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A very rare case of noncommunicating multiple intra and retroperitoneal enteric duplication cysts (EDCs) is reported and discussed. Two large noncommunicating EDCs, one within the mesentery of proximal jejunum causing complete luminal obstruction and other isolated cyst in retroperitoneal area displacing duodenum and extrahepatic biliary system, were resected successfully in a 2-day-old neonate along with correction of malrotation.

P = 0.32 ،11.7% ‫بالفتح‬ ‫بامل�شت�شفى.‬ ‫إقامة‬ ‫ال‬ ‫فرتة‬ ‫طول‬ ‫أو‬ ‫ا‬ ‫املرا�شة‬ ‫عمان.‬ ‫التكلفة؛‬ ‫وحتليل‬ ‫التكلفة‬ ‫الزائدة؛‬ ‫ا�شتئ�شال‬ ‫الزائدة؛‬ ‫التهاب‬ ‫الكلمات:‬ ‫مفتاح‬ abstract: Objectives: Laparoscopic appendectomy (LA) for children has become very popular and is routinely performed in most health care centres around the world. The cost of surgical procedures is always a concern for patients and health care providers. This study compares, the total cost of open appendectomy (OA) with LA in children who required an appendectomy for acute appendicitis. Suitable and safe cost-effective techniques were also explored to reduce the cost of these procedures. Methods: The medical records of all the children (ranging between 0 and 12 years) at Sultan Qaboos University Hospital in Oman, who required OA or LA from June 2009 to July 2011, were reviewed. Results: LA were performed in 75 patients while OA were done in 34. Patients from the OA and LA groups were age-and gender-matched. The average operative time was 76 minutes for LA and 49 minutes for OA (P <0.001) while the average hospital stay was 3.14 days for LA and 2.15 days for OA (P = 0.08). The average cost of the two procedures was Omani riyals (OMR) 534 for LA and OMR 343 for OA (P = 0.00). The complication rate following procedures was lower in the case of LA, however this was not statistically significant (LA = 8% versus OA = 11.7 %, P = 0.32). Conclusion: LA are costlier procedures than OA, however they are as safe as OA, and do not increase morbidity or the duration of hospital stay. Keywords

Objective: The purpose of study was to compare Swenson & Soave-Boley procedure in the staged operative treatment of Hirschsprung's Disease (HD). Methods : During 16 months of study period, 25 patients of histopathologically confirmed HD were selected for staged operative treatment, following certain inclusion & exclusion criteria & were admitted & operated at DSH; after completion of all stages operation they were followed up & studied under two groups : staged Swenson procedure (Group-A; na=13) & staged Soave-Boley procedure (Group-B, nb=12). They were similar for age, sex, body weight, reselected length of aganglionic segment & postoperative follow up. The level of ganglionosis was assessed from marking biopsy. Preoperative & postoperative observations of Swenson procedure were analyzed & compared with those of Soave-Boley procedure in the staged operative treatment of HD statistically (unpaired ‘t' test & χ2 test) Results : For group A (Swenson procedure) the operative time was significantly lesser (unpaired ‘t' test : P < 0.01) than for the group B (Soave-Boley procedure). First bowel movement after colostomy closure was also significantly lesser in duration in Swenson procedure (χ2  test :P < 0.05). DOI = 10.3329/jom.v9i1.1420 J MEDICINE 2008; 9 : 16-19 Â

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