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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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   2012| January-March  | Volume 17 | Issue 1  
    Online since December 22, 2011

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Spectrum of human tails: A report of six cases
Biswanath Mukhopadhyay, Ram M Shukla, Madhumita Mukhopadhyay, Kartik C Mandal, Pankaj Haldar, Abhijit Benare
January-March 2012, 17(1):23-25
DOI:10.4103/0971-9261.91082  PMID:22279360
Human tail is a curiosity, a cosmetic stigma and presents as an appendage in the lumbosacral region. Six patients of tail in the lumbosacral region are presented here to discuss the spectrum of presentation of human tails. The embryology, pathology and treatment of this entity are discussed along with a brief review of the literature.
  9,622 198 6
Kasabach-Merritt syndrome with large cutaneous vascular tumors
Pavai Arunachalam, VR Ravi Kumar, Divya Swathi
January-March 2012, 17(1):33-36
DOI:10.4103/0971-9261.91086  PMID:22279364
A case series of four patients who presented with large surface vascular tumors and low platelet count and their management is reported. Medical management was done with steroids, propranolol and vincristine in different combinations. The final response was excellent without surgery.
  6,362 174 7
Soft tissue covers in hypospadias surgery: Is tunica vaginalis better than dartos flap?
Anjan Kumar Dhua, Satish Kumar Aggarwal, Shandip Sinha, Simmi K Ratan
January-March 2012, 17(1):16-19
DOI:10.4103/0971-9261.91080  PMID:22279358
Aim: To compare tunica vaginalis with dartos flap as soft tissue cover in primary hypospadias repair. Materials and Methods: 25 cases (age range: 12-132 months; all fresh cases) of primary hypospadias were prospectively repaired by tubularized incised plate (TIP)/TIP + graft urethroplasty using tunica vaginalis flap (TVF) as soft tissue cover to urethroplasty (group A). Their results were compared with another set (group B) of age- and anatomy-matched controls (25 patients operated during the previous 3 years) who had undergone TIP repair using dartos flap as soft tissue cover. Statistical analysis of results was done with Fischer's exact test. Results: Group A: No fistula, skin necrosis, meatal stenosis, urethral stricture. One case had partial wound dehiscence that resolved on conservative treatment with no sequelae. One case required catheter removal on 3 rd day because of severe bladder spasm. There was no testicular atrophy/ascent. Group B: 3 fistulae - all required surgery. There were three cases of superficial skin necrosis that healed spontaneously without sequel. There was no meatal stenosis/urethral stricture. The difference in fistula rate between both the groups, however, was not statistically significant (P = 0.4). Conclusion: TVF may have an edge over dartos fascia for soft tissue coverage of the neourethra.
  6,146 271 7
Atypical extragonadal germ cell tumors
Mainak Deb, Suravi Mohanty, Anuradha Ananthamurthy, Isha Garg, Kanishka Das
January-March 2012, 17(1):9-15
DOI:10.4103/0971-9261.91079  PMID:22279357
Aim: To review the experience with the diagnosis and management of extragonadal germ cell tumors (GCT) with a subset analysis of those with atypical features. Materials and Methods: A retrospective chart review of patients of extragonadal germ cell tumors between 2000 and 2010 was carried out. Results: Fifteen children aged 7 days to 15 years (median, 1.5 years) were included. Three had an antenatal diagnosis (one sacrococcygeal, one retrobulbar, one retroperitoneal tumor) and were operated in the neonatal period. The locations were distributed between the retrobulbar area (1), anterior neck-thyroid gland (1), mediastinum (4), abdominothoracic extending through the esophageal hiatus (1), retroperitoneal (4) and sacrococcygeal (4). On histological examination, five harbored immature elements while two were malignant; the latter children received postexcision adjuvant chemotherapy. There was no mortality. At a median follow-up of 4.5 years (6 months to 8 years), 14/15 have had an event-free survival. One immature mediastinal teratoma that recurred locally 7.5 years after the initial operation was excised and adjuvant chemotherapy instituted. Conclusions: Extragonadal GCTs in children are uncommon and occasionally present with atypical clinical, radiological and histological features resulting in diagnostic and therapeutic dilemmas.
  5,094 220 -
Postoperative adhesive intestinal obstruction: The role of intestinal stenting
Ravikumar Ramanathan Valkodai, Rajamani Gurusami, Vijayagiri Duraisami
January-March 2012, 17(1):20-22
DOI:10.4103/0971-9261.91081  PMID:22279359
Aim: Six children with adhesive obstruction in the postoperative period were treated with stenting the small bowel with long intestinal tube. Materials and Methods : In two children the stenting was done through jejunostomy, and in the other four through the base of appendix. Results: During a follow-up period of 2-14 years, there had been no recurrence. Conclusions: Use of an intraluminal tube stent in preventing recurrent small bowel obstruction due to adhesions is safe and effective when used on appropriately selected patients.
  3,825 240 2
Choledochocele: An unusual presentation in a premature neonate
Shivaji Mane, Jamir Arlikar, Nitin Dhende
January-March 2012, 17(1):28-30
DOI:10.4103/0971-9261.91084  PMID:22279362
Choledochocele in a premature neonate who presented with obstructive jaundice and was managed surgically is reported. At 1-year follow-up, the child is asymptomatic.
  3,447 110 -
Hydronephrosis due to pelviureteric junction narrowing: Utility of urinary enzymes to predict the need for surgical management and follow-up
Kirtikumar J Rathod, Ram Samujh, Sumeet Agarwal, Ravi Prakash Kanojia, Ujjawal Sharma, Rajendra Prasad
January-March 2012, 17(1):1-5
DOI:10.4103/0971-9261.91077  PMID:22279355
Aim: To study the role of urinary enzymes N-acetyl-b-glucosaminidase (NAG), alkaline phosphatase (AKP) and gamma glutamyl transferase (GGT) in the diagnosis and follow-up of patients with suspected pelviureteric junction obstruction (PUJO). Materials and Methods: A total of 70 patients, 29 managed conservatively (group A) and 41 managed by pyeloplasty (group B), were studied prospectively. A serial measurement of urinary enzymes NAG, AKP and GGT level was performed in both the groups. The mean levels of these urinary enzymes were compared between the two groups and among the patients of the same group at presentation as well as during follow-up. Results: There was a significant fall in the mean AKP level in patients managed conservatively at 8 months of follow-up. Similarly, in the operated group, there was a significant fall in the AKP levels at both 3 months and 8 months of follow-up. The mean level of GGT also showed a significant fall after 3 months of surgery but did not show further significant change at 8 months after surgery. The mean levels of NAG and GGT in the conservatively managed group were significantly low compared with that of patients requiring pyeloplasty at presentation as well as in the follow-up. The mean level of AKP was significantly low in the conservatively managed group when compared with the patients requiring surgery, but did not differ significantly in both the follow-ups after surgery. Conclusions: The level of urinary enzymes NAG, AKP and GGT are significantly high in the patients with hydronephrosis (HDN) requiring pyeloplasty when compared with the patients managed conservatively. The level of AKP significantly falls after pyeloplasty in the patients of HDN due to PUJO. There is a negative correlation with the preoperative level of enzyme NAG with split renal function in the patients of HDN requiring pyeloplasty.
  3,084 270 2
Heterotopic pancreas causing duodenal obstruction in a patient previously treated for choledochal cyst
Vidyanand P Deshpande, BV Raghunath, Yogesh K Sarin, Shalini Sinha
January-March 2012, 17(1):40-42
DOI:10.4103/0971-9261.91088  PMID:22279366
A 9-year-old boy presented with duodenal pancreatic rest causing obstruction and required surgical intervention. He had been treated at the age of 4 months for a choledochal cyst. Both choledochal cyst and heterotopic pancreas are entities that are commonly encountered in children, but the incidental presence of both the entities in the same child, albeit presenting metachronously, is extremely rare.
  3,225 104 3
Retrieval of proximally migrated double J ureteric stents in children using goose neck snare
Sivasankar Jayakumar, Mohamed Marjan, Key Wong, Amman Bolia, George K Ninan
January-March 2012, 17(1):6-8
DOI:10.4103/0971-9261.91078  PMID:22279356
Purpose: Proximal migration of the ureteric double J stent is a rare but known complication. We describe three cases where a minimally invasive technique for retrieval of displaced double J stents using Amplatz™ goose-neck snare was successful. Materials and Methods: A retrospective review of patients with displaced double J stent was carried out, in whom cystoscopy guided retrieval of double J stent was attempted with the help of Amplatz goose-neck snare under radiological control. Results: All three patients were under the age of 3 years. Two patients had migrated double J stent following pyeloplasty and in one patient the double J stent was displaced during a retrograde insertion of double J stent. In all cases, retrieval of displaced double J stent was successfully achieved using Amplatz goose-neck snare. There were no postoperative complications. Conclusion: Our method of retrieval of stent from renal pelvis is simple, safe and minimally invasive. This technique is a useful and safe alternative option for retrieval of proximally migrated double J stents in children.
  2,815 135 2
Congenital diaphragmatic hernia in identical twins
Mustafa T Gurbaz, Ahmet Kazez, Unal Bakal, Tugay Tartar, Fikret Ersoz, Yunus Colakoglu
January-March 2012, 17(1):26-27
DOI:10.4103/0971-9261.91083  PMID:22279361
Congenital diaphragmatic hernia (CDH, Bochdalek type) is rarely seen in both members of identical twins. Herein, we report a 37 weeks' twins with CDH along with a brief review of the literature. Both the neonates survived.
  2,751 105 2
Endodermal sinus tumor of testis with acute intestinal obstruction: A rare presentation
Biswanath Mukhopadhyay, Ram M Shukla, Madhumita Mukhopadhyay, Kartik Chandra Mandal, Dipankar Roy
January-March 2012, 17(1):37-39
DOI:10.4103/0971-9261.91087  PMID:22279365
A 7-year-old boy reported with endodermal sinus tumor of left testis, jejunal metastasis and intestinal obstruction. He was treated by high inguinal orchidectomy and resection of jejunal mass followed by chemotherapy.
  2,560 91 -
Ingested foreign body in the common bile duct
Ranjan Dias, Parackrama Dharmaratne
January-March 2012, 17(1):31-32
DOI:10.4103/0971-9261.91085  PMID:22279363
We report a case of a 5-year-old boy who accidentally ingested a metal pin which was found inside the common bile duct on surgical exploration of duodenum and was removed through the ampulla of Vater. This is the first instance that an ingested metal pin in the common bile duct has been reported in the world literature.
  2,415 103 3
Sigmoid colon in right iliac fossa in children
Jigyasa Pandey, Anand Pandey, Jiledar Rawat
January-March 2012, 17(1):43-43
DOI:10.4103/0971-9261.91089  PMID:22279367
  1,855 104 -
Author's reply
Akshay Kumar Saxena
January-March 2012, 17(1):43-44
  1,656 125 -
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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

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