Surgery in the Neonatal Intensive Care Unit in Indian Scenario: Should It be "The New State of the Art" or Just "The Need of the Hour"?

Introduction: Critically ill surgical neonates are physiologically challenged and delicately poised on ventilator and inotropic support systems. They experience significant stress in the event of surgery. Shifting them poise further addition to this stress.

Neonatal Gastric Perforation: Our Experience and Important Preoperative and Intraoperative Caveats to Prognosticate and Improve Survival.

Aim: Neonatal gastric perforation (NGP) is a rare, perplexing, life-threatening entity affecting neonates. We share our experience of operating upon cases of NGP s and highlight important points observed which may aid in further improving care of neonates, diagnosed with this entity.

Materials And Methods: A retrospective analysis of all consecutive patients with NGP operated by the author, at various centers between January 2015 and December 2018, was carried out.

Intussusception in children aged under two years in India: Retrospective surveillance at nineteen tertiary care hospitals.

Objective: Intussusception has been linked with rotavirus vaccine (RVV) as a rare adverse reaction. In view of limited background data on intussusception in India and in preparation for RVV introduction, a surveillance network was established to document the epidemiology of intussusception cases in Indian children.

Methods: Intussusception in children 2-23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016).

Mesonephric Remnant (Paroophoron) Presenting as a Congenital Lumbar Sinus in a Child.

Presence of symptomatic mesonephric duct remnants is rare in pediatric age group. These can be present in dormant physiological or symptomatic pathological states. Pathologies can vary from benign cysts to malignant tumors.

A Case of Occipital Rudimentary Cephalocoele.

We report a case of a 1-month-old boy with a cystic swelling in the occipital region without intracranial communication, called atretic cephalocoele. We discuss clues to the diagnosis of atretic cephalocoeles. We also discuss common clinical findings and a possible mechanism by which these lesions develop.

Scrotal Migration of Tubing: An Unusual Complication after Ventriculo-peritoneal Shunt.

Scrotal migration of peritoneal end of ventriculo-peritoneal (VP) shunt into the patent processus vaginalis (PPV) is a rare complication. Its exact incidence is not mentioned in the literature till date. This may be because of the rarity of this complication, and also because all previous articles related to the complication were case reports.

Early Thoracoscopic Plication of Diaphragm in a Newborn with Brachial Plexus Palsy and Concurrent Phrenic Nerve Palsy.

Phrenic nerve palsy is a rare cause of respiratory distress in a newborn. When conservative measures fail to achieve adequate ventilation, then early surgical plication has been found to be associated with good outcome. We report a case of neonate with phrenic nerve palsy in whom an early thoracoscopic diaphragmatic plication was done.

Role of feeding jejunostomy in major anastomotic disruptions in esophageal atresia: A pilot study.

Aims: To investigate the role of feeding jejunostomy (FJ) in patients of esophageal atresia with anastomotic leak (AL) to decrease the degree of gastroesophageal reflux (GER) and its effect on anastomotic healing.

Materials And Methods: Twenty neonates, with major AL and severe GER after primary repair were managed with decompressing gastrostomy and transgastric FJ and analyzed prospectively.

Results: Male to female ratio was 1.

Concealed Epispadias: Report of Two Cases and Review of Literature.

Objective: To present an overview of the clinical presentation and pathological anatomy of epispadias with intact prepuce--a rare condition that has only occasionally been reported in literature.

Materials And Methods: We present two cases of concealed epispadias. We also review the available literature with regard to this rare condition.

Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female.

We report a rare case of uterovaginal duplication in a prepubertal female. The patient also had a permeable ureter (ureter with urine passing through it) subtending a poorly functioning kidney with ectopic insertion in the obstructed hemivagina.

Hepatic duct confluence injury in blunt abdominal trauma - a diagnostic dilemma.

Isolated hepatic duct confluence injury due to trauma is unusual. Two cases of isolated bile duct injury are presented, which were diagnosed and managed successfully at our institution.

The role of preoperative CT scan in patients with tracheoesophageal fistula: a review.

Purpose: The morbidity and mortality associated with esophageal atresia with or without a fistula make it a challenging congenital abnormality for the pediatric surgeon. Anatomic factors like inter-pouch gap and origin of fistula are not taken into consideration in various prognostic classifications. The preoperative evaluation of these cases with computerized tomography (CT) has been used by various investigators to delineate these factors.

Traumatic renal artery occlusion in the pediatric age group: a case and review of the literature.

Blunt trauma represents a major cause of death in children. The incidence of renal arterial injuries in these cases is less than 1%. Traumatic renal artery occlusion is a rare occurrence in the pediatric age group.

A rare case of isolated Cushing syndrome in a 3-month-old boy.

Adrenocortical carcinoma (ACC) is a rare malignancy in children. Most of these are endocrinologically active tumors, with virilizing features being typically dominant. Its presentation with isolated Cushing syndrome is rare.

Vesicoureteral reflux: Endoscopic therapy and impact on health related quality of life.

Aim: To evaluate the health related quality of life (HRQOL) after endoscopic injection treatment for vesico ureteral reflux (VUR) in children.

Materials And Methods: Fifty four children received treatment and were prospectively evaluated for their quality of life scores, according to resolution of reflux on cystograms and status of renal scars.

Results: Of the 81 refluxing units, 72 (89%) had resolution of reflux whereas 9 (11%) did not resolve.

Duplicated gall bladder with duodenal duplication cyst.

A four year old boy with a duplicated gall bladder communicating with a duplication cyst of the duodenum is reported for the first time in the literature. It is also reported for the absence of any connection with the biliary system.

An unusual variant of urethral duplication: an addition to the Effman classification.

A rare association of horseshoe kidney with pyelic fusion with crossed single ureter along with a rare unusual variant of complete urethral duplication is described. We review the available literature on this rare association and present its management.

Isolated cystic cervical oesophageal duplication: a rare congenital anomaly.

Oesophageal duplication is a rare congenital anomaly. The cystic form is the usual presentation of the duplication, found predominantly in the lower third. Less than 20 cases of isolated cystic oesophageal duplication in the cervical region have been reported till date in the English literature.

Extra vestibular schwannoma: a two year experience.

We present series of head, neck extracranial non-vestibular schwannomas treated during 2-year period. All patients with head and neck schwannomas treated at our department from April 2007 to July 2009 were reviewed. There was female predominance (72%).

Rare association in a female DSD case of phallus, accessory phallic urethra, perineal lipoma and anterior ectopic anus.

Disorders of sex differentiation (DSD) are a heterogeneous and broad spectrum group of diseases with a varied appearance. Presence of an accessory phallus with a phallic urethra in association with a normal vagina in a female is an extremely uncommon anomaly. We present a rare case of a genotypically female child with a normal urethra and vagina in association with a phallus, accessory phallic urethra, perineal lipoma and anterior ectopic anus.

Undiagnosed ureteroinguinal hernia with solitary kidney in a child with ureteric injury during herniotomy.

Iatrogenic ureteric injuries are an uncommon but difficult problem to manage. Although ureteric injury has been reported during hernia surgery in adults, it has not been reported in children during herniotomy. An 18-month-old male child underwent repair of an inguinal hernia and developed postoperative anuria.