Virilising Adrenal Adenoma in Children.

Tumours of the adrenal cortex are most commonly seen in adults but rare in children. The clinical manifestations depend on the age and sex of patients; about two-thirds of the cases virilisation is the predominant presentation, whereas many presents with both virilisation and cushingoid features. Diagnosis is confirmed by hormonal evaluation and radiological investigations.

Comparison of ultrasound-guided sacral erector spinae plane block and caudal epidural block for analgesia in paediatric patients undergoing hypospadias repair: A double-blind, randomised controlled trial.

Background And Aims: Caudal block is more frequently used in children for postoperative analgesia. However, its disadvantage is its short duration. Erector spinae plane block (ESPB) at the sacral level can potentially block the pudendal nerve.

Evaluation of USG-guided novel sacral erector spinae block for postoperative analgesia in pediatric patients undergoing hypospadias repair: A randomized controlled trial.

Background And Aims: Erector spinae plane block (ESPB) has been found to be simple, safe, and effective at thoracic and lumbar levels. There is no randomized controlled trial evaluating its effectiveness at sacral level. The present study was conducted to evaluate its effectiveness at sacral level for postoperative analgesia in pediatric patients undergoing hypospadias repair.

Evaluation of perfusion index as a predictor of successful caudal block in pediatric patients: A prospective randomized study.

Background And Aims: Caudal block is among the most widely administered regional anesthesia in pediatric patients. The clinical signs and objective assessments are not fast and reliable enough to provide a good feedback. Perfusion index (PI) is considered as a sensitive marker to assess the efficacy of caudal block.

Surgical neonates with coronavirus infectious disease-19 infection: An experience with five cases at high-volume tertiary care centre of India.

Coronavirus infectious disease-19 (COVID-19) has caused serious threat to global health. With progression of time, more and more cases are being reported in paediatric age group. Management of COVID-19-positive neonates with surgical condition is challenging as apart from medical management of COVID-19-induced morbidities, they also require surgical intervention.

Tubercular liver abscess rupturing into the pleural cavity: a rare complication.

Liver abscesses, either pyogenic or amoebic, with or without the involvement of the pleura, are not infrequently encountered in children. Isolated tubercular liver abscess without active pulmonary, gastrointestinal or other clinical evidence of tuberculosis is, however, rare and more so its rupture into the pleura. We report a case of a 14-year-old girl who presented with a liver abscess rupturing into the pleura causing an empyema.

The role of tunica vaginalis flap in staged repair of hypospadias.

Objective: The surgical repair of hypospadias is done in two stages in a select group of patients with severe anomaly. The first stage (I) procedure consists of correction of penile shaft curvature and second stage (II) repair involves the creation of a neourethra. This neourethra needs a cover of an intermediate layer in order to have good functional and cosmetic results.

Vitellointestinal Duct Anomalies in Infancy.

Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5-9 of intrauterine life.

Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013.

Results: Male to female ratio (M:F) was 4.

Congenital Pyloric Atresia with Distal Duodenal Atresia- Role of CT Scan.

The mainstay of diagnosis of congenital pyloric atresia is by plain X-ray of the abdomen showing a large gas bubble with no gas distally. But very rarely it can be associated with distal duodenal atresia when the baby may present as lump abdomen. In such a situation apart from the X-ray, another radiological investigation is needed to delineate the exact nature of the lump.

Congenital spigelian hernia and cryptorchidism: another case of new syndrome.

Spigelian hernia (SH) is rarely seen in pediatric age group and is usually associated with cryptorchidism on the same side; termed as a syndromic association of the defect in the Spigelian fascia and absence of gubernaculum and inguinal canal. The absence of the inguinal canal has surgical implication as to placement of the undescended testis into the scrotum. A 3-month-old baby presented with spigelian hernia and ipsilateral impalpable testis.

Idiopathic unilateral lower limb gangrene in a neonate.

We are reporting a very unusual case of unilateral lower limb gangrene in 12 days neonate, who was brought to us with bluish discoloration of left foot with gangrene of toes. A negative sepsis screen, normal Doppler study, normal magnetic resonance angiography and absence of evidence of hypercoagulable state prompted us to make the diagnosis of idiopathic unilateral lower limb gangrene in this newborn. Because of the rarity we are reporting this case with vide review of literature.

Tunica vaginalis: an aid in hypospadias fistula repair: our experience of 14 cases.

Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue.

Congenital diaphragmatic hernia: Misdiagnosis in adolescence.

We report 3 cases of congenital diaphragmatic hernia (CDH) in the second decade of life which were misdiagnosed on initial presentation. The first case had an iatrogenic gastric injury because of intercostal tube drainage for suspected pleural effusion. The second case was treated for pulmonary tuberculosis for 6 months before being diagnosed as a case of CDH.

Splenic abscess in children: a report of three patients.

Splenic abscess is uncommon in paediatric age group. It usually occurs in conditions of disseminated infective focus. Conventional treatment of abscess is incision and drainage, although splenectomy or splenic conservation is alternative.

Primary leiomyosarcoma of broad ligament: case report and review of literature.

Introduction: Primary leiomyosarcoma of the broad ligament (LBL) is a very rare and highly malignant gynecological tumor.

Materials And Methods: A 45 year old hysterectomized woman with this rare tumor is presented. Treatment consisted of resection of the tumor along with omental and peritoneal sampling and adjuvant chemotherapy.

Perforated duodenal ulcer a rare cause of acute abdomen in infancy: a report of two cases.

Duodenal ulcer perforation is very uncommon in infants and children, that is why it is not usually considered in the differential diagnosis of acute abdomen in this age group. Moreover, the diagnosis of this condition is usually overlooked because of vague and variable symptoms and low index of suspicion on the part of the treating physicians. In this brief report, we are reporting two cases of successfully managed perforated duodenal ulcer in infancy.

Caecal volvulus in pregnancy: is delay in diagnosis avoidable?

Intestinal volvulus is not an uncommon cause of obstruction in pregnancy. Diagnosis is often delayed due to poor knowledge of the condition and a hesitation to use abdominal X-rays in a pregnant patient. Here, two cases of caecal volvulus in pregnancy are reported.