treatise on intestinal duplications

Duplications of the alimentary tract are unusual congenital anomalies that often present a diagnostic, as well as therapeutic challenge to the treating surgeon. These lesions occur infrequently and are often not suspected until encountered intraoperatively. Due to the complicated anatomy and involvement of the adjacent bowel, appropriate management requires familiarity with the anatomy and clinico-pathological characteristics. This review article is a treatise on intestinal duplications which addresses the current understanding, their epidemiology, classifi cation, etiogenesis, management options and prognosis

Primary torsion of the omentum mimicking acute appendicitis in a female child: case report and review of literature

Primary torsion of the omentum is an unusual cause of an acute abdomen and commonly mimics acute appendicitis. A case of primary omental torsion seen in a seven-year-old girl is discussed. All the signs and symptoms mimicked acute appendicitis. The patient underwent emergency laparotomy in which a normal appendix and serous fluid in the pelvis were observed. The pathological diagnosis was a primary torsion of the omentum which was excised. This case helps to emphasize the importance of a routine exploration of the abdomen when finding a normal appendix at the time of laparotomy

Congenital pouch colon from Al Ahsa region of Saudi Arabia - A changing demography?

To study the demography, anatomy and management of congenital pouch colon [CPC] in the Al -Ahsa region of the Kingdom of Saudi Arabia [KSA]. Retrospective descriptive analysis of CPCs was made with regard to patient demography, pre- and intra-operative diagnostic features and initial neonatal management. Maternity and Children Hospital, Al-Ahsa region, KSA. Records of all children with anorectal malformations [ARM] treated between August 2004 and August 2007 were reviewed. Out of the 37cases of ARMs, seven were diagnosed as CPCs. Records were analysed for perineal findings, X-ray abdomen and invertogram [when indicated], abdominal ultrasound, type of pouch, division of any urinary fistula, and surgical management. Six out of seven CPCs were among Saudi nationals belonging to Al-Ahsa region. The male to female ratio was 4:3. Six were type IV and one was type III pouch. Preoperative diagnoses were made in two cases by radiology and all cases showed classic anatomical features of CPC intra-operatively. 71% had associated anomalies. Excision of pouch and end colostomy was done in three, loop stoma was done in two and excision of pouch with neonatal pull-through was done in two cases. CPCs are recently being increasingly reported in Saudi nationals. Adequate awareness about radiological, anatomical and histological features would lead to correct diagnosis and reporting. Appropriate neonatal management would prevent pouch related morbidity. Collective data from multiple centers across the Arab peninsula will help define the demographic pattern of this entity in the region

Diffuse idiopathic hyperplasia of the sternocleidomastoid muscle in a child

Unilateral diffuse or localized enlargement of the sternocleidomastoid muscle [SCM] is an event commonly seen in infancy, and is popularly known as 'sternocleidomastoid tumor'. The condition, which usually spontaneously resolves with or without physiotherapy, is due to a hematoma following a difficult labor. The muscle regains its elasticity and complete function. In some infants it resolves with fibromatous changes in the muscle leading to shortening, fibrosis and finally culminating in torticollis. We describe a case of idiopathic diffuse enlargement of unilateral SCM in a 12-year-old child without any functional compromise or torticollis. The histopathological and clinical characteristics differentiating it from more commonly described sternocleidomastoid tumor or fibromatosis coli are described. We believe this is the first case report of idiopathic hyperplasia of SCM

Intestinal perforation by multiple ectopic pancreatic tissues in a neonate with multiple congenital anomalies

Ectopic pancreatic tissues of the gut are usually found incidentally during laparotomy or are reported in the autopsy findings. Rarely these ectopic pancreatic tissues may cause symptoms such as hemorrhage, pancreatitis, intussusception or perforation. We present a case report of the presence of multiple ectopic pancreatic tissues in the gut causing hemorrhage and perforation in a preterm, extremely low birth weight neonate with multiple congenital anomalies