ABSTRACT: Duplication of the penis is an extremely rare anomaly. Approximately 100 cases have been reported since the first case report by Wecker in 1609. There are broadly three types of diphallus,viz. true diphallus with two independent penises, bifid phallus that may be glandular or complete and pseudodiphallus having a rudimentary phallus in addition to the normal penis. Numerous associated genitourinary and gastrointestinal anomalies have been described with diphallus. We encountered a complete bifid phallus in a 2 year old boy, with epispadias and a yentral preputial hoo, making the diphallic organ completely buried within it. In our exhaustive review of the literature, we did not come across any other case of this variety of the penile duplication that we termed the 'concealed or buried diphallus'. We did the corrective surgery in one stage with a good result.

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ABSTRACT: Background: The conventional treatment for high anorectal malformations requires the reconstruction of a neoanus involving a staged operative approach. We tried to prospectively compare the results of a single-stage neonatal posterior sagittal anorectoplasty, with the conventional 3-stage procedure, in the high and the intermediate anorectal malformations. Patients and Method: Thirty four cases of male anorectal malformations, having high or intermediate anomalies, and less than 48 hours old with good sacrum, were included in the study. In 14 cases neonatal posterior sagittal anorectoplasty (PSARP) without backup colostomy was done. In the other 20 cases neonatal sigmoid colostomy was followed by posterior sagittal anorectoplasty and subsequent colostomy closure. The results in respect of mortality, morbidity and continence (according to the Kiesewetter criteria) were compared after 12 months. Results: There were 4 early deaths in the neonatal PSARP group. Wound infection, bowel retraction and urethral injury were the complications. The final assessment for continence could be made only in 7 neonatal cases and 14 staged cases. In the neonatal group, 2 had good, 4 fair and 1 poor continence. In the staged PSARP group, 9 had good, 4 fair and 1 poor continence. Conclusion: Staged repair had a better outcome in our center.

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ABSTRACT: Two rare cases of colorectal adenocarcinoma in a 12 year and an 8 year old boy are reported. It is emphasized that despite its rarity in children, the diagnosis should be considered in patients with history of subacute intestinal obstruction or alternate diarrhea and constipation or prolonged bleeding per rectum.

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ABSTRACT: A two-day old male child presented with respiratory distress. Chest X-ray showed a cystic lesion in the right mid zone. A lobectomy was done and the histology showed a congenital cystic adenomatoid malformation. The infant also had an associated ventricular septal defect.

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ABSTRACT: Neonatal urinary ascites due to bladder perforation, in the absence of any obvious urinary outlet obstruction, is rare. Early diagnosis and management by peritoneal paracentesis and urethral catheterization lower the morbidity and mortality. We report a case of neonatal urinary ascites in girl who had an intra-peritoneal bladder rupture, presenting with gross abdominal distension and respiratory distress. She ha hypospadias and has been under follow-up for the last nine year.

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ABSTRACT: A rare case of carcinoma rectum in a 9 year old boy presented with bleeding per rectum for 9 months. The boy had a huge growth in the rectum involving the posterior and lateral walls. A curative anterior resection of rectum was done. The free margins of the resected specimen showed a single perirectal node involvement. Other tissues were free of metastasis. It was reported as signet ring carcinoma on histology. There was no recurrence after 3 months.

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ABSTRACT: A 10 year old boy presented with clinical features suggestive of an abdominal wall abscess. Exploration after investigations revealed a perforation in the sigmoid colon. Review after one month with a diverting colostomy revealed a tumor-mass under the scar, which proved to be a mucin secreting adenocarcinoma of the sigmoid colon.

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ABSTRACT: Colorectal carcinomas are rare in children. Between 1993 and 1998 only 2 cases were treated in our institute. Hospital records and world literature were reviewed. Laparatomy was performed in both the cases. The primary tumor site was in the hepatic flexure in the first case and in the rectum in the second. Right Hemicolectomy was done in the first case and low anterior resection in the second. In both the cases chemotherapy was given (5FU).

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ABSTRACT: Background/Objective: A survey of the views of Pediatric Surgeons on the training, status and career of pediatric surgery in India. Method: By a qestionnaire mailed to 200 randomly selected members of the Indian Association of Pediatric Surgeons representing different age groups and centers throughout India. Results: Only 50 questionnaires were returned. Six percent of the respondent pediatric surgeons were women. The majority of the respondents felt that long training years did not affect their family life and 94percent of the respondents had one or more children. Only 50 percent of the respondents were economically satisfied. Twenty-eight percent had to resort to general practice and general surgery to augment their income. Three fourths felt that they had sufficient training and were doing quality professional work. Two third felt the need for a change in the training program based on their practical professional lives. They felt the need for a uniform curriculum, better hands-on experience, and rotation during the training period among 2 or 3 centers. A need for refresher training courses was felt in the areas of endoscopy (70 percent respondents), neonatal surgery (28 percent respondents) and critical care (26 percent respondents). The cities were overcrowded with pediatric surgeons but there were insufficient practitioners in the rural areas. All the responses received were from the cities and the large towns. Sixty percent of the pediatric surgeons in practice had to use unskilled nursing staff to manage their patients postoperatively. The majority of the pediatric surgeons felt that general surgeons had inadequate training to operate on children and that better cooperation with pediatricians during training will help foster a good professional relationship in the private sector.Conclusion: More thorough curriculum planning, training, and proper placement, along with help from the pediatricians in the community and the institutions, are necessary to achieve a high quality of pediatric surgical services.

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