Sunita Ojha

Meckel’s diverticulum with segmental dilatation of the ileum: radiographic diagnosis in a neonate

We report a neonate with segmental dilatation of the ileum and a Meckel’s diverticulum that was diagnosed preoperatively on the plain abdominal radiograph.

Labial adhesions: Facts and fiction

Sir,Labial adhesions (vaginal synechiae) are a commonproblem encountered in general pediatric but there are alot of misconceptions regarding the etiology andmanagement. We had a similar case where a case of labialadhesion was misdiagnosed as case of vaginal agenesis. Athree-year-old girl was referred by local practitioner withcomplaints of absent vagina and burning micturition. Thechild also had dribbling of urine on standing up aftermicturition. The child was advised, apart from a urineroutine urine examination, a urine culture, anultrasonography of the pelvis and a micturatingcystourethrography to rule out genitourinaryabnormalities. On local examination the child was foundto have adhesion of the labia minora which lead to thecomplete closure of the introitus and child voided from asmall orfice at the posterior aspect of introitus near theposterior fourchette (Fig. 1). The urine culture was sterile.These adhesions were lysed in the out patient departmentusing a blunt artery forceps after local application of 5%lidocaine ointment and it revealed a normal urethral andvaginal orifices. The child started on a regimen ofestrogen cream application for three weeks. The child isasympomatic after three months of follow up with norecurrence.occur much later.

Pseudoexstrophy with Epispadias

The exstrophy variants are uncommon anomalies. The variants of the exstrophy complex have all the stigmata of the classical exstrophy such as divergent recti, widened symphysis pubis, and low-set umbilicus; however, the urinary tract is intact to a varying degree. Pseudoexstrophy, an exstrophy variant, is very rarely associated with epispadias. We report an unusual case of pseudoexstrophy with epispadias, in whom the intact bladder was initially covered by a mucous membrane which later epithelialized. The epispadias was repaired using a penile disassembly technique with posterior and ventral placement of bladder neck and urethra. Although the urethral meatus was hypospadiac, the child had achieved dry intervals with occasional stress incontinence.

Benign retroperitoneal mesenchymoma of childhood

Benign mesenchymoma is a rare tumor composed of mature fat, thin small and medium-sized vessels and spindle cells of smooth muscle origin and has been found in variable locations. There have been only three reports of such cases in the retroperitoneal location. We report one such rare retroperitoneal tumor.

Anterior urethral valves associated with hypospadias

An association of coronal hypospadias with meatal stenosis and anterior urethral valves is described in this report. A combination of double obstruction in anterior urethra may overshadow the expression of proximal one.