Background:This study was done at Niloufer hospital and institute of child health, Hyderabad with an aim of evaluating the clinical presentation, diagnostic evaluation, management and outcome of malrotation of intestines in the neonates.Methods: Cases of neonatal small intestinal obstruction due to malrotation presenting to the Department of Pediatric Surgery, Niloufer hospital over a period of two years were evaluated.Results: A total of 38 newborns presented to our department with intestinal obstruction due to malrotation. 3/38 patients presented with extensive gangrene of midgut. 4/38 patients died during the course of treatment.Conclusions: Malrotation is a relatively common cause of neonatal small bowel obstruction. A high index of suspicion is needed in neonates presenting with bilious vomiting. Early laparotomy prevents fatal complication of extensive gangrene due to midgut volvulus.
BACKGROUNDThe neonatal period is defined as the first four weeks after birth. Intestinal atresia is the commonest cause of intestinal obstruction in the new born children. It requires early recognition and prompt treatment to obtain better outcome.The aim of the present study was to focus on aetiology, diagnosis and surgical management of intestinal atresia and obstruction in neonates.
Lymphangiomas are developmental defects of the lymphatic channels that belong to a large spectrum of vascular malformations usually located in the head and neck region. They present variedly and occur anywhere there are lymphatic vessels. These are seen in infants and children primarily. Retroperitoneal lymphangiomas pose diagnostic challenge as well as its surgical management. OBJECTIVEOur study focused on the location, clinical presentation, and management of lymphangiomas in infancy and childhood. METHODSThe medical records of children with lymphangiomas admitted to MGM Hospital, Warangal, Telangana State over a period of 7 years from April 2009 to March 2016 were reviewed for age with gender, location, mode of presentation, management, and its outcome. RESULTSWe managed 50 children with lymphangioma in last 7 years at MGM Hospitals, Warangal. The age range from 9 days to 10 years. About 65% of children were in the age group of less than 5 years with female-to-male ratio of 2:1. The youngest was 9 days and the eldest was 10 years. In 20 patients (40%), lymphangioma was present in the neck, 18% in axilla (9 patients), 10% in over the chest wall/abdominal wall, 10% over the back, 10% over the limbs (5 patients each) respectively, 8% over the perineal region (4 patients), 2% in retroperitoneum (1 patient), and 2% in the floor of the mouth (1 patient). Surgical excision was the treatment of choice and performed in all cases. CONCLUSIONSLymphangiomas are rare congenital malformations seen in infancy and childhood. They are usually asymptomatic at the time of clinical presentation. They are diagnosed by ultrasonography. CT and MRI scan are performed in doubtful cases. Total or subtotal excision was the treatment of choice by preserving the surrounding important structures.
Background: Intestinal malrotation is a congenital anomaly that results from abnormal or incomplete rotation and fixation of midgut during embryonic development. This study was done at Niloufer Hospital and Institute for Women and Child Health, Hyderabad with an aim of evaluating the clinical presentation, diagnosis, management and outcome of malrotation presenting beyond 1 year of lifeMethods: Overall 50 cases of malrotation presented to the department of pediatric surgery over a period of 2 year (April 2015 to April 2017). 12 patients of these 50 (12/50) whose age was above 1 year i.e. who were beyond infancy were studied in this studyResults: Out of the 12 patients, 6 were female and 6 were male. Age of patients ranged from 15 months to 13 years. Younger patients below 2 years commonly presented with typical symptoms of bilious vomiting and patients above 2 years of age presented with more varied and vague symptoms. 1/12 of patients presented with a poor general condition and succumbed during the course of treatmentConclusion: Small intestinal obstruction due to malrotation is relatively common in neonatal period. Malrotation beyond infancy is an uncommon diagnosis. Malrotation in grown up children usually is not suspected due to varied symptoms. High index of suspicion is needed as early intervention and treatment in the form of Ladds procedure can prevent any catastrophic events like volvulus and bowel ischemia.
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