ABSTRACT: There are many hypotheses for the etopathogenesis of infantile hypertrophic pyloric stenosis (IHPS), as no definitive specific etiological factor has been identified till date. Our work is an attempt further, to understand the histopathology involved in IHPS. Biopsy specimens were obtained from 20 cases IHPS at pyloromyotomy by taking full thickness of pyloric muscles; these were studied for histological details by using different staining techniques. Hematoxylin and eosin stained paraffin sections were employed for evaluation of 20 biopsy specimens. Histologically IHPS cases showed smooth muscle cells running in different directions in all cases with leiomyomatous appearance in 20 percent cases. Muscular hypertrophy was appreciated in 60 percent cases and 10 percent showed nerve tissue undergoing degeneration. Ganglion cells were present in 20 percent cases and 35 percent cases had varying degree of increase in connective tissue stroma. Mild focal inflammatory cells were noticed in muscle tissues. The above findings have also been documented by Que & Puri, although in our study, the findings indicated by those authors were not found in all cases for running smooth muscle cells in all directions and presence of nerve bundles. The presence of degenerative changes in nerves and ganglion cells may indicate their possible role in etopathogenesis of IHPS.

ABSTRACT: Sixty cases of intestinal obstruction of the age group between 12 months and 12 years who were admitted in our hospital for treatment, were studied. the period of study was form May 2000 to July 2001. Thirty four cases had history of passage of roundworms, either through mouth or anus within a span of 2 weeks before presentation. A provisional diagnosis of roundworm inspection causing intestinal obstruction was made. With conservative treatment however, intestinal obstruction could not be relieved in 19 out of these 34 cases. Laparotomy was undertaken in these 19 patients. In only 3 cases out of 19, roundworm bolus was the direct of obstruction. We conclude from our study that intestinal obstruction in children clinically diagnosed to be due to roundworms, should not be treated conservatively for a prolonged period of time. Failure to improve within 24 hours of conservative treatment, should suggest immediate laparotomy. Often a pathology other than roundworm bolus may be found as the cause for obstruction. Moreover, presence of roundworms in the intestine could be a mere coincidence.

ABSTRACT: We report a series of 90 patients of hypospadias that were treated at our set up from 1992 to 2002 by transverse preputial flap technique. The age range was 2-27 years. The main complaints of these patients were abnormal opening to urinary meatus with downward curvature of penis. There were 52 cases (57.77 percent) of distal penile hypospadias, 32 cases (35.55 percent) of mid penile hypospadias and 6 cases (6.66 percent) of proximal penile hypospadias. All patients underwent single stage orthoplasty, glanduloplasty and urethroplasty by transverse preputial flap technique. Postoperative complications were noted in 36 patients (40 percent) and 10 of them (11.11 percent) required further operative procedures. Follow up period approaches 10 years for patients operated earlier. The technique of repair and relevant literature are discussed.

ABSTRACT: The authors report their study of laparoscopic pyloromyotomy in 10 infants with infantile hypertrophic pyloric stenosis (IHPS). The average age of the patients was 6.9 weeks, and weight 3.6 kg. Three 3 mm ports were used in each procedure. The average operating time was 30 minutes. Feeding was begun 6 hours postoperatively, and the average postoperative hospital stay was 3.4 days. Laparoscopic pyloromyotomy is a safe procedure for infants with hypertrophic pyloric stenosis

ABSTRACT: A 12-day old male neonate was admitted with the history of intermittent seizures from day 1, progressive abdominal distension from day 3, bilateral scrotal swellings, pneumoperitoneum, surgical emphysema and respiratory distress form day 5, and blood mixed stool from day 8. The baby passed scanty meconium in the first 3 days of his life, but never thereafter. X-ray of the abdomen showed huge pneumoperitoneum and surgical emphysema restricted to the left side of the abdomen and the left inguinoscrotal area. Exploratory laparotomy revealed flakes over the gut a various places but mostly confined to the lesser sac, especially on the posterior surface of the stomach. The exact site of perforation could not be located. The anterior wall of the lesser sac was torn and the surgical emphysema was perhaps the result of the air being squeezed from the lesser sac into the retroperitoneal tissue plane, which later manifested itself at the anterior abdominal wall, flank, loin, back and the left inguinoscrotal region.

ABSTRACT: Anterior sacral meningocele (ASM) is a very rare swelling in the sacrococcygeal region and is difficult to detect, as it does not usually present as an exophytic swelling. We came across a newborn with an Altmann type III swelling. CT scan and MR scan did not show extension into the spinal canal and there was no sacral bony defect. MR scan diagnosed a sacrococcygeal cystic teratoma, which was consistent with physical findings. It contained clear fluid only. It had no definite cyst wall on histopathologic examination and it recurred after excision. At a second operation transfixion of the pedicle was also done. The literature on anterior sacral meningocele is reviewed.

ABSTRACT: A male child presented at 2 weeks of age with abdominal distension since birth and fever. Clinical examination revealed a soft, irregular, lobulated, mass occupying the whole abdomen. Investigations revealed a multiseptate cystic lesion occupying almost the entire abdomen and a non-functioning right kidney. Exploration revealed a grossly dilated and tortuous right ureter which ended blindly above the bladder, containing turbid fluid and capped by a hypoplastic kidney. No other congenital abnormalities were detected. Right sided nephroureterectomy was performed