A neonate, who had undergone primary repair of esophageal atresia with tracheo-esophageal fistula, developed right pleural effusion in the postoperative period. It was initially misdiagnosed as an anastomotic leak, but later confirmed to be chylothorax. Conservative treatment failed. Application of biological fibrin glue (sealant) on the mediastinum through a thoracotomy was curative.
Esophageal atresia; Tracheo-esophageal fistula; Chylothorax; Fibrin glue
A 30-month-old male infant presented with sacrococcygeal and pre-sacral mass. Ultrasound (US) abdomen revealed a huge pre-sacral mass with irregular margins extending into the pelvis, pushing the rectum antero-laterally. CT scan and MRI confirmed the US findings. Serum alpha fetoprotein level was abnormally elevated. Histopathological examination of surgical-specimen suggested sacrococcygeal yolk sac tumor (YST).
Segmental dilatation; Colon; Colorraphy
Segmental dilatation of the colon is a rare congenital disorder of colonic motility and often involves a short segment that causes chronic constipation in children. There are only 10 cases of neonatal colonic segmental dilatation described in literature. We managed a case who presented in the neonatal period with abdominal distension. There was dilatation of whole of the colon except part of ascending colon and the rectum. The case was managed by tubularization of the segmental dilatation of colon with stoma formation as first stage followed by delayed anastomosis during second stage.
Segmental dilatation; Colon; Colorraphy
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
Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension.
Bilateral congenital diaphragmatic hernia; Pulmonary hypertension; Silo
A heterotopic pancreas as the lead point of ileo-ileal intussusception is extremely rare. A 12-year-old previously healthy boy, presented to the emergency room with the complaint of severe abdominal pain for the last 6-8 hours. A preoperative diagnosis of ileo-ileal intussusception was made on ultrasound and an emergency exploratory laparotomy was done. At laparotomy an ileo-ileal intussusception was found and a polyp noted as a lead point. On histopathology this polyp was found to be heterotopic pancreas.
Intussusception; Heterotopic pancreas; Lead point
Congenital median upper lip fistula (MULF) is an extremely rare condition resulting from abnormal fusion of embryologic structures. We present a new case of congenital medial upper lip fistula located in the midline of the philtrum of a 6 year old girl.
Fistula; Congenital; Median; Lip
Peritonitis due to rupture of liver hydatid cyst secondary to blunt abdominal trauma can present with fatal consequences. Timely diagnosis and appropriate surgical management can be life saving. We report a case of ruptured liver hydatid cyst in the peritoneal cavity following trauma and its successful operative management in a preadolescent previously asymptomatic boy. Importance of detailed physical examination and early diagnosis by using appropriate radiological investigations is highlighted.
Hepatic hydatid cyst; Peritonitis; Trauma
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
Empyema thoracis is a well known complication following para-pneumonic effusions in paediatric age group. Usually it is unilateral but rarely could be bilateral. Herein we report a case of bilateral tuberculous empyema thoracis in a 12 years old, unvaccinated girl with a positive history of contact with tuberculosis. She was managed conservatively with tube thoracostomies and anti-tuberculous drugs. Emphasis is on the conservative approach and patience in management of patients with bilateral empyema thoracis.
Empyema thoracis; Tuberculosis; Tube thoracostomy
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
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.
Spontaneous intracerebral haemorrhage; Intracerebral haematoma
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.
Retroperitoneal teratoma; Peritonitis; Infected teratoma; Mature teratoma
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.
Tracheoesophageal fistula; H-Type; Esophagus; Atresia
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.
Popliteal pterygium syndrome; Autosomal dominant disorder; Familial