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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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  Citation statistics : Table of Contents
   2011| October-December  | Volume 16 | Issue 4  
    Online since October 31, 2011

 
 
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CASE REPORTS
Amyand's hernia
Kulwant Singh, Rana Ranjit Singh, Sundeep Kaur
October-December 2011, 16(4):171-172
DOI:10.4103/0971-9261.86890  PMID:22121323
We report two children with Amyand's hernia, where the appendices along with caecum were found within the left hernial sac, which were operated for obstructed inguinal hernia.
  5 2,037 139
Recurrent malignant juxtaglomerular cell tumor: A rare cause of malignant hypertension in a child
Altaf H Shera, Aejaz A Baba, Iftikhar H Bakshi, Iqbal A Lone
October-December 2011, 16(4):152-154
DOI:10.4103/0971-9261.86876  PMID:22121315
A juxtaglomerular cell tumor or reninoma is a very rare renin-secreting tumor of the kidney and can be an unusual cause of secondary hypertension. We report a case of recurrence of this uncommon tumor at the hilum of left kidney in an 8-year-old male child.
  4 2,636 102
Intraperitoneal leech: A rare complication of leech bite
Manoj Saha, Sedengulie Nagi
October-December 2011, 16(4):155-157
DOI:10.4103/0971-9261.86877  PMID:22121316
An intraperitoneal leech, which entered through vagina and uterus in a 2-year-old girl is reported. The child presented with intraperitoneal hemorrhage and shock. A leech inside the peritoneal cavity has never been reported in the literature.
  4 16,491 145
ORIGINAL ARTICLES
Interventional sialendoscopy for treatment of juvenile recurrent parotitis
Celeste Gary, Evelyn A Kluka, Barry Schaitkin, Rohan R Walvekar
October-December 2011, 16(4):132-136
DOI:10.4103/0971-9261.86865  PMID:22121310
Objective: To evaluate our preliminary experience with interventional sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis (JRP). Materials and Methods: Three consecutive pediatric patients with JRP who underwent interventional sialendoscopy were identified. Interventional sialendoscopy consisted of serial dilation of the Stenson's duct, endoscopy of the ductal system and saline irrigation followed by instillation of triamcinolone acetate. Clinical, demographic, procedure-related data and complications were documented. End points of the study were technical success, defined as completion of the procedure, subjective improvement in symptoms as indicated by the patients or their parents and assessment of safety in terms of complications. Results: Three male patients with a mean age of 9 years (range 6-11 years) underwent interventional sialendoscopy for JRP. Endoscopic findings included a blanched stenotic duct with intraductal debris in those who were symptomatic. Technical success was 100%. The mean number of episodes of JRP in the year prior to presenting to our service among the three patients was 5 (range 4-6 per year). There were no new episodes of JRP reported at the last follow-up. There were no major complications. Conclusion: Our preliminary experience concurs with the current literature and suggests that interventional sialendoscopy is effective for the management of JRP and can be considered for patients who fail conservative medical management.
  3 3,292 130
CASE REPORTS
Congenital pouch colon with ileovesical and colovesical fistulae: A new variant
Bilal Mirza, Lubna Ijaz, Maham Zaman, Afzal Sheikh
October-December 2011, 16(4):167-168
DOI:10.4103/0971-9261.86885  PMID:22121321
We report a case of persistent cloaca and type I congenital pouch colon associated with ileovesical and colovesical fistulae. Such a malformation has not been reported so far.
  2 2,131 104
Accessory scrotum in the perineum
Pananghat A Kumar, Pavai Arunachalam, Prasanna N Kumar
October-December 2011, 16(4):169-170
DOI:10.4103/0971-9261.86887  PMID:22121322
A case of accessory scrotum in a 2-day-old male infant is reported because of its rarity. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypotheses regarding etiology of accessory scrotum.
  2 3,737 101
Animal bite of penis in a neonate and macroscopic repair
Pankaj Haldar, Partha P Mukherjee, Tapan J Ghosh, Ram M Shukla, Biswanath Mukhopadhyay
October-December 2011, 16(4):163-164
DOI:10.4103/0971-9261.86882  PMID:22121319
We are reporting a newborn male who had injury of the penis probably due to rat bite. The baby was brought to the hospital within 3 h of the injury. The urethra was completely transected. Macroscopic repair was performed. The patient had an uneventful recovery and was discharged after 2 weeks. The patient is doing well 3 months after the operation.
  2 5,515 117
LETTERS TO THE EDITOR
Role of propranolol in hemangiomas
Vishal Gajbhiye, Sasanka Nath, Souvik Chatterjee, Avidip De, Dipak Ghosh, Sukanta Kumar Das
October-December 2011, 16(4):173-174
DOI:10.4103/0971-9261.86892  PMID:22121324
  2 1,902 157
CASE REPORTS
Acute gastric volvulus: Late-onset ischemic consequences and their management
Kshama Vasudev Kulkarni, Sudipta Sen, Sampath Karl, VR Ravikumar
October-December 2011, 16(4):148-151
DOI:10.4103/0971-9261.86875  PMID:22121314
We report three infants who presented with acute gastric volvulus and recovered initially after de-torsion, but later presented with sequelae due to ischemia of gastroesophageal junction, stomach and gastroduodenal junction. The first two infants could not be fed orally or by gastrostomy tube because of microgastria and stricture of the lower esophagus and gastroduodenal junction, and were managed on jejunostomy feeds, while the third child was managed on gastrostomy feeds till the gastric substitution surgery. The first case was treated nonsurgically with repeated dilatations, but ultimately succumbed to sepsis and malnutrition. In the second child, attempted dilatation resulted in esophageal perforation and she was reconstructed using ileocecal segment as a substitute for stomach and lower esophagus, and has done well. The third child was managed surgically by the Hunt Lawrence J pouch as stomach substitute and has also done well.
  1 3,794 122
Primary pigmented nodular adrenocortical disease
Marie T Manipadam, Rachel Abraham, Sudipta Sen, Anna Simon
October-December 2011, 16(4):160-162
DOI:10.4103/0971-9261.86881  PMID:22121318
Primary pigmented nodular adrenocortical disease (PPNAD) is a rare cause of ACTH-independent Cushing's syndrome and has characteristic gross and microscopic pathologic findings. We report a case of PPNAD in a 15-year-old boy, which was not associated with Carney's complex. Bilateral adrenalectomy is the treatment of choice.
  1 1,898 87
Proximal hypospadias with skin-covered shaft of penis and absent urethral plate: An unknown variant and its management
Kumar A Rashid, Nisar A Bhat
October-December 2011, 16(4):165-166
DOI:10.4103/0971-9261.86884  PMID:22121320
We report a case of proximal hypospadias with an absent urethral plate having intact ventral shaft skin with hooded dorsal prepuce and a good glans groove. Such a variant of hypospadias has not been reported in the literature.
  - 7,009 119
Hypospadias with dorsal chordee: Case report of a novel approach for correction
Shivaji B Mane, Jamir D Arlikar, Suyodhan Reddy, Nitin P Dhende
October-December 2011, 16(4):158-159
DOI:10.4103/0971-9261.86878  PMID:22121317
We report a novel surgical technique for correction of dorsal chordee with coronal hypospadias. The bulbar elongation and anastomotic meatoplasty procedure gave an excellent cosmetic and functional outcome.
  - 4,758 134
EDITORIAL
Presidential Address at 37 th Annual Conference of the Indian Association of Paediatric Surgeons, Chennai, October 2011; The future - Are we ready?
Ashley L.J D'Cruz
October-December 2011, 16(4):123-125
DOI:10.4103/0971-9261.86862  PMID:22121307
  - 1,692 93
LETTERS TO THE EDITOR
Ingested foreign body lodged in the appendix
Vipul D Yagnik
October-December 2011, 16(4):174-174
DOI:10.4103/0971-9261.86895  PMID:22121325
  - 1,198 65
ORIGINAL ARTICLES
Neonatal posterior sagittal anorectoplasty for a subset of males with high anorectal malformations
Nilesh G Nagdeve, Pravin D Bhingare, Harish R Naik
October-December 2011, 16(4):126-128
DOI:10.4103/0971-9261.86863  PMID:22121308
Aim: To assess the results of primary posterior sagittal anorectoplasty (PSARP) in male neonates with high anorectal malformations (ARM) who on invertogram showed well descended rectum. Materials and Methods: Twelve full-term male neonates with high ARM over a period of one and half years were selected for primary PSARP based on the findings of invertogram. Primary PSARP was performed in all neonates with lower limit of rectal gas bubble at or below the ossified fifth sacral vertebra. The patients were followed-up for a period between three to four and half years. The clinical evaluation of fecal continence was performed using Pena's criteria for assessment of continence. Results: All neonates underwent PSARP on second to fourth postnatal day. The fistula with urinary tract was found in 11 patients (seven had fistula to bulbar urethra and four to prostatic urethra). Rectal tapering was not required in any neonate. No patient had urinary problems after removal of catheter. Most of the neonates were discharged by ninth day. Postoperatively, two patients had superficial wound infection of anoplasty without any disruption or bowel retraction. Two patients had severe perianal excoriation. No patient had anorectal stenosis. Nine of twelve patients on follow-up had good voluntary bowel movements. Of the three patients who had grade I soiling two had recto-prostatic urethral fistula. No patient had constipation. All patients had good urinary stream. Conclusions: Repair of high ARM in male neonates with a well descended rectum is feasible without significant morbidity and good continence.
  - 2,305 250
Intravesical pressure: A new prognostic indicator in congenital diaphragmatic hernia
Mohan K Abraham, Naveen Viswanath, P Ramakrishnan, S Bindu, P Kedari, Aisha Naaz, Lukman O Abdur Rahman, Abdulrasheed A Nasir, Sharon Mohan, R Shivji, P Sasidharan
October-December 2011, 16(4):129-131
DOI:10.4103/0971-9261.86864  PMID:22121309
Aims: To evaluate the usefulness of intravesical pressure as a prognostic indicator in congenital diaphragmatic hernia. Material and Methods: In 25 cases, bladder pressure was measured intraoperatively during repair. Results: Cases were divided into three groups according to the intravesical pressure. Group 1: pressure <10 cm (n.9), Group 2: 10-15 cm (n.11) and Group 3: >15 cm (n.5). Number of ventilated days was tabulated against these groups. Median number of ventilated days for Group 1, with the lowest pressure, was 3 days, while that for Group 2 was 5 and for Group 3, with the highest pressure, was 10 days. This was significant, with a P-value of 0.016. Conclusion: Measurement of intravesical pressure is a reliable prognostic indicator in newborns with congenital diaphragmatic hernia. It also helps in predicting postoperative ventilatory requirement.
  - 2,036 171
Nissen fundoplication for gastroesophageal reflux: No deterioration of gastric emptying measured by 13C-acetate breath test
Tadao Okada, Shohei Honda, Hisayuki Miyagi, Masashi Minato
October-December 2011, 16(4):137-141
DOI:10.4103/0971-9261.86866  PMID:22121311
Aim: To study the gastric emptying 30 days after laparoscopic Nissen fundoplication (NF) in gastroesophageal reflux. Materials and Methods: Three patients were evaluated with 13 C-acetate breath test (ABT) performed pre and post-NF. The liquid test meal consisted of Racol TM mixed with 13 C-acetate. Results: In the patient without neurological impairment (NI), the preoperative t 1/2 ex and t lag were 0.900 and 0.510 hours, respectively. The postoperative t 1/2 ex and t lag were 0.959 and 0.586 hours, respectively. In one patient with NI, the preoperative t 1/2 ex and t lag were 1.828 and 1.092 hours, respectively. The postoperative t 1/2 ex and t lag were 2.081 and 1.025 hours, respectively. In the other patient with NI, the preoperative t 1/2 ex and t lag were 2.110 and 0.980 hours, respectively. The postoperative t 1/2 ex and t lag were 1.118 and 0.415 hours, respectively. Conclusions: Our findings suggest that 13 C-ABT parameters did not worsen in any of the children after laparoscopic NF.
  - 1,746 90
Scrotal fixation in the management of low undescended testes
Paul A Sutton, Owen J Greene, Louise Adamson, Shailinder Jit Singh
October-December 2011, 16(4):142-144
DOI:10.4103/0971-9261.86871  PMID:22121312
Aims: Scrotal fixation (SF) is a known technique for the management of low undescended testes (UDT). SF assumes that most low UDT have no patent processus vaginalis (PPV) and can be managed via scrotal mobilization alone. We report our experience of the role of SF in the management of low UDT. Materials and Methods: A retrospective review of all palpable UDT operated on by the senior author between 1998 and 2008 was undertaken. Children diagnosed with palpable UDT were examined under general anesthesia; if the whole testis could be manipulated into the upper part of the scrotum, low UDT was assumed and SF was performed. Attempts to identify a PPV intraoperatively were made in all and, if found, the procedure was converted to standard inguinal incision orchidopexy. Results: One hundred and thirteen children with 134 UDT were identified. SF was performed in 55 testes; inguinal orchidopexy (IO) in 75 and four testes were excised. The median (IQR) age at SF was 5.5 [4.7-6.3] years. Three SF were converted to an IO when a PPV was discovered. The complications in SF were scrotal hematoma (n = 1) and superficial wound infection (n = 1). No post-operative herniae or atrophied testis were seen and none required a redo operation. The mean (SD) operative times for SF and IO were 29.5 (18.1) and 42.7 (16.6) min, respectively (P = 0.04). Conclusion: In our study, 52 of 55 (94.5%) patients with low UDT lacked a hernial sac and were successfully fixed by SF. SF is a viable, simple, quick and safe alternative to IO in the management of low UDT.
  - 1,899 179
Immediate complications of percutaneous central venous cannulation in children
Geetika Dheer, Gurmeet Kaur Chaudhry, Tejinder Singh
October-December 2011, 16(4):145-147
DOI:10.4103/0971-9261.86873  PMID:22121313
Objective: To study the incidence of immediate complications associated with percutaneous central venous catheterization. Materials and Methods: A total of 103 central venous catheters were inserted in 70 children over a period of 18 months, governed by a uniform protocol. Sixty-three percent of the catheters were inserted in neonates, 23.3% in infants and 13.6% in children between 1 and 12 years of age. Statistical Analysis Used: Software SPSS version 15. Results: There were a total of 41 insertion-related immediate complications, of which 75.6% were in neonates. Neonatal age, hemodynamic instability and more number of attempts to catheterize the vein had a higher risk of insertion-related problems. There was no mortality directly as a result of the procedure. Conclusion: In our practice, it was observed that complications were fewer with increasing familiarity with the procedure. Hence, percutaneous central venous catheterization is a safe procedure when performed in experienced hands.
  - 1,901 125
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