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Aim:To assess the usefulness of ultrasonography in the differentiation of causes of chronic cervical lymphadenopathy in children.Materials and Methods:Children with palpable cervical lymph nodes were included. An ultrasonographic examination was performed to delineate multiple lymph nodes, irregular margins, tendency towards fusion, internal echos, the presence of strong echoes and echogenic thin layer.Results:The total number of patients was 120. Echogenic thin layer and strong internal echoes were specific for tuberculosis. Long axis to short axis (L/S) ratio was more than 2 in most of the tubercular nodes (85.71%). Hilus was present in 50 (73.53%) tubercular lymphadenitis, 12 (40%) lymphoma and 10 (62.5%) cases with metastatic lymph nodes. Hypoechoic center was present in 60 (88.24%) tubercular lymphadenitis cases followed by 62.5% metastatic and 60% malignant lymphoma cases.Conclusions:Ultrasonography is a non-invasive tool for lymph nodal evaluation in children. It may be used to differentiate cervical lymphadenopathy with different etiologies in children. When correlated clinically, it may avoid biopsy in a patient.

Duplication of the alimentary tract is an important surgical condition. It may occur anywhere in the gastrointestinal tract. An important complication of this entity is perforation of the normal or abnormal gut. Malrotation with midgut volvulus can be a surgical emergency. We present a patient, who presented as malrotation with midgut volvulus associated with perforated ileal duplication. The patient was successfully managed.

SummaryEctopic kidney is a well-known congenital anomaly. Intrathoracic kidney, as a form of renal ectopia, is an extremely rare entity. A 62-year-old man presented to the department of radiodiagnosis for evaluation of urinary problems. On the basis of ultrasonography, he was diagnosed to be having intrathoracic kidney, which was confirmed by CT scan. We present the details of the patient and brief review of the relevant literature. BACKGROUND

extensive caseous necrosis. No neoplastic cells were detected. Tuberculin skin test was positive (17 mm, vesicular). There was no history of contact with a TB-positive patient. The diagnosis of the chest wall TB was made in view of histopathologic and image studies and the positive result of the tuberculin skin test. The patient underwent anti-TB treatment Such localisation of a TB process is rare in pulmonological practice 1 accounting for 1-2% of TB cases.2 Tuberculous chest wall abscess may involve sternum, osteocartilaginous articulations, costal arches, costovertebral joints and vertebrae. The most common localisation is along costal arches and sternal margins. Chest computed tomography (CT) is recognised as a diagnostic tool of choice for the differential diagnosis of chest wall tumours. It allows for assessment of the nature and extent of the pathologic lesions in soft tissues and associated erosions of the bone structures as well as to examine lungs and mediastinum.3,4 A biopsy is required for histopathologic confirmation. UNILATERAL TOTAL LUNG SEQUESTRATION: A RARE CONDITIONA 3-day-old full-term male neonate presented to the Department of Pediatric Surgery at a university hospital with complaint of respiratory distress. On examination, the baby was in severe respiratory distress. Abdominal examination was noninformative. On auscultation of the chest, heart sounds were not displaced. The respiratory sounds were absent on the left side.There was history of respiratory distress since birth for which the attendants were taking some treatment from a physician. The details of the physician and the treatment provided were not available as they had no records with them. When the condition of the baby deteriorated, he was referred to us.Immediate endotracheal intubation was done. After stabilization, an X-ray of the patient was taken which showed a ground glass appearance of the left hemithorax (Fig. 1). This was followed by the computerised tomography (CT) scan of the thorax, which revealed a mass in whole of the left hemithorax (Fig. 1), supplied by a systemic artery arising from the aorta. Thus, the diagnosis of left total lung sequestration (TLS) was made. Unfortunately, the patient deteriorated again and expired before any operative intervention could be done.Pulmonary sequestration (PS) is defined as non-functioning lung tissue that is not in normal continuity with the tracheobronchial tree and derives its blood supply from systemic vessels.1 It has three main variants: intralobar, extralobar and communicating bronchopulmonary foregut malformations.2 An intralobar sequestration shares the visceral pleural covering of an otherwise normal pulmonary lobe, whereas an extralobar sequestration is separated from normal lung by its own pleural covering.TLS is an extremely rare condition where the whole of one lung is sequestrated. PS is the second most common congenital lung anomaly 2 and constitutes 0.15-6.4% of all congenital pulmonary malformations.1 The exact embryological cause for this condition is not clea...

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Lumbosacral parasitic twin is an extremely rare entity. About 200 cases have been reported in the literature. It may be associated with neural tube defects. We encountered a 3-day-old female child with this presentation, who was successfully operated on at the age of about 2 months. Being an uncommon entity, it is presented here.