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.
Gastric teratoma is a very rare tumour during infancy and childhood, usually benign and predominantly affects males. We present two infants, one male and a female, 7 and 6 months of age respectively, who presented with distension of the upper abdomen with palpable mass. The 2nd child had feeding problem for 2 days. Imaging studies showed both the tumours arising from the posterior walls of the stomach. In both the patients, the tumours could be completely excised. The histology had shown features of mature teratoma. Both the children are on regular follow up for 12 months and 36 months, respectively and are doing well.
BACKGROUNDThe most common cause of bowel obstruction in the neonates is Hirschsprung's disease. Traditionally Hirschsprung's disease was managed in stage procedure of colostomy, the definitive pull-through followed by closure of colostomy but Primary Transanal Endorectal Pull-Through procedure is a recent development in the concept of the management of Hirschsprung's disease through minimally invasive surgery. In this study we represent our early experience to evaluate the feasibility and safety of Primary Transanal Endorectal Pull-Through for management of Hirschsprung's disease during early neonatal period.
METHODSSix male and four female neonates with Hirschsprung's disease were included in this study. The age ranged from 3-30 days. All babies presented with Hirschsprung's disease was diagnosed with Barium enema study. The inclusion criteria included radiological transitional zone at rectosigmoid or mid-sigmoid region, weight more than 2.5 kg, abdominal distention response to rectal decompression, no evidence of enterocolitis and no associated major anomaly. This is a retrospective study of early neonates with primary transanal endorectal pull-through procedure done for Hirschsprung's disease in our institute from January 2012 to January 2016.
RESULTSSix male and four female neonates who were included in the study underwent primary transanal endorectal pull-through. The mean operating time was 60 minutes and mean intra-operative blood loss was 20 ml. The mean length of bowel resected was 16 cms. Patients passed stool between 3 rd and 4 th day post-operatively. Oral feeding was started on 5 th and 6 th day postoperatively. The average post-operative hospital stay was seven days. None of the patients had post-operative bleeding, urethral injury, anastomotic leak or retraction of anastomotic sites and enterocolitis. Two patients had perineal excoriation. In this study there was no mortality.
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