sinus; Anorectal malformation; Fecal continence
Pulmonary sequestration cyst is a rare entity in pediatric patients. Most of the time, it is diagnosed as an incidental finding. It is associated with other congenital anomalies, especially congenital diaphragmatic hernia. We report a patient of cerebral palsy presented with vomiting and recurrent chest infections. He was diagnosed to have hiatal hernia on computed tomography scan of chest. At operation, a pulmonary sequestration cyst along with hiatal hernia, malrotation, and meckel's diverticulum was encountered. The sequestration cyst was managed through transhiatal approach.
Bronchopulmonary sequestration; foregut malrotation; hiatal hernia; meckel's diverticulum
Crystal jelly balls are used for decorative purpose in homes and offices. They swell on contact with water. We managed a patient with a clinical diagnosis of acute abdomen. At surgery, there was fecal peritonitis and three ileal perforations caused by previously ingested decorative crystal balls.
Acute abdomen; crystal balls; generalized peritonitis; intestinal perforation; missing foreign body
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.
Lymph node infarction; Acute appendicitis; Pain right iliac region
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.
Gastric teratoma; Endogastric tumor; Exogastric tumour
Intrapulmonary sequestrations are quite uncommon in pediatric age group. The preoperative diagnosis of pulmonary sequestration is not possible in most of the cases. A 2-year-old boy presented with recurrent episodes of chest infections and respiratory distress. A preoperative diagnosis of congenital lobar emphysema was made on the basis of chest radiograph and computed tomography scan. At operation, an intralobar pulmonary sequestration was found. The sequestration cyst was excised with uneventful recovery.
Congenital lobar emphysema; pediatric age group; pulmonary sequestration