ABSTRACT
One of the typical complaints in the pediatric population is umbilical discharge. Among the congenital causes, remnants of omphalomesenteric duct or patent urachus are often detected. On a few occasions, multiple types of ectopic tissue are present. We describe histopathologic findings of two cases reported recently at our center as pediatric umbilical lesions with associated ectopic tissue. Histopathology of the excised mass confirmed the patent omphalomesenteric duct with ectopic gastric, duodenal, and colonic mucosa and pancreatic tissue in two patients with the clinical presentation of umbilical discharge. There were no associated congenital anomalies in these patients. The presence of multiple ectopic gastrointestinal mucosa and pancreas in the umbilical mass is unusual. Herein, we report these cases because of its rarity, multiple ectopic tissues, and reviewing the literature of the reported cases of multiple ectopic tissues.
Subject(s)
Choristoma , Vitelline Duct , Humans , Child , Choristoma/diagnosis , Choristoma/pathology , Patient Discharge , Vitelline Duct/pathology , Stomach/pathology , Pancreas/pathologyABSTRACT
Duplication of urethra is a rare congenital anomaly; a Y-shaped urethral duplication is the rarest variant and lacks a standardised treatment plan. We report a nine-year-old male patient with a Y-duplication of urethra diagnosed during neonatal age who presented to a tertiary care teaching hospital in India in 2018. The patient had undergone a vesicostomy on the seventh day of life for passing urine per anus and was lost to follow-up thereafter. At eight years of age, there was a failed attempt at disconnection of the duplicated urethral tract from the anus after colostomy. The patient was managed successfully by progressive dilatation of the orthotopic urethra, which required multiple stages, followed by separation of the urethra from the rectum. At three-years follow-up the patient was continent and asymptomatic.
Subject(s)
Pelvis , Urethra , Male , Infant, Newborn , Humans , Child , Urethra/surgery , Dilatation , India , RectumABSTRACT
A urethral caruncle is a rare differential diagnosis for a prolapsed mass at the urethral meatus. The aetiopathogenesis of this entity is unclear. We report a three-year-old female patient who presented to a tertiary care teaching hospital in India in 2019 with intermittent bleeding from the introitus for a month. Investigations revealed a urethral caruncle and associated renal anomalies which has not been described in the previous literature. The patient was discharged with a prescription of a Sitz bath twice daily and advised to apply betamethasone (0.1%) cream locally once daily. There was a significant improvement after six weeks of therapy; at two-years follow-up, the lesion had disappeared completely.
Subject(s)
Betamethasone , Emollients , Female , Humans , Child, Preschool , Diagnosis, Differential , India , Patient DischargeABSTRACT
Congenital short bowel syndrome (CSBS) is a very rare gastrointestinal anomaly of unknown etiology. We report a case of a six-week-old male with CSBS who presented with features of intestinal obstruction and failure to thrive. The abdominal radiograph was suggestive of a central gasless abdomen, and a provisional diagnosis of malrotation of the gut with volvulus was considered. On exploration, the duodenum was hugely dilated with annular pancreas, which was not obstructing the duodenum. The length of the intestine was 20 cm from the duodenojejunal junction to the ileocecal junction. Duodenal web was ruled out. Total parenteral nutrition (TNP) was started postoperatively. Early and long-term parenteral nutrition and referral to specialist centers with intestinal rehabilitation programs have improved the overall outcome; however, the challenges are entirely different in developing countries.
ABSTRACT
Parasitic twin is a rare occurrence, with rachispagus being the rarest. The surgical approach and timing are not standardized. We describe the management of two cases of rachispagus and review the sparse literature on this entity. Both cases were operated early because of the social burden on the family as well as difficulty in nursing care. The first patient had associated major systemic malformations in the autosite (cerebral, spinal and cardiac), and succumbed in the postoperative period. The entity was isolated in the second who is doing well.
