Background and objectivesMesenteric cysts are rare in paediatric age group and usually present as asymptomatic abdominal lumps. Acute presentations are uncommon and their preoperative diagnosis is difficult.Design and settingsThis is a retrospective observational study describing three children with mesenteric cysts who presented with symptoms and signs of acute intestinal obstruction.Patients and methodsThree children with mesenteric cysts who presented with acute abdomen are described as per their age, presenting symptoms and signs, investigations, management, and outcome.ResultsThe three children presented in emergency with symptoms and signs of acute intestinal obstruction. On exploration, all had mesenteric cyst and were managed by deroofing, marsupilisation and excision. All patients recovered uneventfully.ConclusionsPresentation of mesenteric cyst as acute obstruction in paediatric age group is rare and preoperative diagnosis is difficult. The larger cysts are more likely to have an acute presentation.
Background: The term Spontaneous Intestinal Perforation (SIP) suggests a perforation in the gastrointestinal tract of a newborn with no demonstrable cause.Methods: Four neonates presenting with spontaneous bowel perforation were analyzed with respect to clinical presentation, management and outcome.Results: The mean age at presentation was 11.4 days. There were three males and one female. One of the neonates was preterm, very low birth weight and the other three were full term. Two neonates underwent emergency exploratory laparotomy and two were initially managed by peritoneal drainage in view of poor general condition; one of them improved and did not require further operative intervention. The preterm very low birth weight neonate was stabilized and explored after 48 hours. Intra-operatively, two of them had two ileal perforations each which required ileostomy; one had single perforation in the transverse colon which was primarily repaired. All four had an uneventful recovery.Conclusion: SIP is a distinct clinical entity and has better outcome than neonates with intestinal perforation secondary to Necrotizing Enterocolitis (NEC).
Phyllodes tumors are rare fibroepithelial tumors that account for less than 0.5% of all breast tumors. Presentation in children is even rarer. In this paper, we describe a case of an adolescent with a phyllodes tumor. The rare presentation at this age, its distinguishing features, the preoperative diagnostic difficulties, and the management protocols of this uncommon tumor are highlighted.
Rectal atresia is a rare form of anorectal malformation, with reported incidence of 1 to 2% and membranous variety of rectal atresia is even rarer. Most reported cases have been dealt with a staged procedure which includes sigmoid colostomy. We diagnosed and classified the variety of rectal atresia by performing an X-Ray (invertogram along with the red rubber catheter in situ.). In lesser developed geographies where MRI is not readily available or not affordable, this simple test could be used to confirm the variety of rectal atresia. However, the usual fallacies of invertogram should be considered. Here we report a neonate with membranous variety of rectal atresia managed by transanal endoscopic fulguration using bugbee passed through the cystourethroscope, without a covering sigmoid stoma.
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