Objective:The aim of this study was to evaluate the magnetic resonance imaging (MRI) findings of caudal regression syndrome (CRS) and concomitant anomalies in pediatric patients.Materials and Methods:A hospital-based cross-sectional retrospective study was conducted. The study group comprised 21 pediatric patients presenting to the Departments of Radiodiagnosis and Pediatric Surgery in a tertiary care hospital from May 2011 to April 2016. All patients were initially evaluated clinically followed by MRI.Results:In our study, 21 pediatric patients were diagnosed with sacral agenesis/dysgenesis related to CRS. According to the Pang's classification, 2 (9.5%) patients were Type I, 5 (23.8%) patients were Type III, 7 (33.3%) patients were Type IV, and 7 (33.3%) patients were of Type V CRS. Clinically, 17 (81%) patients presented with urinary incontinence, 6 (28.6%) with fecal incontinence, 9 patients (42.9%) had poor gluteal musculatures and shallow intergluteal cleft, 7 (33.3%) patients had associated subcutaneous mass over spine, and 6 (28.6%) patients presented with distal leg muscle atrophy. MRI showed wedge-shaped conus termination in 5 (23.8%) patients and bulbous conus termination in 3 (14.3%) patients above the L1 vertebral level falling into Group 1 CRS while 7 (33.3%) patients had tethered cord and 6 (28.6%) patients had stretched conus falling into Group 2 CRS.Conclusion:MRI is the ideal modality for detailed evaluation of the status of the vertebra, spinal cord, intra- and extra-dural lesions and helps in early diagnosis, detailed preoperative MRI evaluation and assessing concomitant anomalies and guiding further management with early institution of treatment to maximize recovery.
A case of midline cleft of the lower lip with cleft of the mandible and complete duplication of the tongue is reported here. Median cleft of the lower lip, mandible and bifid tongue with ankyloglossia is reported in the literature, but complete duplication of the tongue as part of the Tessier 30 cleft is not yet reported.
The Tokay Gecko (Gekko gecko) is the second largest surviving Gecko species and are distributed across much of South-East Asia, Southern China and Northeastern India and Nepal. In Kaziranga landscape Tokay Gecko are fairly common and frequently seen around households in rural area. Though tail bifurcation is common in lizards but till date no recorded specimen of Tokey Gecko with bifurcated tail had been reported from Kaziranga Landscape.
BACKGROUND Hirschsprung's Disease (HD) is the commonest cause of functional intestinal obstruction in children and poses challenges to paediatricians and paediatric surgeons in resource-limited countries. This disease results from failure of ganglion cells to migrate cephalocaudally through the neural crest during 4 th to 12 th weeks of gestation, causing an absence of ganglion cells in all or part of the colon. This study describes the clinical characteristics and management of this disease in our setup and highlights the challenges associated with the care of such patients. METHODS This was a prospective observational study of children from neonatal age group up to 10 years who were histologically diagnosed and treated for HD at our institute between March 20013 and February 2018. RESULTS A total of 63 patients (M: F= 2.5: 1) with a median age of 3.2 months (IQR of 0.17-10.00 months) were studied. Almost all patients presented with intestinal obstruction followed by constipation in 93.65% cases. We did not encounter enterocolitis. All the patients underwent Swenson's definitive pull-through. Postoperative complications were very minimal. Mortality rate was 12.69%. During the follow-up period results of Swenson's procedure was found to be good. CONCLUSIONS HD is the commonest cause of functional intestinal obstruction in children and in older children presenting with constipation. This disease is associated with high morbidity and mortality especially in those older children who present late and when the dise ase becomes complicated. Early diagnosis and treatment are the cornerstones of the management of this malady. HOW TO CITE THIS ARTICLE: Mahanta K, Gogoi M. Complications of swenson's procedure in hirschsprung's disease-a hospital based 5 year study.
Parotid tumors are mostly benign, but their evaluation and treatment require a thorough knowledge of the relevant anatomy and pathology. Surgical treatment of benign tumors is aimed at complete removal of the mass with facial nerve preservation. The aim of this study was to evaluate the post-operative complications of superficial parotidectomy in benign parotid tumors.
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