Familial duodenal atresia: a report of two siblings.

The familial occurrence of duodenal atresia is extremely uncommon. The author reports duodenal atresia occurring in two siblings who underwent successful surgical repair at the Pediatric Surgical Unit, Department of Surgery, Ratchaburi Hospital. To the author's knowledge, this is the first report of familial duodenal atresia in Thailand.

Left-sided gastroschisis: two case reports in Ratchaburi Hospital.

Left-sided gastroschisis has rarely been reported. From August 1987 to April 1998, 73 cases of gastroschisis were treated at the Pediatric Surgical Unit, Department of Surgery, Ratchaburi Hospital. The abdominal wall defect of only 2 cases occurred on the left side of the umbilicus. The 2 cases of left-sided gastroschisis were girls and were successfully treated by primary fascial closure. After 7 and 1 year follow-up the patients remain asymptomatic.

Hepaticojejunostomy after excision of choledochal cyst in two children with previous biliary surgery.

Hepaticojejunostomy Roux-en-Y after excision of choledochal cyst is the treatment of choice for children with choledochal cyst, to prevent the risk of postoperative cholangitis, stone formation and malignancy. The author reports two children with previous biliary surgery for choledochal cyst, one with cystojejunostomy without cholecystectomy and the other with cholecystectomy alone. Two children were admitted to the Pediatric Surgical Unit, Ratchaburi Hospital, with the complaint of chronic abdominal pain. After investigation the two children had cyst excision and hepaticojejunostomy Roux-en-Y. After six and one year follow-up the patients remain asymptomatic. The aim of this report was to show the complication of two previous biliary surgeries for choledochal cyst and support total cyst excision combined with hepaticojejunostomy Roux-en-Y being the treatment of choice for choledochal cyst.

Separation of labial fusion under topical anesthesia.

A prospective study from August 1987 to April 1996 at the Outpatient Pediatric Surgical Unit, Ratchaburi Hospital, of labial separations performed under topical analgesic cream in 31 labial fusions. The ages ranged from 5 months to 5 years. Topical analgesic cream (EMLA cream) produces adequate anesthesia for labial separation in children without causing pain. It is a simple, safe and effective technique including a very short duration of therapy that should be performed in children with labial fusion.