Background
Pseudotail with occult spinal dysraphism with neurological deficit is a rare phenomenon. Ignoring pseudotail as sign of occult spinal dysraphism may lead to catastrophe in diagnosis and further management.
Case presentation
We are reporting a case of a 30-month-old male child who presented with a tail-like structure at lower back and dribbling of urine since birth. On initial evaluation at some other hospital, he was misdiagnosed as posterior urethral valve and underwent fulguration of valve. However, dribbling of urine persisted after initial procedure. On evaluation at our center, he was found to have pseudotail with occult spinal dysraphism and neurogenic bladder.
Conclusion
Pseudotail with occult spinal dysraphism with neurological deficit is a rare phenomenon. Neurogenic bladder in such case can be misdiagnosed as posterior urethral valve. So, neurogenic bladder with pseudotail should be evaluated cautiously to avoid misdiagnosis and mismanagement.
Background
Currarino syndrome is a rare congenital malformation having autosomal dominant inheritance. It comprises of anorectal malformation, presacral mass, and sacral vertebral defect occurring in variable proportion. The most common presentation is chronic constipation which is usually due to compression of rectum by anterior sacral mass. If clinical examination is not properly done and digital rectal examination is excluded from the examination, it can be misdiagnosed as other common cause of constipation like Hirschsprung disease.
Case presentation
We are reporting one such case of one-and-half-year-old female child with chronic constipation which was initially managed as Hirschsprung disease, but later on, after a repeat clinical examination with digital rectal examination, it was evaluated on the line of Currarino syndrome. The diagnosis was confirmed by contrast-enhanced computed tomography of abdomen with 3 dimensional reconstruction. It was then managed by posterior sagittal approach with excision of mass and anorectoplasty.
Conclusion
A proper protocol for clinical evaluation of patient with constipation prevents diagnostic dilemma between surgical causes of constipation in pediatric age group. Digital rectal examination must be included in the protocol for evaluation of chronic constipation. In pediatric age group, clinical workup should be done with keeping in mind the rare diagnosis of Currarino syndrome along with common cause of constipation like Hirschsprung disease.
Mermaid syndrome is a very rare, lethal congenital anomaly. It is associated with other congenital anomalies and is incompatible with life. Typical clinical features are fused lower limb from perineum to ankle and single umbilical artery. Etiology is multifactorial and is extreme form of caudal regression syndrome. When diagnosed in early gestation, termination of pregnancy may be considered.
Acid ingestion in children is a common problem in developing countries. Immediate complications of acid ingestion are oesophageal perforation, laryngeal trauma, bleeding and fistula formation but stricture is a delayed complication. Gastric outlet obstruction is known complication of acids and surgery is the mainstay of treatment. Heineke-Mikulicz pyloroplasty was done in five cases without complications and the outcomes were satisfactory.
Foreign body aspiration is a life threatening emergency in children. Different types of foreign bodies are aspirated and reported in literature but light emitting diode (LED) bulb is an unusual cause of foreign body aspiration. Rigid bronchoscopy is gold standard for treatment of foreign body aspiration. We wish to present a case of 9 years old male child with LED bulb aspiration which was retrieved with rigid bronchoscopy.
Urethral catheterisation is a common routine procedure. Knotting of infant feeding tube in genitourinary tract is a rare complication. Various methods have been used in the removal of a knotted catheter. The methods include gentle but sustained traction under general anaesthesia, open cystostomy and endoscopic retrieval.
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