A retrospective (2004-2013) and prospective (2014-2015) study of new born with special reference to anorectal malformations over a period of 10 years at a tertiary care centre

Background:A surgical audit of neonates with anorectal malformation in advanced tertiary neonatal care unit.Methods: A retrospective (2004-2013) and prospective (2014-2015) audit of medical records of newborn with GIT disorders admitted in a tertiary care center of central India. The trends analyzed for the duration based on gender, region and birth weight and data base was generated depicting the burden of disease in the region. The data base for the prospective study was also compared with a tertiary center from Nigeria.Results:Total 3309 admission included 73.56% (2438) patients of GIT diseases. Congenital anomalies were the most common cause in each category, major part being anorectal malformation (727) and trachea-esophageal fistula (730). Out of 727 admissions, 651 neonates were operated & total 1194 deaths recorded during this audit year 2004 to July 2015. Majority of new born admitted with were low birth weight male from rural skirts of this region. 509 have associated anomalies and 218 isolated ARM.  Conclusions:There is significant increase in admissions in last decade with triple fold increase in GIT disorder and twice rate in anorectal malformation substantially increasing onwards. The quality of management has to continue further to achieve parity with international standards, as there is lack of antenatal screening and details of any antenatal checkup are scarce, for congenital anomalies at primary level. Early recognition, risk stratification of the baby and timely referral to higher pediatric surgery units is the way forward

Rhabdomyosarcoma of the posterior chest wall in a newborn: a case report

Rhabdomyosarcoma is the most common soft tissue malignancy of childhood, but may occur extremely rarely in the neonatal period. There are only a few reports of rhabdomyosarcoma in neonates. Although, it may arise anywhere in the body, the head and neck, and genitourinary regions are the most frequent sites. Truncal and chest wall rhabdomyosarcoma is relatively rare occurrence. We report a neonate with embryonal rhabdomyosarcoma arising from the posterior chest wall muscles at birth. Computer Tomography scan raised the possibility of rhabdomyosarcoma or neurofibroma, fine-needle aspiration cytology was inconclusive. Total excision was done and chemotherapy given. At 6 months child is without recurrence

Immature cystic teratoma of head of pancreas

Cystic pancreatic tumors are rare in children and the immature cystic teratoma of the pancreas is even rarer. A review of the world literature shows 18 documented cases involving all the age groups. The preoperative evaluation of this lesion is rather questionable, with definitive diagnosis taking place intraoperatively. We report the 19th case, in a 5-month-old male child. The clinical presentation and preoperative diagnosis of this anomaly are discussed

Immature cystic teratoma of head of pancreas

Cystic pancreatic tumors are rare in children and the immature cystic teratoma of the pancreas is even rarer. A review of the world literature shows 18 documented cases involving all the age groups. The preoperative evaluation of this lesion is rather questionable, with definitive diagnosis taking place intraoperatively. We report the 19 th case, in a 5-month-old male child. The clinical presentation and preoperative diagnosis of this anomaly are discussed

Leiomyoma of the mesentery in an infant

Leiomyoma of the mesentery is an uncommon tumor among gastrointestinal stromal tumors. This has been documented in adults and children. However, there is only one case reported in an infant and we are presenting such a rare second case in a 6-month-old male infant. Exploration of the abdomen revealed a solid mass within the leaves of the mid-ileal mesentery that could be enucleated out entirely after careful dissection. Histopathology suggested it to be leiomyoma of mesentery

Hemostasis during hypospadias surgery via topical application of feracrylum citrate: A randomized prospective study

Aim: Report of our experience with topical feracrylum citrate to minimize hemorrhage-related complications in pediatric hypospadiac patients. Materials and Methods : One hundred and fifty consecutive pediatric hypospadiac patients over 3 years (75 in study group and 75 controls - random allocation) were studied. One hundred milliliter of 1% feracrylum citrate solution was used in study cases and equivalent normal saline in controls. The parameters assessed were frequency of cauterizations, intraoperative blood loss, wound edema and postoperative complications. Results: Average number of cauterizations was 1.55 per patient in study group and 5.7 per patient among controls. Among cases, average number of blood soaked gauge pieces was 3.56 per patient, correlating with average intraoperative blood loss of 17.8 ml. In controls, average blood soaked gauge pieces were 6.2 per patient corresponding to an average blood loss of 31 ml. Postoperative hematoma was seen in 8% cases compared with 18% controls. Wound edema appeared in 13.3% cases and 47% controls. Postoperative complications were higher among controls. Conclusions: Feracrylum is an effective and safe topical hemostatic agent to minimize significantly diffuse capillary oozing and surface bleeding. It reduced the frequency of cauterization and tissue damage, intraoperative blood loss, postoperative hematoma, wound edema and postoperative complications

Leiomyoma of the mesentery in an infant

Leiomyoma of the mesentery is an uncommon tumor among gastrointestinal stromal tumors. This has been documented in adults and children. However, there is only one case reported in an infant and we are presenting such a rare second case in a 6-month-old male infant. Exploration of the abdomen revealed a solid mass within the leaves of the mid-ileal mesentery that could be enucleated out entirely after careful dissection. Histopathology suggested it to be leiomyoma of mesentery

A retrospective (2004-2013) and prospective (2014-2015) study of new born with special reference to anorectal malformations over a period of 10 years at a tertiary care centre

Background:A surgical audit of neonates with anorectal malformation in advanced tertiary neonatal care unit.Methods: A retrospective (2004-2013) and prospective (2014-2015) audit of medical records of newborn with GIT disorders admitted in a tertiary care center of central India. The trends analyzed for the duration based on gender, region and birth weight and data base was generated depicting the burden of disease in the region. The data base for the prospective study was also compared with a tertiary center from Nigeria.Results:Total 3309 admission included 73.56% (2438) patients of GIT diseases. Congenital anomalies were the most common cause in each category, major part being anorectal malformation (727) and trachea-esophageal fistula (730). Out of 727 admissions, 651 neonates were operated & total 1194 deaths recorded during this audit year 2004 to July 2015. Majority of new born admitted with were low birth weight male from rural skirts of this region. 509 have associated anomalies and 218 isolated ARM.  Conclusions:There is significant increase in admissions in last decade with triple fold increase in GIT disorder and twice rate in anorectal malformation substantially increasing onwards. The quality of management has to continue further to achieve parity with international standards, as there is lack of antenatal screening and details of any antenatal checkup are scarce, for congenital anomalies at primary level. Early recognition, risk stratification of the baby and timely referral to higher pediatric surgery units is the way forward