Mullerian duct anomalies are rare and can present with abnormalities in upper vagina, cervix, uterus, and fallopian tubes. The exact incidence of cervicovaginal agenesis is unknown and there are very few cases recorded in the literature. Authors report a 12-year-old girl referred from gynaecologist with chronic cyclical abdominal pain with underdeveloped, geniatilia and developed secondary sexual characters. Radiological investigations showed hypoplastic cervix with hematometra and left hemato salpinx. A definitive repair with creation of a neovagina using a sigmoid colon segment was performed in a single stage. Many techniques are described for reconstruction of cervicovaginal canal. Use of colon in creation of a neovagina is described by authors. Here we report a case of complete vaginal agenesis presenting with Hematometra-Hematosalpinx where a neovagina was created using a segment of sigmoid colon. Single staged surgery for neovagina creation using segment of sigmoid colon offers a promising and safe alternative for cervicovaginal agenesis.
The kidney is the most common genitourinary organ injured from external trauma, occurring in 1% to 5% of all injuries. Non operative management of renal injuries with renal salvage as the primary aim has gained much support in the past decades; though paediatric data is limited. Here we present a case of unilateral complete transection managed conservatively and the renal salvage was possible with retaining normal function.
Abstract:Introduction: One in 5,000 live births is found to have anorectal malformations with a female preponderance. These patients are managed during the first year of their life with advanced health care facilities. Still a few cases present in adult life. Case Report: One such case of a 24 year old female is reported here who presented with chronic constipation. Transverse colostomy was done at birth, soon after diagnosing anorectal malformation. The stoma underwent spontaneous closure and she continued to pass faeces through anovestibular fistula. Anterior sagittal anorectoplasty was performed and a continent neo-anus was created. Conclusion: Careful neonatal examination shall diagnose all anorectal malformations at birth. Illiteracy, lack of neonatal health care, inadequate medical facilities are some of the reasons for the delayed diagnosis and persistence of this condition till adulthood. Most pediatric surgeons consider posterior sagittal anorectoplasty as the procedure of choice in treating anorectal malformation.
Background: A bezoar is persistent, ingested material that collects within the gastrointestinal tract. The most common type of bezoar, a gastric trichobezoar, is made up of human hair and found in the stomach. Patients with trichobezoar often remain asymptomatic for many years. The aim of treatment of trichobezoar is removal of the bezoar and to prevent recurrence. Case Report: A 12 year old girl presented with abdominal pain and vomiting. suffering from trichophagia developing trichobezoar. Ultrasonography was suggestive of partial gastric outlet obstruction and barium swallow was suggestive of bezoar in gastric lumen. Conclusion: Trichobezoar should be considered in young females presenting with non-specific abdominal complaints.
Incidence of empyema is increasing despite various treatment modalities available. Management of pediatric empyema remains a challenge due to factors like malnutrition, poverty, TB, delay in early intervention and incomplete treatment course. It is necessary to address these issues at ground level. A short 2-year prospective study was carried out at a tertiary care teaching hospital where 17 consecutive cases of pediatric empyema were managed. Among 17 cases, all patients intercostal tube drainage (ICD) was required. Six patients underwent surgical interventions [2 video-assisted thoracoscopic surgery (VATS) and 4 open thoracotomies] while 11 were managed on ICD and antibiotics. Fibrinolytic therapy was not administered in any case. Follow-up showed good lung expansion with apparent rib crowding in 3 cases and no mortality. Majority of empyema in children are post pneumonic. Chest tube drainage, antibiotics along with intrapleural fibrinolytic is a safe and effective method of treating empyema thoracis in children in resource- poor settings and can reduce the need for invasive interventions.
A small evagination of parietal peritoneum forms the canal of Nuck. By the first year of life this extension condenses into a fibrous cord. Cyst of canal of Nuck is a rare developmental anomaly. The inguinal canal is traversed by the spermatic cord in male and the round ligament of uterus in female. The processus vaginalis accompanies the round ligament through the inguinal canal through into the labium majus. This evagination of parietal peritoneum forms the canal of Nuck in the female. These cases are rarely seen in surgical practice. In this case series we described three clinical scenario of canal of Nuck and their management.
Teratomas are composed of tissues derived from ectoderm, mesoderm, and endoderm. Sacrococcygeal teratomas are developed from the totipotential cells of primitive knot which is a remnant of the primitive streak in the coccygeal region. With the incidence of 1/35000–1/40000 live birth, sacrococcygeal teratoma is considered as the most common germ cell tumor in the neonatal period and infancy. Sacrococcygeal teratoma shows female preponderance with male to female ratio 1:4 . AIMS AND OBJECTIVES: To study clinical presentation and management of sacrocoocygeal teratoma in paediatric age group. CASE REPORT: A seven year old child presented to our tertiary care hospital with a swelling of size 20 x 10 cm in sacrococcygeal region Which was initially smaller in size about 6 X 3cm and have gradually progressed to the present size swelling was soft to rm in consistency, patient was subject to MRI pelvis which was suggestive of solid cystic swelling in sacrococcygeal region of size 20 X 15 cm with maintained fat planes with rectum and adjacent organs. Patients was subjected to surgery in which the teratoma was removed of size 20 x 15 cm along with coccygectomy was done intraoperatively there was no involvement of rectum or other organs or pelvic walls. Child recovered well post operatively and the histopathological report conrmed the diagnosis of sacrococcygeal teratomawith solid cytic compoments.
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