Splenogonadal Fusion - A Rare Anomaly.

Splenogonadal fusion (SGF) is a rare congenital anomaly. Less than 200 cases of SGF have been documented till date. We present a case of 14-year-old male patient with swelling in the left scrotum for 3 years. Left orchidectomy was done. Histopathology showed ectopic splenic tissue surrounding testicular parenchyma suggestive of SGF. This rare congenital malformation may occur due to the proximity of developing gonad and spleen, resulting in abnormal connection between them during gestation. SGF presents a diagnostic challenge preoperatively; however, recent imaging methods can aid with the diagnosis. SGF as a rare cause of testicular swelling should be kept in mind and evaluated to avoid unnecessary orchidectomy.

Long term follow up of proximal hypospadias repair-urethral stricture should be excluded in adults who present with epididymo-orchitis.

OBJECTIVE: Epididymo-orchitis (EO) is a well-known complication of urinary tract infections (UTI) in children. This is commonly seen in children who had hypospadias repair or in those who had surgery for anorectal malformation especially when it results in urethral stricture. However EO occurring as a complication of urethral stricture in adults operated for hypospadias in childhood is not well documented in the literature. MATERIAL AND METHODS: This is a retrospective review of four adults who had proximal hypospadias repair in childhood. All four men presented to us with EO. They were thoroughly investigated to rule out presence of urethral stricture. RESULTS: Three patients had urethral stricture of which two responded well to dilatation and one required cystoscopy and visual internal urethrotomy. The fourth patient did not have urethral stricture. EO in this patient is thought to be due to excessive straining during micturition causing reflux into seminal vesicles. CONCLUSION: Urethral stricture should be excluded in any adult who had a hypospadias repair and presents with EO. Urethral strictures after hypospadias surgery respond well to dilatation and to endoscopic urethrotomy.

Horseshoe kidney and associated anomalies: Single institutional review of 20 cases.

BACKGROUND: Horseshoe kidney (HSK) is a common renal fusion anomaly. We undertook this study to discuss various anomalies associated with HSKs. The objective of the study is to study various anomalies associated with HSKs and to assess the need for surgical intervention in patients with these anomalies. PATIENTS AND METHODS: This is a retrospective cohort study of twenty patients who presented to our institute with the diagnosis of HSKs. The data were analysed with regard to age at presentation, symptoms, associated anomalies, investigations and surgical intervention. RESULTS: Twenty patients were included in this study. They were referred either with a diagnosis of HSK or were diagnosed during investigations for symptoms and during workup for associated anomalies. Eleven patients were incidentally diagnosed and were asymptomatic, and there were no associated anomalies diagnosed in these patients. Nine patients were symptomatic and were diagnosed with various associated anomalies. Our results concur with recent literature review which suggests that nearly half of the patients with HSKs have associated anomalies. In the present series, all symptomatic patients with associated anomalies required surgical intervention. CONCLUSION: HSKs being a common fusion anomaly, necessitates a prompt and thorough search of the search for any associated anomalies. Many of these anomalies may require surgical intervention.

Rupture of Umbilical Hernia with Evisceration in a Newborn - A Case Report.

Most umbilical hernias in infants do not need surgery and the ring will eventually close. Occasionally few complications can arise and incarceration is most common. Spontaneous rupture of the hernia and eventual evisceration is a rarely seen complication. A 3-week-old neonate having umbilical hernia presented with rupture of the sac with evisceration of bowel within a few days of first visit. No underlying cause like umbilical sepsis was found. The baby had emergency repair of the hernia with an uneventful recovery.