Chris Grant

Congenital intrinsic duodenal obstruction: Problems in the diagnosis and management*

Nineteen infants with intrinsic duodenal obstruction are analyzed. Atresia was the most common lesion. An exceptionally high rate of associated anomalies (73.7%) were present; Downs syndrome, the single most common anomaly, was seen in 47% of the infants. In seven infants, the diagnosis was delayed and in another three it was made intraoperatively while establishing a gastrostomy for esophageal atresia. Three infants died without operation because of gross prematurity and multiple anomalies. Of the 16 operated on, three died, one due to peritonitis and the other two because of metabolic derangements. Of the various operative procedures used, no significant difference was found in the final outcome of treatment. A schematic approach to the diagnosis and management is proposed.

Segmental dilatation of the colon

A case of segmental dilatation of the colon involving the rectosigmoid area is presented and added to 11 cases of segmental dilatation of the colon reported previously in the literature. The clinicopathologic features, etiology, and management are discussed.

Infantile hypertrophic pyloric stenosis and congenital diaphragmatic hernia

The association of infantile hypertrophic pyloric stenosis with congenital diaphragmatic hernia is rare. We report three cases of infantile hypertrophic pyloric stenosis who had concomitant congenital diaphragmatic hernia.

Abdominal tuberculosis: a frequent diagnostic challenge

In recent years, abdominal tuberculosis has become rare in many countries even where pulmonary tuberculosis still exists. A case of abdominal tuberculosis is described in a young male who presented with non-specific symptoms together with CT scan findings that simulated abdominal lymphoma. Diagnosis was established during abdominal exploration. The frequency of various presenting manifestations of abdominal tuberculosis are discussed. The report emphasizes the need for a high index of suspicion to save patients unnecessary exploratory laparatomy.

Fistula-in-ano: A pathological study.

A review of 229 cases of fistula-in-ano in our institution has shown that nonspecific inflammatory tissue lines the majority of tracts. Epithelial lining was present in 50 cases and was encountered proportionately more frequently in subjects under 10 years of age, thus supporting a congenital origin as well as infection of anal glands, earlier proposed by other workers. Intestinal contents may have a role in the foreign body response seen in many cases. Locally endemic infectious conditions do not appear to play a significant role in the cause of the disease.

Cecal Diverticulitis: A Report of Three Cases

ABSTRACT Three patients, all over 30 years old, had acute isolated cecal diverticulitis. The preoperative diagnosis was acute appendicitis in all cases. The intraoperative diagnosis was cecal diver...