http://www.jiaps.com/currentissue.asp Table of Contents:J Indian Assoc Pediatr Surg 2009 - 14(4) Rao K.L.N Editorial Journal of Indian Association of Pediatric Surgeons 2009 14(4):191-1910971-9261 Rao K.L.N

Journal of Indian Association of Pediatric Surgeons 2009 14(4):191-191

]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=191;epage=191;aulast=Rao Raina V K Editorial Journal of Indian Association of Pediatric Surgeons 2009 14(4):192-1930971-9261 Raina V K

Journal of Indian Association of Pediatric Surgeons 2009 14(4):192-193

]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=192;epage=193;aulast=Raina Gazula Suhasini, Pawar D K, Seth T, Bal C S, Bhatnagar V U C Chakrovorty Award Paper Journal of Indian Association of Pediatric Surgeons 2009 14(4):194-1990971-9261 Gazula Suhasini, Pawar D K, Seth T, Bal C S, Bhatnagar V

Journal of Indian Association of Pediatric Surgeons 2009 14(4):194-199

Aim: To objectively demonstrate the gain in blood volume and blood components following early ligation of splenic artery during splenectomy and splenorenal shunts in children with extra hepatic portal venous obstruction (EHPVO). Methods: Twenty-eight children (20 males and 8 females, mean age: 9.9 (±3.2) years) with EHPVO and hypersplenism were recruited. We followed a protocol of systematically locating and ligating the splenic artery first, followed by a 30-minute waiting period to allow the massive spleen to decongest via the splenic vein and venous collaterals and then completing the splenectomy by standard procedure. No intravenous fluid was administered during this 30-minute period. Blood samples were drawn just prior to splenic artery ligation and soon after splenectomy for the estimation of hematological and biochemical parameters. Results: We noticed a highly significant increase in the hemoglobin, hematocrit, leukocyte, platelet, and RBC counts by early ligation of the splenic artery (p < 0.0004). The gain in hemoglobin and hematocrit was equivalent to a transfusion of atleast 100-150 ml of packed RBC. The increase in platelet count was equivalent to a platelet transfusion of atleast 4 units of platelet concentrates in an adult. There is a positive correlation between the splenic weight and the platelet gain (p= 0.0568) and the splenic volume on preoperative imaging and the platelet gain (p= 0.0251). Conclusion: Early ligation of the splenic artery during splenectomy results in passive splenic decongestion and thereby a significant gain in blood components. This protocol appears to be a feasible blood conservation method to avoid blood transfusions in this group of hypersplenic EHPVO patients.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=194;epage=199;aulast=Gazula Sengupta Subhabrata, Pal Ranabir, Saha Somnath, Bera S P, Pal Indranil, Tuli Isha Preet Original Article Journal of Indian Association of Pediatric Surgeons 2009 14(4):200-2030971-9261 Sengupta Subhabrata, Pal Ranabir, Saha Somnath, Bera S P, Pal Indranil, Tuli Isha Preet

Journal of Indian Association of Pediatric Surgeons 2009 14(4):200-203

Aim: To assess the incidence of different head and neck cancers in pediatric age group in a referral hospital. Methods: In this prospective study, children below the age of 12 years underwent a thorough clinical, ENT examination and the diagnosis was conformed histologically in all the cases. Results: Fifty-three were diagnosed to be suffering from different head and neck neoplasms among 21,216 children (0.25%). Male-to-female sex distribution was 1.78:1. The lymphomas were the most common (43.39%) followed by the rhabdomyosarcoma (20.75%) and the nasopharyngeal carcinoma (15.09%). Of the lymphomas, the non-Hodgkin's lymphoma was predominant (26.41%). Other lesions were thyroid carcinomas and mucoepidermoid carcinoma of parotid. Conclusions: Malignancy should always be considered in the differential diagnosis of masses in the head and neck region in children.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=200;epage=203;aulast=Sengupta Gowda Deepak Javare, Agarwal Prakash, Bagdi RajKishore, Subramanian Balagopal, Kumar Manoj, Ramasundaram Madhu, Paramasamy Balamourougane, Khanday Zaffer Saleem Original Article Journal of Indian Association of Pediatric Surgeons 2009 14(4):204-2060971-9261 Gowda Deepak Javare, Agarwal Prakash, Bagdi RajKishore, Subramanian Balagopal, Kumar Manoj, Ramasundaram Madhu, Paramasamy Balamourougane, Khanday Zaffer Saleem

Journal of Indian Association of Pediatric Surgeons 2009 14(4):204-206

Aim: To evaluate the role of laparoscopic cholecystectomy (LC) in the management of cholelithiasis in children. Methods: A retrospective review of our experience with LC for cholelithiasis at our institution, between April 2006 and November 2008, was done. Data included patient demographics, clinical history, hematological investigations, imaging studies, operative technique, postoperative complications, postoperative recovery, and final histopathological diagnosis. Results: During the study period of 32 months, 18 children (8 males and 10 females) with cholelithiasis were treated by LC. The mean age was 9.4 years (range 3-18). Seventeen children had symptoms of biliary tract disease and 1 child had incidentally detected cholelithiasis during an ultrasonography of abdomen for unrelated cause. Only 5 (27.8%) children had definitive etiological risk factors for cholelithiasis and the remaining 13 (75.2%) cases were idiopathic. Sixteen cases had pigmented gallstones and 2 had cholesterol gallstones. All the 18 patients underwent LC, 17 elective, and 1 emergency LC. The mean operative duration was 74.2 min (range 50-180). Postoperative complications occurred in 2 (11.1%) patients. The average duration of hospital stay was 4.1 days (range 3-6). Conclusion: Laparoscopic chloecystectomy is a safe and efficacious treatment for pediatric cholelithiasis. The cause for increased incidence of pediatric gallstones and their natural history needs to be further evaluated.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=204;epage=206;aulast=Gowda Hasan Zaheer, Gangopadhyay A N, Srivastava Punit, Hussain Mohammad Akhtar Original Article Journal of Indian Association of Pediatric Surgeons 2009 14(4):207-2090971-9261 Hasan Zaheer, Gangopadhyay A N, Srivastava Punit, Hussain Mohammad Akhtar

Journal of Indian Association of Pediatric Surgeons 2009 14(4):207-209

Aim: To evaluate the role of end-to-end oblique bowel anastomosis in bowel atresia. Methods: End-to-end oblique anastomosis was done in 25 neonates of bowel atresia and the results were compared with traditional method of end to back anastomosis in 25 cases. Results: We found less mortality and morbidity (5%) in our technique as compared to end to back technique (20%). Conclusions: We recommend this technique, as anastomosis is wide with less angulations, flow of effluent is linear, and there is less force exerted over post-anastomotic side wall.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=207;epage=209;aulast=Hasan Bhandary Karthik S, Kumaran V, Rajamani G, Kannan S, Mohan N Venkatesa, Rangarajan R, Muthulingam V Original Article Journal of Indian Association of Pediatric Surgeons 2009 14(4):210-2140971-9261 Bhandary Karthik S, Kumaran V, Rajamani G, Kannan S, Mohan N Venkatesa, Rangarajan R, Muthulingam V

Journal of Indian Association of Pediatric Surgeons 2009 14(4):210-214

Aim: To assess the modifications in the technique of laparoscopic assisted anorectal pull through (LAARP) practiced at our institute and analyze the post operative outcome and associated complications. Materials and Methods: A retrospective study from January 2001 to May 2009 analyzing LAARP for high anorectal malformations. Results: A total of 40 patients - 34 males and six females, in the age group of two months to six years were studied. Staged procedure was done in 39 patients; one child with recto vestibular fistula underwent single stage procedure. All the patients withstood surgery well. One patient required conversion due to problems in gaining enough length for the distal rectum in a patient with rectovesical fistula so colostomy was closed and re-located at a proximal splenic flexure. The complications were mucosal prolapse (six cases), anal stenosis (three), adhesive obstruction (two), distal rectal necrosis (one), and urethral diverticulum (one). The patients were followed up with clinical evaluation and continence scoring. The progress has been satisfactory and weight-gain is adequate. Conclusions: The advantages of the reformed techniques are as follows: Transcutaneous bladder stitch provides excellent visualization; traction over the fistula helps in dissection of the puborectalis, dividing the fistula without ligation is safe, railroading of Hegar's dilators over the suction canula creates adequate pull through channel, saves time and makes procedure simpler with reproducible comparable reports.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=210;epage=214;aulast=Bhandary Einama Takahiro, Okada Tadao, Sasaki Fumiaki, Todo Satoru Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):215-2170971-9261 Einama Takahiro, Okada Tadao, Sasaki Fumiaki, Todo Satoru

Journal of Indian Association of Pediatric Surgeons 2009 14(4):215-217

Chylous ascites (CA) is an extremely rare complication of abdominal surgery in children. This report describes a 4-month-old girl with malignant rhabdoid tumor of the kidney (MRTK), who developed CA after left nephrectomy without lymphadenectomy, and who was successfully treated conservatively with enteral therapy. The literature on CA after nephrectomy without lymphadenectomy for MRTK is reviewed herein, and the clinical problems of postoperative CA are discussed.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=215;epage=217;aulast=Einama Pavai Arunachalam, Pillai Suma D, Shanthakumari S, Sam Cenita J, Shylaja M, Sabarivinoth R Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):218-2200971-9261 Pavai Arunachalam, Pillai Suma D, Shanthakumari S, Sam Cenita J, Shylaja M, Sabarivinoth R

Journal of Indian Association of Pediatric Surgeons 2009 14(4):218-220

Three cases of type IV congenital pouch colon associated with low anorectal anomaly are reported here. Pouch colon may be a cause of intractable constipation in children operated for low anorectal anomaly. Excellent results can be obtained by exicision of the pouch. The radiological and pathological features of this condition are discussed.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=218;epage=220;aulast=Pavai Qureshi Umar Amin, Ahmad Nisar, Rasool Akhter, Choh Suhail Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):221-2230971-9261 Qureshi Umar Amin, Ahmad Nisar, Rasool Akhter, Choh Suhail

Journal of Indian Association of Pediatric Surgeons 2009 14(4):221-223

Clinical manifestations of adrenal hemorrhage vary depending on the degree and rate of hemorrhage, as well as the amount of adrenal cortex compromised by hemorrhage. We report here a case of neonatal adrenal hemorrhage that presented with late onset neonatal jaundice. The cause of adrenal hemorrhage was birth asphyxia.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=221;epage=223;aulast=Qureshi Hombalkar N N, Dhanawade Sara, Hombalkar Priya, Vaze Dhananjay Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):224-2250971-9261 Hombalkar N N, Dhanawade Sara, Hombalkar Priya, Vaze Dhananjay

Journal of Indian Association of Pediatric Surgeons 2009 14(4):224-225

The diagnostic feature of esophageal atresia (EA) is the inability to pass a catheter into the stomach. EA can be ruled out if the feeding tube can be passed into the stomach. In EA, when a tracheo-esophageal fistula (TEF) is present, theoretically the feeding tube can find its way into the stomach via tracheal route and through the TEF. We report such a rare occurrence. In this situation, the diagnosis and further management of EA and TEF was delayed.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=224;epage=225;aulast=Hombalkar Bhat Nisar Ahmad Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):226-2270971-9261 Bhat Nisar Ahmad

Journal of Indian Association of Pediatric Surgeons 2009 14(4):226-227

We report an unusual case of duodenal diaphragm (DD) with "wind-sock" anomaly in a 6-year-old male. The child presented with an acute duodenal obstruction precipitated by multiple pigmented stones completely blocking the duodenum.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=226;epage=227;aulast=Bhat Ramachandra Mukunda, Bendre Pradnya S, Redkar Rajeev G, Taide Devendra V Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):228-2290971-9261 Ramachandra Mukunda, Bendre Pradnya S, Redkar Rajeev G, Taide Devendra V

Journal of Indian Association of Pediatric Surgeons 2009 14(4):228-229

Complete excision of a prostatic utricle through posterior sagittal rectum retracting approach is reported in an infant.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=228;epage=229;aulast=Ramachandra Jain Vishal K, Singh Sangram, Garge Saurabh, Negi Anupama Case Report Journal of Indian Association of Pediatric Surgeons 2009 14(4):230-2310971-9261 Jain Vishal K, Singh Sangram, Garge Saurabh, Negi Anupama

Journal of Indian Association of Pediatric Surgeons 2009 14(4):230-231

Congenital lymphoedema is a rare disorder that may result in disfiguring edema of the male genitalia. The treatment of persistent lymphoedema is surgical and consists of meticulous excision of all subcutaneous layers of the affected skin, combined with reconstruction of the penis and or scrotum.]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=230;epage=231;aulast=Jain Pandey A, Gangopadhyay A N, Sharma S P, Kumar V Letter To Editor Journal of Indian Association of Pediatric Surgeons 2009 14(4):232-2320971-9261 Pandey A, Gangopadhyay A N, Sharma S P, Kumar V

Journal of Indian Association of Pediatric Surgeons 2009 14(4):232-232

]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=232;epage=232;aulast=Pandey Wiwanitkit Viroj Letter To Editor Journal of Indian Association of Pediatric Surgeons 2009 14(4):232-2330971-9261 Wiwanitkit Viroj

Journal of Indian Association of Pediatric Surgeons 2009 14(4):232-233

]]> http://www.jiaps.com/article.asp?issn=0971-9261;year=2009;volume=14;issue=4;spage=232;epage=233;aulast=Wiwanitkit Parikh Mitul, Samujh Ram, Kanojia Ravi Prakash, Rao K.L.N Letter To Editor Journal of Indian Association of Pediatric Surgeons 2009 14(4):233-2330971-9261 Parikh Mitul, Samujh Ram, Kanojia Ravi Prakash, Rao K.L.N

Journal of Indian Association of Pediatric Surgeons 2009 14(4):233-233

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