Malignant abdominal tumors in children

The medical records of 53 patients between the ages of 1 and 18 years, with malignant abdominal tumors seen between 1987 and 1993 were reviewed. Wilms' tumor was the most common tumor constituting 28.3% of all cases. The others included Non- Hodgkin's lymphomas [20.8%], neuroblastomas [11.3%], rhabdomyosarcomas, germ cell tumors 9.4% each and a miscellaneous group. Majority of patients [60.3%] were under 5 years of age. The male to female ratio was 1:1. Among 15 patients with Wilms' tumor, majority [46.7%] had stage III tumors at presentation and all but one patient, were referred to our Hospital more than a month following initiation of their symptoms. In contrast, 5 out of 7 patients with Stage I and II tumors were seen within the first month of their symptoms. The commonly utilized techniques to aid diagnosis were ultrasonography and computerized tomography scan and the common treatment modality was a combination of surgery and chemotherapy. For Wilms' tumor, the mean follow-up was 1 year and nine months, the survival rate was 93.3% and there were no recurrences. With early diagnosis and multimodality treatment, the survival rates for childhood malignancies can be greatly improved

Penile constrictive band injury

Penile strangulation caused by a thread or human hair is an uncommon cause of urethral injury described in paediatric practice. Five children presented with this entity to the Aga Khan University Hospital, Karachi between August, 1991 and August, 1992. Three children had uneventful recoveries after removal of the contricting agent. Two patients developed urethrocutaneous fistulae and partial amputation of the penis because of late presentation. Early recognition and removal of the constricting agent is necessary to prevent serious complications

Corrosive pyloric obstruction: a case report and review of literature

Alkali ingestion usually injures the esophagus, while ingested acid often spares the esophagus and damages the gastric outlet. A case of gastric outlet obstruction without esophageal involvement secondary to acid ingestion is presented to illustrate the difficulties encountered in managing such an injury. The literature on this subject is briefly reviewed

Short gut syndrome: the Aga khan University Hospital experience

Despite recent advances in post operative care, problems associated with a short gut remain difficult to manage in neonates and infants. Five neonates with short gut syndrome secondary to various congenital intestinal anomalies were managed at the Aga Khan University Hospital between July 1986 and November 1988. The total length of the small bowel ranged from 55 cms to 130 cms and one patient had concomitant total colonic aganglionosis. The period of hospitalization ranged from 36 days to 6 months. Post operative management included the judicious use of Immodium, Cholestyramine and formulas containing medium chain triglycerides. Total parenteral nutrition was employed in one patient. Neonates, with retained ileum and ileocecal valve had smoother post operative courses and shorter hospitalization. All patients are showing satisfactory weight gain and development following discharge