[size=20px]4 months old boy, healthy, brought by parents due abdominal pain and excessive crying for 1 day. Pain is intermittent, pulling his legs up during pain, associated with vomiting. Later he passed blood with stool. On physical examination, he is lethargic, abdomen is distended. US showed a classic target sign at Left iliac fossa.

What is your initial management?[/size]

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a 19-month-old female patient.

The parents noticed abdominal distension incidentally during routine care. An ultrasound was performed, which suggested a left renal unilocular cyst. They then repeated the ultrasound at another center, where it was reported as a mesenteric cyst or omental cyst.

A contrast-enhanced CT scan of the abdomen has also been performed, what is the most likely diagnosis? the best management and surgical approach for this patient.

what next?[/size]

3 years old boy, Presented with bowel obstruction. Patient has a past history of Laparoscopic reduction of intussusception with appendectomy 1 month back.

OR finding:

Complete obstruction at the previous site of intussusception, 20 cm proximal to IC​, resection and anastomosis was done.[/size]

Delayed presentation , 3 month old bladder exstrophy , with small bladder plate.

primary repair & post osteotomy was performed, but pt developed generalized oedema ,& severe ascites on the 6th day post op , not responding to fluid restrictions or Human albumin.

How to manage

6 month old child presented with difficulty in passing urine and stool. His bladder was palpable. He had foleys's catheter insertion. On USG and CT scan of abdomen, he was found to have large cystic mass in the presacral area or retrorectal area. It was excised laparoscopically. Post op patient was started feeding on the same day and discharged on post op day 4. Histopath was suggestive of pelvic hamartoma

see video link in second post

How do you manage this rectal prolapse post ARM repair?

the baby weighs 4 kgs and does not seem malnuritied

flexible fiber-optic bronchoscopy and Upper GI endoscopy were done at the same anesthesia.

• bronchoscopy was normal
  
• upper gi endoscopy showed esophageal stenosis 13cm from the tooth arch. no hiatal hernia or signs of esophageal inflammation were detected.
  

the stenosis appeared to be because an external compression, so a contrast-enhanced chest CT was performed to exclude external compression by a foregut cyst or vascular ring.

looking for opinions about management.

dissection of the common channel after placing catheters in the vagina and bladder and continued into the public bone where suspensory ligaments released. then mobilized the sinus into the perineal skin.

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