Shashi Shankar Sharma

Cystic lymphangioma of the breast in a 6-year-old boy☆

Cystic lymphangiomas commonly occur in childhood, but breast involvement is an extremely rare entity that tends to be more common in adults, with only a few cases reported in children. We describe a 6-year-old boy who presented with a lump in the left breast that measured 4.5 x 3.5 x 2.5 cm. A local excision was performed, and a diagnosis of cystic lymphangioma was confirmed. There was no recurrence of the lesion after 18 months after surgical excision. A brief case description and review of the relevant literature is presented.

Rhabdomyosarcoma of the posterior chest wall in a newborn: a case report

Rhabdomyosarcoma is the most common soft tissue malignancy of childhood, but may occur extremely rarely in the neonatal period. There are only a few reports of rhabdomyosarcoma in neonates. Although, it may arise anywhere in the body, the head and neck, and genitourinary regions are the most frequent sites. Truncal and chest wall rhabdomyosarcoma is relatively rare occurrence. We report a neonate with embryonal rhabdomyosarcoma arising from the posterior chest wall muscles at birth. Computer Tomography scan raised the possibility of rhabdomyosarcoma or neurofibroma, fine-needle aspiration cytology was inconclusive. Total excision was done and chemotherapy given. At 6 months child is without recurrence.

Hemostasis during hypospadias surgery via topical application of feracrylum citrate: A randomized prospective study

Aim: Report of our experience with topical feracrylum citrate to minimize hemorrhage-related complications in pediatric hypospadiac patients. Materials and Methods: One hundred and fifty consecutive pediatric hypospadiac patients over 3 years (75 in study group and 75 controls - random allocation) were studied. One hundred milliliter of 1% feracrylum citrate solution was used in study cases and equivalent normal saline in controls. The parameters assessed were frequency of cauterizations, intraoperative blood loss, wound edema and postoperative complications. Results: Average number of cauterizations was 1.55 per patient in study group and 5.7 per patient among controls. Among cases, average number of blood soaked gauge pieces was 3.56 per patient, correlating with average intraoperative blood loss of 17.8 ml. In controls, average blood soaked gauge pieces were 6.2 per patient corresponding to an average blood loss of 31 ml. Postoperative hematoma was seen in 8% cases compared with 18% controls. Wound edema appeared in 13.3% cases and 47% controls. Postoperative complications were higher among controls. Conclusions: Feracrylum is an effective and safe topical hemostatic agent to minimize significantly diffuse capillary oozing and surface bleeding. It reduced the frequency of cauterization and tissue damage, intraoperative blood loss, postoperative hematoma, wound edema and postoperative complications.

A prospective comparison of topical feracrylum citrate versus adrenaline as haemostatic agent in hypospadias surgery in children

Background: A comparative study of topical feracrylum citrate versus adrenaline to minimise haemorrhage-related complications in paediatric hypospadiac patients. Patients and Methods: A total of 108 consecutive paediatric hypospadiac patients (48 in the study group and 60 control - random allocation) were studied. In the study group, 1% feracrylum citrate solution was used and adrenaline (1:100,000) in controls. Results: Among the study group, average number of blood-soaked gauge pieces were 2.95/patient, correlating with average intraoperative blood loss of 14.74 ml. In controls, average blood-soaked gauge pieces were 4.83/patient corresponding to an average blood loss of 24.13 ml. The average amount of blood loss during surgery in the <5 years was 13.70 ml/patient in the feracrylum group, while the same in the adrenaline group was 23.45 ml. Average duration of surgery was 79 min in the study group, while the same in controls was 94 min/patient. Average number of cauterisations was 0.255/patient in the study group and 0.583/patient among controls. Postoperative haematoma was seen in 8% study group compared with 18% controls. Wound oedema appeared in 4.17% study group and 11.67% controls. Postoperative complications were higher among controls. Conclusions: Feracrylum is more efficient and safer topical haemostatic agent than adrenaline. It reduced the frequency of cauterisation and tissue damage, intraoperative blood loss, and postoperative complications.

Congenital bilateral syngnathia and tracheoesophageal fistula: A rare presentation

Congenital syngnathia (CS), first reported by Burket in 1936, is a rare condition, with <50 reported cases and is associated with other conditions and syndromes. CS restricts mouth opening, causing difficulty in feeding, swallowing, and respiration. This report puts forth the clinical findings and management of this challenging condition in association with tracheoesophageal fistula in a neonate.

STUDY OF PRESENTATION AND MANAGEMENT OF THYROGLOSSAL CYST IN INDIAN POPULATION

1Resident, Department of General Surgery, M. G. M. Medical College and M. Y. Hospital, Madhya Pradesh. 2Professor, Department of General Surgery, M. G. M. Medical College and M. Y. Hospital, Madhya Pradesh. 3Associate Professor, Department of General Surgery, M. G. M. Medical College and M. Y. Hospital, Madhya Pradesh. 4Assistant Professor, Department of General Surgery, M. G. M. Medical College and M. Y. Hospital, Madhya Pradesh.

Failure of bronchoscopy in airway obstruction: A case series

Bronchoscopy in this modern era has proved its utility and superiority far beyond imagination and has surpassed and replaced the majority of the surgical procedures. However, there have been certain limitations to the applicability of this vital technique especially in a country where we face lack of proper equipments and trained personnel at all health centers. This case series with review of literature examines the spectrum of limitations of bronchoscopy and the rare cases encountered, which leads to the surgical alternatives for managing intrabronchial pathology based on relevant current literature.

Congenital fibrosarcoma of the chest wall: Report of a case

Congenital fibrosarcoma (CFS) is a rare soft tissue tumour that usually occurs before the age of 1, and involves the distal extremities. The literature regarding the precise diagnosis and treatment of these tumours is limited. We present and discuss a case of CFS which ended fatally due to lung metastasis after 2 years.

Paediatric pancreatic problems: a five-year experience.

BACKGROUND To analyse a tertiary care experience with various pancreatic problems in the paediatric age group and clarify the frequency of various pancreatic diseases in the same patient population as well as the role of surgical or conservative management in their treatment. PATIENTS AND METHODS All patients with clinical suspicion of disease pertaining to the pancreas, substantiated by laboratory investigations or imaging modalities over a period of five years are included in our study. RESULTS Of the total 228 patients with various pancreatic problems, who presented to us, mostly with acute pancreatitis and pancreatic trauma, 64 needed surgical interventions. The total mortality rate encountered was a meagre 3.5%. CONCLUSION Paediatric pancreatic disorders are not so infrequent; and a high index of suspicion aided by the newer modalities of investigation greatly helps in the appropriate and timely management.