Double Pouch Colon Revisited

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Infantile hypertrophic pyloric stenosis in twins

Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical cause of vomiting, which requires surgery in infant. There is the complete or partial obstruction of pylorus due to hypertrophy of circular muscle of the pylorus leading gastric outlet obstruction. The occurrence of IHPS in dizygotic twins is rarer and the theory of genetic origin alone does not explain it. Recent literature points to the association of bottle feeding in singletons to be a major aetiological factor for this condition. Here, we present a rare case of dizygotic twins who were bottle-fed and were affected with IHPS. We review the literature and focus on the question of whether this condition in twins supports a genetic or environmental origin of IHPS.

Intraoral teratoma in a newborn presenting as severe respiratory distress

A new born female presented to us immediately after birth with mass protruding from the mouth, with severe respiratory distress and was immediately intubated. Antenatal ultrasonography did not reveal any abnormality. On examination, a non-pulsatile, multilobulated, 4 cm×5 cm sized mass of variable consistency was seen originating from the palate with no other associated congenital anomaly. CT showed a large heterogeneous mass arising from the hard palate with few hyperdense calcific areas with no intracranial extension. Mass was excised completely. Histopathological examination showed features of mature teratoma.

Wandering Distal End of Ventriculo-Peritoneal Shunt: Our Experience with Five Cases and Review of Literature

Ventriculo-peritoneal (VP) shunt is the most commonly performed procedure for the management of hydrocephalus. Although shunts have improved the morbidity and mortality associated with disordered Cerebrospinal fluid (CSF) mechanics over the past 30 years, they still are associated with many potentially avoidable complications in clinical practice. However, extrusion of VP shunt catheter is an unusual complication of VP shunt Surgery. We are presenting this unusual complication in five patients. The lower end of the shunt was seen extruding from anal opening in one patient, umbilicus in one, urethra in one, inguinal hernia sac in one and oral cavity in one patient. All of these patients were managed by shunt removal, intra venous antibiotics followed by shunt replacement on the other side except the patient with inguinal hernia sac. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6935 J. Nepal Paediatr. SocVol.32(3) 2012 266-269

A rare case of isolated complete diphallia and review of the literature

A 3-year-old boy presented with complaints of abnormal genitalia. On examination, there was penile duplication with two completely separate phalluses, unequal in size, one with hypospadias and the other with meatus at the tip of the glans. Voiding cystourethrography revealed a normal sized single bladder but two urethras with no associated vesicoureteral reflux.

A case of thalamic abscess treated by endoscopic surgery

We report about a 7-year-old female child with cyanotic heart disease whose thalamic abscess was successfully treated by endoscope-assisted abscess drainage. Endoscopic aspiration of thalamic abscess appears to be a safe and effective method of treatment for deep-seated abscesses, as direct visualization of the abscess cavity is possible and the completeness of evacuation can be assessed.