Background: Mesenteric cysts are exceptional abdominal lesions of childhood. Presentation may vary with broad spectrum of symptoms from asymptomatic mass and nonspecific complaints to an acute abdomen. Objectives of this study were to present a series of patients with mesenteric cysts and to analyze our experience with emphasis on the presentation, management, and outcome.Methods: This observational study included thirteen children were diagnosed and treated for mesenteric cysts. All cases subjected to clinical evaluation, laboratory investigations and radiological studies. The diagnosis was confirmed on laparotomy. Ethics committee approval was obtained. The main data which extracted and analyzed included demographic data, operative finding, postoperative complications and duration of hospital stay. Data were analyzed using SPSS for Windows software and P value of ≤ 0.05 was considered significant.Results: There were 13 patients with mesenteric cyst, 5 girls and 8 boys. The ages ranged from neonate to 8 years. Abdominal mass and pain was the main presenting symptoms. Prenatal diagnosis established in two cases. Laparotomy performed in all cases. Small bowel mesentery is the commonest site. Two patients required urgent surgery. Surgical procedures included cyst excision with or without intestinal resection. Chylolymphatic cyst was documented in 4 cases. Post-operative complications reported in 2 cases.Conclusions: Mesenteric cysts are unusual in children with variable clinical presentation. Complete excision was feasible in nearly all cases, bringing a favorable outcome. The possibility of this disease entity should be considered as the cause of acute abdomen.

Surgical excision is almost always the best choice of treatment in neck lesions, for cosmetic reasons, to prevent recurrent attacks of infections in addition to the actual potential risk of malignancy. 7 The commonest congenital ABSTRACT Background: Neck masses are common pathologies in pediatrics, surgery is considered the only line of treatment in most of neck lesions, and usually early intervention is recommended to avoid complications, The aim of our study is to evaluate the clinical and radiological presentations, the pathological findings, and the surgical outcome of neck lesions operated in our institution in pediatric age group. Methods: All pediatric patients presented at our pediatric surgery unit in the period from January 2017 to January 2018 by neck masses were included in this study, Patients with fistulae without underlying swellings and those with inflammatory lesions who responded to medical treatment and surgery wasn't indicated were excluded from this study. History taking, clinical evaluation, routine laboratory investigations and neck ultrasound were done in all cases, and Imaging studies (CT, MRI) were done in selected cases, all resected specimens were sent for histopathological examination, demographic data, duration of surgery, using of haemostatic devices, need of blood transfusion, duration of hospital stay, morbidity and mortality all were recorded and statistically analyzed. Results: In the majority of cases swelling was cystic in nature (69.4%), with lateral position in most of the lesions (61.2%), thyroglossal cyst proved to be the commonest (30.6%), followed by branchial cyst (22.4%). Clinical diagnosis with neck ultrasound was sufficient for diagnosis in most of the cases (55.1 %). Follow up of patients for 3 months in all cases with no mortality recorded and very low incidence of morbidity (6.1%). Conclusions: Neck swellings in pediatric population is common with wide range of differential diagnosis, with respecting anatomical and pathological backgrounds surgery has excellent outcome with very low incidence of morbidity.

Background: Neonatal and infantile fistulas are diverse and include many types. Conventional contrast images are used to delineate the fistulous tracts. The aim of this study is to illustrate the conventional radiological spectrum of neonatal and infantile fistula with surgical correlation. Methods: Neonates and infants with suspected fistulas were included in this study. The patients may be presented by cutaneous fistula with discharge, profuse oral secretion and cyanosis on feeding, or imperforate anus. After full clinical data were taken, plain X-ray, contrast imaging, and abdominal sonography were done to the patients. Treatment was tailored according to the case. Results: Our study included 34 patients (25 boys and 9 girls): one case of branchial fistula; 2 cases with thyroglossal fistula; 10 cases of tracheo-esophageal, esophago-cutaneous, and esophago-pleural fistulas; 3 cases with vitello-intestinal fistula; one case with urachal fistula; 12 cases with recto-urinary, recto-vaginal, and recto-perineal fistula; 4 cases with peri-anal fistulas; and finally one case with iatrogenic urethra-cutaneous fistula. Radiological findings were well correlated with the surgical data. Conclusion: Many types of neonatal and infantile fistulas were shown in this series including tracheoesophageal, recto-urinary, and other neonatal fistulas. Radiological and surgical data were well matched.

Background: Laparoscopic repair of perforated peptic ulcer (PPU) has become an accepted way of management. Omentopexy was the main method of repair for decades. Objective: The goal of the present study was to evaluate whether laparoscopic simple repair of PPU is as safe as omentopexy.Patients and Methods: This prospective study included 50 patients who were diagnosed with perforated peptic ulcers and underwent laparoscopic repair of perforated peptic ulcers at our institute from September 2019 to September 2020. They were divided into two groups: Omentopexy (group A) (n=20) and repair with simple closure only (group B) (n=30). Patients' age, sex, pulse, blood pressure, respiratory rate, Boey score, perforation size, operation time, leakage, wound infection, and length of hospital stay were evaluated. The data were compared by Mann-Whitney U test and the Pearson's chi-square test. Results: No patients died nor leaked. After matching, the simple closure and omentopexy groups had similarity in age, gender, pulse rate, respiratory rate, Boey score, perforation size and wound infection. There were statistically significant differences in systolic blood pressure (P = 0.002), operating time (136.40 ± 10.45 versus 106.83 ± 6.89 minutes; P < 0.0001), and length of hospital stay (7.20 ± 1.32 versus 5.67 ± 0.55; P < 0.0001). Conclusion: Laparoscopic repair of a perforated peptic ulcer without an omental patch is a safe option and shortens the operating time.

Background: Duodenal and pyloric obstruction in neonates and young children have diverse causes such as atresia, volvulus, and foreign body or may be extra-luminal obstruction. Aim of Study: To assess causes of pyloric and duodenal obstruction in pediatric population (other than CHPS) and determine the causes of obstruction radiologically and compare them with surgical data. Patients and Methods: Our study included 22 patients (12 boys and 10 girls), age range from 1 day to 6 years. This study was done on cases of pyloric and duodenal obstruction in newborns, infants and young children less than 6 years in the period from 2017 through 2019. Cases of Congenital Hypertrophic Pyloric Stenosis (CHPS) were excluded from the study. The clinical, radiological data were gathered and compared to each other. Results: The spectrum of causes of pyloric and duodenal obstruction was as follow: 4 cases of pyloric atresia, 5 cases with duodenal atresia, 3 cases with duodenal stenosis by incomplete web, one case with annular pancreas, 4 cases with midgut volvulus, one case with duodenal duplication cyst, 3 cases with foreign body obstruction and one case with trichobezoar. All cases were treated surgically to alleviate the obstruction. The radiological data were well correlated with surgical findings. Conclusion: Pyloric and duodenal obstruction in pediatric population has different causes. Radiological imaging could determine the cause of obstruction with good correlation with surgery.