Interesting cases discussions

[center][/center] This Forum is dedicated to Interesting cases discussions

Case by prof Tariq Altokais, Professor and consultant of pediatric surgery King Saud university, Riyadh, Saudi Arabia [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]

[color=rgb(44, 130, 201)]case of Dr. Usman, from Pakistan. [/color]

case of Dr. Usman, from Pakistan. 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.

Case of Cloacal Extrophy with prolapsed gut . Presented a while ago . How to proceed in Emergency.

2 year old boy with History of magnet ingestion 1 month before. Admitted in for acute bowel obstruction.

15M, splenic flexure and descending colon high, positioned between the spleen and diaphragm, impacting stomach and pancreas, with symptoms. Are there any pediatric surgeons who have experience with this condition and/or who would perform reposition of the colon?

29 days old neonate with BW 1400 gr was taken to OR for complicated NEC (free gas in abdomen, signs of peritonitis). perforated appendicitis revealed At the time of procedure. Appendectomy was done. Uneventful recovery.

Case by dr Abdul Wahab Aljubab, consultant pediatric surgeon, king Fahad Medical city, Riyadh, Saudi Arabia

[size=20px]male neonate 15 days old presented with left Parotid swelling as per clinical examination and U/S what next?[/size]

[size=20px]Case by prof Tariq Altokais (KKUH, Riyadh, Saudi Arabia): https://pediatricsurgery.club/forums/member/2177-tariq424 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]

Male infant 2m, with the following sublingual mass, which appeared two weeks post tongue tie release by bipolar diathermy. what next?

4 yer old girl. Congenital H-type recto-vaginal fistula repair. Simultaneous sigmoid end colostomy done. Preoperative bowel preparation with polyethyleneglycol.

Bilateral axillary masses in four yrs old male

4 day old neonate. Full term. BW 2800 qr. First pregnancy. Prenatally - without any problem. two functioning anal opening, two external urethral opening and two vagina. Urination and defecation are normal. There are no signs of urinary tract or bowel obstruction symptoms. bladder herniated, it is under supra-pubic skin. Ultrasonography - there are no presacral mass, no upper urinary tract duplication, no other organs pathology identified.

Congenital cricopharyngeal​ diverticulum in 3 year old child.

Case submitted by dr Arwa, 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

case of Dr. Rasik Shah 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

6-month-old baby-boy admitted on hospital 02.08.2017, with inability to pass urine due to urethral obstruction, hyperthermia. On examination – urethral duplication with normal anatomic location of first urethra and penile hypospadias like second urethral meatus. Both urethras were obstructed. Emergent Vesicostomy was done. Complete Duplication with complete stricture of both urethrae, bilateral uretero-hydronephrosis (Rt grade 4, Lt grade 5), non-functional left kidney (Scintigraphy - 5% function of Lt kidney) revealed after full workup. He operated on (2) resection of accessory urethra and main urethroplasty; 12.10.17 (3) urethral fistula repair with processes peritoneal…

case posted by Drboughabanadji How do you manage this rectal prolapse post ARM repair?

A 5-month old boy with recurrent respiratory tract infections from birth until now with multiple admissions in the Hospital the chest X-ray density in the right upper lobe the boy has been observed for about 1-month and put on antibiotics and chest physiotherapy without showing any improvement in this density in the right upper lobe a flexible bronchoscopy was done about month ago and there was only a signs of a external compression on the right main bronchus vin a chest CT with contrast was done and the images are shown below I appreciate your opinions about this pathology on the right upper lobe

A 4-month-old baby girl with a history of chronic cough and difficulty feeding and regurgitation was referred to our hospital because she was diagnosed with esophageal stenosis after performing a contrast swallow. 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 foregu…

Management of H-type rectovaginal fistula.

Case of prof Amin 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.

I had an 11 years old boy who presented with delayed perforation of the jejunem after blunt trauma that was inflicted 3 days prior to referral. If somebody have similar cases we can Wright it for publication.