Corrosive Tracheo-esophageal Fistula Following Button Battery Ingestion.

We describe a case of corrosive tracheo-esophageal fistula following button battery ingestion in a 1-year old nonverbal pediatric patient. The delay in diagnosis was caused by failure to obtain correct history and failure to detect opacity of the battery in the neck at the first visit. The large fistula was successfully treated with division and repair with non absorbable sutures, with interposition of strap muscles between separated trachea and esophagus.

Congenital prepubic sinus: a case report

Congenital prepubic sinus is an exceptional disorder of uncertain origin. These sinuses may represent a variant of epispadiac duplication or dorsal urethral duplication of the urethra.We present a case of isolated blind ending prepubic congenital sinus in a 5-year-old male child; which revealed transitional epithelium lining proximally; and squamous epithelium distally. This entity presents with either an opening in the prepubic region and/or persistent mucoid discharge. Excision leads to a permanent cure

Laparoscopic orchiopexy: is closure of the internal ring necessary?

BACKGROUND: Narrowing of the internal ring around the pulled through spermatic cord in cases of laparoscopic orchiopexy is the norm. AIM: To carry out a prospective study to see if closure of the internal ring is really necessary, hypothesis being that mobilization of the impalpable testis leaves a raw surface, which, coupled with the presence of the spermatic cord results in effective closure of the internal ring. METHODS AND MATERIALS: 51 patients with 65 impalpable testes underwent laparoscopic orchiopexy between July 1998 and June 2003. An impalpable testis was present in 21 cases on the left, 16 cases on the right and bilateral in 14 cases. Following complete mobilization required for orchiopexy, all testes with adequate length of spermatic cord were pulled down into the scrotum through the inguinal canal. No suture was applied to narrow the internal ring around the pulled through spermatic cord. Five testes were pulled down by an opening in the medial end of the inguinal canal due to inadequate length of the spermatic cord. In these cases the internal ring was closed by a suture. RESULTS: Follow up of all cases ranged between 1.5 years to 6.5 years. Not a single case has reported with recurrence of a hernia. CONCLUSION: The results suggest that narrowing of the internal ring around the pulled through spermatic cord may not be necessary.

Posterior urethral valves with congenital megalo-urethra.

A 3-year-old male child was admitted with complaints of dysuria and dribbling of urine since birth. There was a small plum sized swelling, on the ventral surface of penis, which increased in size during micturition and on compression of the swelling urine dribbled out. Voiding cysto-urethrogram showed posterior urethral valves with scaphoid megalo-urethra. Vesicostomy with fulguration of the valves and one year later reduction urethroplasty were performed.

Hirschsprung's disease: revisited.

The diagnosis and therapy of Hirschsprung's disease has changed in recent times and a firm diagnosis of the entity can be made pre-operatively by immunohisto-chemistry. There has been a recent trend of switching over from the conventional staged surgical procedures to primary pull-through procedures. In this article the newer concepts referring to its aetiology, pathogenesis, and the current technical advancements like stapler anastomosis, laparoscopic assisted pull-through and single one stage operation without colostomy are discussed along with a brief mention of current concepts in intestinal neuronal dysplasia, enterocolitis and total colonic aganglionosis.

Congenital urethral fistula.

A 3-year-old male child was presented with the history of passage of urine coming from the undersurface of penis and its tip since birth. An opening was present on the ventral aspect of midshaft of penis through which a catheter could be passed. It was diagnosed as urethral fistula which was managed surgically.