S. Chooramani Gopal

A new variant of esophageal atresia with tracheoesophageal fistula and duodenal atresia: a diagnostic dilemma

A new variant of esophageal atresia (EA) with tracheoesophageal fistula (TEF) associated with duodenal atresia is reported. The TEF was between the lower pouch and the trachea, with a cystic dilatation in the midportion. The tracheal end of the fistula was obstructed by a membranous septum at both ends of a cystic dilatation, leading to a diagnosis of pure EA (gasless abdomen). After the lower pouch was opened beyond the cystic dilatation, 100 ml nonbilious fluid was obtained. A laparotomy revealed a type III atresia of the first part of the duodenum.

Agenesis of the bladder: A rare clinical entity in a male child

Agenesis of the bladder, one of the rarest anomalies of the urinary bladder, was for the first time managed successfully by primary ileocecal functional bladder reconstruction at the Childrens Hospital, Institute of Medical Sciences, Banaras Hindu University. The salient features along with a review of literature are presented.

A unique presentation of atypical complete duplication of terminal ileum, colon, rectum, and urinary bladder

A unique case of complete duplication of urinary bladder, distal ileum, cecum, appendix, colon, and rectum with two mesocolons and separate vascular arcades is being reported.

Dog bite of the prolapsed rectum in a child

A case of a dog bite of the massively prolapsed rectum in a 2-year-old male is reported due to its rarity.

Nonrefluxing biliary appendicoduodenostomy for choledochal cyst

A new technique of biliary appendicoduodenostomy along with an antireflux procedure was used for the treatment of a choledochal cyst, with a satisfactory result.

Children presenting with hydatid cysts in common bile duct and choledochal cyst

Hydatid cysts developing primarily in the common bile duct are extremely rare. Occasionally, hydatid cysts rupture into the extrahepatic biliary ducts and cause obstruction [1–7]. Two children with intact hydatid cysts in the common bile duct and choledochal cysts were seen during a 2-year period in the Paediatric Surgery Division of the Childrens Hospital, Banaras Hindu University, Varanasi. The details of their presentation and operative management are reported.

Membranous atresia of the lower oesophagus

A very rare type of atresia of the lower end of the oesophagus without a tracheo-oesophageal fistula in a neonate is reported

Estimation of tissue DNA content in Wilm’s tumour

DNA genome, is affected by malignant processes. Estimation of DNA content was carried out biochemically using Gile’s and Myer’s technique to assess its prognostic value in 21 cases of Wilm’s tumour. The DNA content of tumour tissue and normal adjoining renal tissue was estimated in each case. The DNA content was significantly higher in Wilm’s tumour tissue as compared to normal renal tissue (p<0.05). As the disease advanced, the DNA content of the tumour further increased. The tumours having unfavourable histology had significantly higher DNA content as compared to favourable histology cases (p<0.001). Similarly, the patients who died because of the disease, had a very high DNA content as compared to those who survived. Further, it was seen that two fold increase in DNA content indicated advanced stage (III&IV), whereas a three fold or more increase indicated grave prognosis as it was usually seen in advanced stage with unfavourable histology and such cases died early. Thus, the DNA content estimation has a prognostic significance in Wilm’s tumour.

Single-stage repair of severe hypospadias using bladder mucosa graft

Our experience of single-stage repair of severe hypospadias (penoscrotal, scrotal, and perineal) in 30 children using urinary bladder mucosa for urethroplasty is reported. These children had severe chordee, small prepuce, and often ventral transposition of the penis with bifid scrotum where Devine and Horton, Asopa, or Duckett techniques are not so suitable. The graft uptake was uniformly satisfactory. Ten patients had complications; most of the fistulae healed spontaneously. Surgical intervention was required in 2 cases only: 1 for a fistula and another for a stricture with fistula. Meatal stenosis, seen in 4 cases, led to delayed distal fistulae in 2, which healed spontaneously with meatal dilatation. Regular dilatation of the external meatus is recommended to prevent this problem.