Dipak Ghosh

Achalasia cardia in infants: report of two cases.

Achalasia cardia is a neuromuscular disorder of unknown etiology involving the body of the esophagus and lower esophageal sphincter (LES). It is characterized by aperistalsis of the body of the esophagus and failure of relaxation of lower esophageal sphincter. It usually affects patients between the ages of 30 and 60 years. It is unusual in childhood and extremely rare in infants. We report two cases of achalasia cardia in infants. Both cases were treated with open Heller’s esophagocardiomyotomy with anti-reflux procedure.

Is ligation of hernial sac during orchiopexy mandatory

Aim: Traditionally, ligation of hernial sac during orchiopexy is considered mandatory to prevent postoperative development of hernia. A prospective study was carried out to see if it is actually required based on the fact that any peritoneal defect closes within 24 hours by metamorphosis of the in situ mesodermal cells. Methods: Fifty cases of undescended testis, age ranging from eight months to 12 years were enrolled. All of them underwent standard orchiopexy without ligation of the hernial sac. Results: Follow up of all cases ranged between 1.5 years to three years. Not a single case was reported with evidence of hernia. Conclusions: It is unnecessary to ligate the hernial sac during orchiopexy.

Perineal accessory scrotum with congenital lipoma: a rare case report.

A case of accessory scrotum in a 1-year-old boy is reported because of its rarity. A boy presented with a tumor mass attached with scrotum-like skin on its tip in the right side of perineum between the scrotum and anus. Both testes had descended into the scrotum. There was no other urological anomaly. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion accessory scrotum. 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 hypothesis regarding etiology of accessory scrotum.

Heteropagus Twins—A Tale of Two Cases

Heteropagus twinning is a rare occurrence. Parasitic and asymmetric conjoined twins are rarer anomalies of monochorionic monoamniotic twins; which consist of an incomplete twin attached to the fully developed body of the co-twin. We present here two such cases of Heteropagus twinning.

Scenario of neonatal surgery in West Bengal with reference to cases of anorectal malformation

Pediatric Surgery, though a super specialty does not enjoy the glamour and importance like other specialities, though, dealing with the most delicate of mankind, the children. The reasons for this are manifold and the results of this, brutal. This is a retrospective study carried at the major institutes of West Bengal where departments of pediatric surgery exist. We have observed a gross discrepancy between the number of patients admitted for surgically correctable congenital malformations and the standard state/ national frequency of these disorders. We focus on the plight of a child not able to reach the leval III health care system with a pediatric surgical back up and analyze the pros and cons with constructive criticism of the existing system.

Separation of thoraco-omphalopagus siamese twin

A pair of female thoraco-omphalopagus twins, with two pairs of lungs, common diaphragm and separate pleural cavities was separated at the age of 51/2 months after a parasitic relationship had developed between them. Before separation both the babies developed recurrent respiratory tract infection and frequent diarrhea. They were treated with medical therapy and made fit for anesthesia. The combined weight of the twins was 41/2 kg at birth and the combined weight at the time of separation was 91/2 kg. One baby was smaller in growth compared to the other baby. The closure of anterior abdominal wall was difficult in both babies. However, we could close it without use of any biodegrActable patches or tissue expander. Both the babies survived and are doing well after 3 months of separation.

Congenital Urethrocutaneous Fistula—Our Experience with Nine Cases

Congenital urethrocutaneous fistula is a very rare anomaly with about 40 odd cases reported in literature till 2008 .We present here 9 such cases all of whom were uncircumcised at presentation.7 out of 9 cases had a fistula in the distal shaft and the rest 2 cases had a fistula in the mid-shaft of the penis with an associated chordee.Associated congenital anomaly was present in only one case which had an associated imperforate anus . When the fistula was present distally , we did a primary repair of the fistula which was reinforced by a Bayers Flap. When the fistula was present in the mid shaft we did a Primary repair of the fistula & reinforced it by a Tunica Vaginalis Flap.