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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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   2009| October-December  | Volume 14 | Issue 4  
    Online since February 4, 2010

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Saxophone penis due to primary lymphoedema
Vishal K Jain, Sangram Singh, Saurabh Garge, Anupama Negi
October-December 2009, 14(4):230-231
DOI:10.4103/0971-9261.59611  PMID:20419030
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.
  5,927 203 3
Spectrum of head and neck cancer in children
Subhabrata Sengupta, Ranabir Pal, Somnath Saha, SP Bera, Indranil Pal, Isha Preet Tuli
October-December 2009, 14(4):200-203
DOI:10.4103/0971-9261.59601  PMID:20419020
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.
  5,465 310 9
Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice
Umar Amin Qureshi, Nisar Ahmad, Akhter Rasool, Suhail Choh
October-December 2009, 14(4):221-223
DOI:10.4103/0971-9261.59607  PMID:20419026
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.
  5,402 203 3
Laparoscopic cholecystectomy for cholelithiasis in children
Deepak Javare Gowda, Prakash Agarwal, RajKishore Bagdi, Balagopal Subramanian, Manoj Kumar, Madhu Ramasundaram, Balamourougane Paramasamy, Zaffer Saleem Khanday
October-December 2009, 14(4):204-206
DOI:10.4103/0971-9261.59602  PMID:20419021
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.
  5,129 305 5
Extrahepatic portal venous obstruction: The effects of early ligation of splenic artery during splenectomy
Suhasini Gazula, DK Pawar, T Seth, CS Bal, V Bhatnagar
October-December 2009, 14(4):194-199
DOI:10.4103/0971-9261.59600  PMID:20419019
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.
  4,622 295 1
Laparoscopic assisted anorectal pull through: Reformed techniques
Karthik S Bhandary, V Kumaran, G Rajamani, S Kannan, N Venkatesa Mohan, R Rangarajan, V Muthulingam
October-December 2009, 14(4):210-214
DOI:10.4103/0971-9261.59604  PMID:20419023
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.
  4,369 242 4
Concavo-convex oblique anastomosis technique for jejuno ileal atresia
Zaheer Hasan, AN Gangopadhyay, Punit Srivastava, Mohammad Akhtar Hussain
October-December 2009, 14(4):207-209
DOI:10.4103/0971-9261.59603  PMID:20419022
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.
  3,963 273 -
JIAPS is Indexed in Pubmed
K.L.N Rao
October-December 2009, 14(4):191-191
DOI:10.4103/0971-9261.59598  PMID:20419017
  3,651 262 -
Presidential address
VK Raina
October-December 2009, 14(4):192-193
DOI:10.4103/0971-9261.59599  PMID:20419018
  3,587 169 -
Congenital pouch colon: Increasing association with low anorectal anomalies
Arunachalam Pavai, Suma D Pillai, S Shanthakumari, Cenita J Sam, M Shylaja, R Sabarivinoth
October-December 2009, 14(4):218-220
DOI:10.4103/0971-9261.59606  PMID:20419025
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.
  3,475 208 1
Isolated prostatic utricle
Mukunda Ramachandra, Pradnya S Bendre, Rajeev G Redkar, Devendra V Taide
October-December 2009, 14(4):228-229
DOI:10.4103/0971-9261.59610  PMID:20419029
Complete excision of a prostatic utricle through posterior sagittal rectum retracting approach is reported in an infant.
  3,445 141 -
Chylous ascites after nephrectomy without lymphadenectomy for malignant rhabdoid tumor of the kidney: A rare occurrence and literature review
Takahiro Einama, Tadao Okada, Fumiaki Sasaki, Satoru Todo
October-December 2009, 14(4):215-217
DOI:10.4103/0971-9261.59605  PMID:20419024
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.
  3,434 133 -
Esophageal atresia with tracheo-esophageal fistula: Accidental transtracheal gastric intubation
NN Hombalkar, Sara Dhanawade, Priya Hombalkar, Dhananjay Vaze
October-December 2009, 14(4):224-225
DOI:10.4103/0971-9261.59608  PMID:20419027
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.
  3,335 184 3
Congenital duodenal diaphragm and enteroliths: A Unique complication
Nisar Ahmad Bhat
October-December 2009, 14(4):226-227
DOI:10.4103/0971-9261.59609  PMID:20419028
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.
  3,166 135 2
Esophageal atresia with tracheo-esophageal fistula: Role of nebulized N-acetylcysteine in the outcome
A Pandey, AN Gangopadhyay, SP Sharma, V Kumar
October-December 2009, 14(4):232-232
DOI:10.4103/0971-9261.59612  PMID:20419032
  2,755 151 -
Decision-making in surgical neonatal necrotizing enterocolitis
Viroj Wiwanitkit
October-December 2009, 14(4):232-233
DOI:10.4103/0971-9261.59613  PMID:20419031
  2,505 170 -
Authors' reply
Mitul Parikh, Ram Samujh, Ravi Prakash Kanojia, K.L.N Rao
October-December 2009, 14(4):233-233
DOI:10.4103/0971-9261.59614  PMID:20419033
  2,243 104 -
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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

Online since 1st May '05