ABSTRACT: Twenty-one children with cholecystitis requiring surgical intervention were reviewed retrospectively. There were 13 males and 8 females. The age ranged from 2-13 years. Pain in abdomen was the commonest presentation. Ultrasound scan (USS) was the mainstay of diagnosis. Seven cases each of calculus cholecystitis, acalculous cholecystitis and cholecystitis with biliary tract disease were identified. Contrary to expectations, hemolytic disease was found only in one case of choledocholithiasis. Nineteen cases underwent surgery. E. coli was the most common pathogen grown on bile cultures from gall bladder. A diverse spectrum of benign biliary disease were encountered.

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ABSTRACT: Seventy two patients of pelviureteric junction obstruction treated between May 1987 and June 1997 have been included in this study. Majority presented with abdominal limp. Investigation included USG,IVU and radionucleotide study. Eight additional patients had prenatal diagnosis. In 49 patients the disease was left sided, and in 17 patients it was right sided; in 6 the involvement was bilateral. Two patients had hydronephrosis in a solitary left kidney and presented with renal failure. Seventy-one patients had dismembered pyeloplasty. Anastomosis was done with No 5/0 chromic catgut. Stent, nephrostomy and drain were used. One patient had nephrectomy. Two patients presenting with renal failure had preliminary nephrostomy. Postoperative complications included urinoma, prolonged urinary leak, infection, nonfunctioning kidney, and recurrent hydronephrosis. Two patients needed revision procedures. Purpose of this presentation is to highlight excellent result of a simple procedure which can be performed in all centres without the help of any sophisticated instrument.

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ABSTRACT: The 'Syndrome of Caudal Regression' involves in variable proportion anomalies of the anorectum, urinary and genital systems, lumbosacral spine, and lower limbs. We report two such cases, highlighting that this condition represents a wide spectrum, with sirenomelia being its most extreme presentation and the imperforate anus being its most mild form.

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ABSTRACT: Esophageal stricture in children is commonly due to accidental ingestion of strong corrosives. Prevention of esophageal fibrosis is crucial to limit its vicious sequel. Hitherto discovered inhibitors of collagen synthesis (eg. steroids, penicillamine, etc) have shown equivocal results in clinical studies. Zine inhibits prolyl/lysyl hydroxylase key enzymes in collagen synthesis. The effect of oral zine supplementation in rats subjected to a 'standard esophageal alkali burn' was evaluated with suitable controls. Double Blind evaluation of the resultant submucosal fibrosis histologically with connective tissue stains and semiquantitative estimation by a computerized image analysis system was performed. Zine supplemented drinking water (227 mg/L of Zn plus) significantly decreased submucosal fibrosis in alkali induced esophageal stricture in rats.

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ABSTRACT: Paraesophageal hiatus hernia with an intrathoracic stomach is an uncommon surgical emergency in the neonatal period. The clinical features are mainly dependent upon the associated intrathoracic stomach and its degree of volvulus. The symptoms may sometimes suggest the presence of esophageal atresia which is ruled out by the passage of a nasogastric tube. The contrast study of the upper gastrointestinal tract is diagnostic. Prompt surgical intervention in the form of reduction of the paraesophageal hernia, derogation of the stomach volvulus and repair of the esophageal hiatus is associated with good outcome.

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ABSTRACT: The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographical barriers. The pediatric surgery Internet consists of an exponentially growing information available on Internet that deals with information specially for pediatric surgeons and patients of pediatric age group. We reviewed the methods available to take advantage of this network. This will provide a glimpse to busy pediatric surgeons to accrue the benefits easily and efficiently rather than to be lost in the Information ocean by surfing individually. By getting connected to Internet, a pediatric surgeon in India, gains enormous information by interacting with other pediatric surgeon of the world. This could be of use to gain knowledge and to offer the best care to the patient. Internet has revolutionised scientific publication by virtue of its faster and accurate transmission of manuscripts. Pediatric surgeons can send the manuscripts by this channel and also access the journals obviating the inherent lag period of communication by post.

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ABSTRACT: The management of anorectal atresia depends on the level of the lesion and the presence of fistulae or associated genitourinary and sacral anomalies. If the lesion is low and the infant is well then a primary anoplasty may be performed in the early neonatal period. However, for high or intermediate lesions an initial colostomy followed by definitive repair later is recommended. We report a newborn infant with anorectal atresia investigated at six hours of age using MRI to locate the level of atresia. Conventional x-ray utilises bowel gas as contrast to outline the terminal section of the gut. Hence, x-ray is often not performed until 18 hours when adequate gas, to provide contrast, is present in the distal bowel. MR imaging utilises the high signal of meconium on T1 weight scans to delineate the terminal section of the bowel thus removing the need to wait for a delayed plain radiograph. This enables a decision to be made regarding the surgical procedure before the distal bowel is gas filled, hence, the bowel is in better condition for surgery. A further advantage is that it may confirm the presence of associated anomalies including accompanying fistulae and spinal or renal tract malformations.

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ABSTRACT: An association of partially perforated esophageal membrane with anorectal malformation is reported. Low type of anorectal malformation was treated by anoplasty and partially perforated membrane successfully dilated by esophageal dilators passed over a guide wire endoscopically under fluroscopic control.

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ABSTRACT: A case of type III colonic atresia (multiple sites) was diagnosed and salvaged by operation in three stage. Colostomy was done on 2nd day of life. Anastomosis of the segments were performed at 16 months of age. Colostomy was closed afterwards. The child is doing well 6 months after the surgery. Literature has been reviewed.

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