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January-March 2011 Volume 16 | Issue 1
Page Nos. 1-36
Online since Monday, January 3, 2011
Accessed 78,213 times.
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EDITORIAL |
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Pediatric liver transplantation in India: Its time has come |
p. 1 |
Ashley L. J. D'Cruz DOI:10.4103/0971-9261.74510 PMID:21430838 |
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ORIGINAL ARTICLES |
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Pediatric liver transplantation: A report from a pediatric surgical unit |
p. 2 |
Sanjay Rao, Ashley L. J. D'Cruz, Rajiv Aggarwal, Supraja Chandrashekar, G Chetan, Gayathri Gopalakrishnan, Stephen Dunn DOI:10.4103/0971-9261.74512 PMID:21430839Background: Liver transplantation is well established worldwide as an effective treatment for end-stage liver disease in children. Acceptance in India has been slow because of considerations of cost, infections, inability to support long-term care, and non-availability of expertise. Aim: This study was designed to report our experience with pediatric liver transplantation. Materials and Methods: Twenty-eight children underwent liver transplantation. Results: Biliary atresia was the commonest indication (n = 15) followed by metabolic liver disease. Twenty-six children had living donor transplants, mothers being the donors in a majority of these. Common surgical complications included bile leaks (n = 3) and vascular problems (n = 6). Common medical complications included infections, acute rejection, and renal failure. Overall, patient survival was 71%, while that for the last 14 cases was 92%. All survivors are doing well, have caught up with physical and developmental milestones and are engaged in age appropriate activities. Conclusions: The study demonstrates the feasibility of a successful pediatric liver transplant program in our country. |
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Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative? |
p. 8 |
V. V. S. S. Chandrasekharam, Suhasini Gazula, Rajendra Prasad Gorthi DOI:10.4103/0971-9261.74513 PMID:21430840Aim: To evaluate an alternative way of reducing intussusceptions under laparoscopic guidance. Materials and Methods: This is a retrospective observational study of children who underwent laparoscopy-assisted hydrostatic in situ reduction of intussusceptions (LAHIRI). Under general anesthesia with laparoscopic vision, warm saline was infused into the rectum with a 16-18 F Foley catheter and a drip set till the intussusception was reduced. Results: Eleven patients [age 7.8 (±2.8) months] were operated over a period of 1 year. Ten (90.9%) patients had ileocolic intussusception, which got completely reduced, but one (9%) had ileo-ileocolic intusussception, in whom manual reduction by extending the subumbilical incision was required to reduce the ileoileal part. The mean duration of surgery was 38.5 (±6.6) min. No patient had bowel ischemia and there were no intra- or postoperative complications. Conclusions: LAHIRI appears to be an effective and safe technique in children. Specific advantages are that it is performed in a controlled environment in the operating room, avoids patient apprehension and discomfort, avoids bowel handling, provides a safe opportunity to create higher intraluminal pressure, ensures visual assessment of bowel vascularity and completeness of reduction. |
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Hepatoblastoma: Analysis of treatment outcome from a tertiary care center |
p. 11 |
Sanju Cyriac, Ramakrishnan Ayloor Seshadri, Arun Warrier, Tenali Gnana Sagar DOI:10.4103/0971-9261.74514 PMID:21430841Aim : This study was designed to retrospectively review our experience with the multimodality management of hepatoblastomas (HB). Materials and Methods: Thirteen patients were treated for HB between 2000 and 2007. The clinical presentations, chemotherapy tolerance and response, surgical procedure undertaken, and complications were analysed. Results: Median age of the population was 12 months (3-60 months), with a male-to-female ratio of 3.3:1. Nine patients were treated with neoadjuvant chemotherapy incorporating cisplatin and adriamycin. Primary surgery was done in four patients. Extent of hepatic resection in the operated patients varied. Mixed type was the predominant histopathological diagnosis. Adjuvant chemotherapy was well tolerated with no morbidity or mortality. Five-year event-free survival (EFS) and overall survival (OS) of all the 13 patients is 76.9%. All the nine patients who could complete multimodality treatment are alive with no evidence of disease or complications with median follow-up of 63 months (46-122 months). Conclusions: Treatment of HB with multidisciplinary approach was well tolerated. OS and EFS of patients were comparable with published studies. |
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CASE REPORTS |
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Intralobar pulmonary sequestration masquerading as congenital lobar emphysema |
p. 15 |
Bilal Mirza, Afsheen Batool Raza, Iftikhar Ijaz, Lubna Ijaz, Farah Naz, Afzal Sheikh DOI:10.4103/0971-9261.74515 PMID:21430842Intrapulmonary sequestrations are quite uncommon in pediatric age group. The preoperative diagnosis of pulmonary sequestration is not possible in most of the cases. A 2-year-old boy presented with recurrent episodes of chest infections and respiratory distress. A preoperative diagnosis of congenital lobar emphysema was made on the basis of chest radiograph and computed tomography scan. At operation, an intralobar pulmonary sequestration was found. The sequestration cyst was excised with uneventful recovery. |
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Epithelial cyst of the spleen |
p. 18 |
Garima Daga, Varun Mittal, RJ Singh, Neena Sood DOI:10.4103/0971-9261.74516 PMID:21430843This is a report of a case of epithelial cyst of the spleen in an 8-year-old boy. The cyst showed squamous metaplasia on histology. The risk of malignant transformation is discussed. |
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Abernethy malformation with portal vein aneurysm in a child |
p. 21 |
Sheragaru H Chandrashekhara, Ashu Seith Bhalla, Arun Kumar Gupta, CS Vikash, Susheel Kumar Kabra DOI:10.4103/0971-9261.74517 PMID:21430844Abernethy malformation is an extremely rare anomaly of the splanchnic venous system. We describe multidetector computed tomography findings of an incidentally detected Abernethy malformation with portal vein aneurysm in a two-and-half-year old child. The computed tomography scan was performed for the evaluation of respiratory distress, poor growth, and loss of appetite. |
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Multiloculated cervical thymic cyst |
p. 24 |
J Niranjan, KV Santosh, G Prabhakar DOI:10.4103/0971-9261.74518 PMID:21430845In this study, we report a rare case of cervical thymic cyst in an 8-year-old child. |
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Covered exstrophy with anorectal malformation and vaginal duplication |
p. 26 |
Jitendra K Singh, JK Mahajan, Monika Bawa, K. L. N. Rao DOI:10.4103/0971-9261.74519 PMID:21430846Covered exstrophy is a rare variant of the exstrophy-epispadias complex. We report a female newborn with covered exstrophy, absent anal opening and duplication of the introitus and the lower vagina. This rare, previously unreported, combination of anomalies highlights the complexity of the embryological events in the caudal area during separation of the hindgut and allantois. |
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Ingested metallic foreign body lodged in the appendix |
p. 29 |
RR Sarkar, J Bisht, SK Sinha Roy PMID:21430847An 8-year-old child ingested a metallic screw 3 months prior to admission. At laparotomy, the foreign body was found to be lodged inside the vermiform appendix, and was removed by appendicectomy. |
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Perforation into gut by ventriculoperitoneal shunts: A report of two cases and review of the literature  |
p. 31 |
Abdul Hai, Atia Z Rab, Imran Ghani, Muhammad F Huda, Abdul Q Quadir DOI:10.4103/0971-9261.74521 PMID:21430848We report two cases of gastrointestinal perforation by ventriculoperitoneal (VP) shunts and review the literature on the topic. The time interval between shunt surgery and detection of bowel perforation is minimum in infants and increases with age. Sigmoid and transverse colon followed by stomach are the most frequent sites of gastrointestinal perforations by VP shunts. |
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LETTERS TO EDITOR |
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Esophageal atresia with tracheo-esophageal fistula: Making anastomosis easy |
p. 34 |
Sudhakar Jadhav, Dinesh Kittur, Ravindra Vora, Varun Sarode, Amit Raut, Jui Mandke DOI:10.4103/0971-9261.74522 PMID:21430849 |
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Laparoscopic vagotomy with gastrojejunostomy for corrosive pyloric strictures |
p. 34 |
A Prasad, KA Mukherjee, M Kaur, M Ali, S Kaul DOI:10.4103/0971-9261.74523 PMID:21430850 |
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Femoral shaft injuries during childbirth |
p. 35 |
Ram Kinkar Jha, Vivek Trikha DOI:10.4103/0971-9261.74524 PMID:21430851 |
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