Distal foregut atresias in consecutive siblings and twins in the same family.

The distal foregut comprises the antrum of the stomach and supra-ampullary region of the duodenum. In this part of the gut, intraluminal mucosal diaphragms, webs, membranes (type I), and rarely solid cord (type II) atresias are occasionally seen in clinical practice. Due to increased awareness, the number of reported cases has increased in recent years.

Multiple gastrointestinal atresias in two consecutive siblings.

Two consecutive female siblings with multiple gastrointestinal atresias are described. The history of consanguinity in the parents and the presence of extensive typical pathological lesions suggest a genetically-induced developmental fault in the alimentary tract during the early embryonic period.

Atresias of the gastrointestinal tract in an inbred, previously unstudied population.

Retrospective analysis of the records of newborns with gastrointestinal (GI) atresias in a 16-year period revealed that more than 25% of patients had genetically-influenced atresias. Among these, an appreciable increase was observed in atresias confined to the antral region and in a syndrome of hereditary multiple GI atresias. In the absence of environmental and teratogenic factors, this increase could be due to the traditional social practice of endogamy in this population.

Concordant expression of Hirschsprung's disease in monozygous twins.

A monozygous pair of twins with long segment Hirschsprung's disease born to non consanguineous parents is presented. Mother's history was uneventful. In the absence of prenatal and postnatal illness, the concordant lesions in this pair could be attributed to genetic factors.

Junctional epidermolysis bullosa lethalis with pyloric and anorectal obstruction.

The authors present a case of epidermolysis bullosa lethalis (EBL) associated with a double obstruction, one at the pyloric and the other in the anorectal region. Both obstructions could be due to separation of the rectal mucosa during intrauterine life followed by adhesive closure of its wall. Both the gastrointestinal lesions could be part of the generalized denudation process involved in EBL.

Outcome of minimal surgery for hydatid cysts of the liver in children with reference to post-operative biliary leakage.

Analysis of 30 children with hydatid cysts of the liver who were treated by partial pericystectomy and external tube drainage showed that five (21%) of 24 cases in whom clear hydatid fluid was observed during surgery developed biliary leakage. The cysts in the remaining six contained bile-stained fluid, indicating the presence of cystobiliary communications, and five of these children continued to drain bile post-operatively, in spite of appropriate precautions taken during surgery. Histological examination of the pericyst wall confirmed the presence of openings of small bile ducts in the cyst which probably caused the biliary leak.

Surgical and pathological basis for interval appendicectomy after resolution of appendicular mass in children.

Background/purpose: The role of appendicectomy after the resolution of appendicular mass is debatable. A study was conducted to evaluate whether surgical and pathological features of the excised appendices favor the operation in the quiescent period.

Methods: During a 60-month period, 59 patients were admitted in our unit with a diagnosis of appendicular mass and were treated initially with conservative management.

Familial occurrence of congenital incomplete prepyloric mucosal diaphragm.

Incomplete prepyloric mucosal diaphragm (IPMD) is an uncommon congenital anomaly that leads to gastric outlet obstruction in infancy and childhood. This report describes the occurrence of IPMD in six children in a closely knit tribal family from a geographically isolated desert town with a small population in the Sahara. Their records showed similarities of clinical, radiological, operative, and histopathological features.

Early versus delayed repair of reduced incarcerated inguinal hernias in the pediatric population.

This study concerns 183 pediatric patients (age range, 14 days to 10 years) who initially presented with incarcerated inguinal hernias. In all of them, initial conservative management to reduce the hernia was successful. This consisted of elevation of the lower half of body and sedation and/or gentle manual pressure.

Prospective randomized controlled study of excision versus distal splitting of hernial sac and processus vaginalis in the repair of inguinal hernias and communicating hydroceles.

A total of 798 pediatric patients between the ages of 16 days and 10 years underwent a randomized trial of two surgical procedures to assess the superiority of one over the other. In the first group of 231 patients, 236 hernial sacs (HS)/processus vaginalis (PV) were excised completely after transfixation and transection of the sac at the internal ring, whereas in the second group of 567 patients, 595 residual HS/PV were not excised but split longitudinally. The results showed that there was no significant difference in the two groups as far as complications were concerned.

Limitations of surgery in intraabdominal Burkitt's lymphoma in children.

The role of surgery in intraabdominal Burkitt's lymphoma is a controversial subject, and different views are expressed. In the authors' institution, 41 children (30 boys and 11 girls) have been treated who had intraabdominal Burkitt's lymphoma. A study was undertaken to assess the limitations of surgery in the treatment of intraabdominal Burkitt's lymphoma.

Duodenal atresia: its occurrence in siblings.

The authors describe a case of duodenal atresia occurring in two siblings. It is possible that the third sibling also died after complications of the same malformation. This familial occurrence may support the hypothesis that this anomaly is determined by an autosomal-recessive gene.

Management of appendicular mass in children.

Of 66 children under 12 years of age treated for appendicular mass, seven underwent immediate surgery, and two of them developed post-operative wound infection. The remaining 59 children had conservative management which consisted of bedside observation of vital and abdominal signs, intravenous fluids and triple antibiotic therapy with ampicillin, gentamicin and metronidazole. The majority of the children responded well to this method, and in 54 (91.

An effective and safe surgical method for the treatment of hydatid cysts of the liver in children.

Between June 1986 and May 1989 35 children (18 boys and 17 girls) below the age of 12 years were surgically treated for hydatid cysts of the liver. Of the children 24 (68.5%) had a single cyst situated in either of the lobes of the liver, while the remaining 11 (31.

Hospital observation for right lower quadrant abdominal pain with questionable acute appendicitis in children.

920 children below the age of 12 years were admitted with complaints of pain in the right lower abdomen and a suspected diagnosis of acute appendicitis. In 720 patients, clinical diagnosis was made and immediate operation was performed. In 644 of them (89.

Conservative surgery for hydatid cysts of liver in children.

Thirty patients below the age of 12 years were surgically treated for hydatid cysts of the liver. Twenty-two (73.3%) had a single cyst located in either hepatic lobe and eight (26.

Granulomatous peritonitis due to Ascaris lumbricoides.

A child with granulomatous peritonitis caused by ascariasis is described. Laparotomy revealed no obvious evidence of intestinal perforation. It is postulated that a worm escaped through the appendicular tip, causing transient peritonitis followed by adhesions and granulomatas in the peritoneal cavity.

Duodenal ulcer in South Indian children.

Twenty-nine children with duodenal ulcer received treatment during an 18 year period. Twenty-five were followed over a period that ranged from 3 to 18 years; 53.8 percent of the patients who received medical treatment either had recurrence or persistence of ulcer symptoms during adolescence or adulthood.