Interesting cases discussions

[color=#ff0000]Case of prof Amin [/color]

Pt 15 day old admitted to NICU due to RDS. FT. NSVD. Chest XRay - Rt pleural effusion with mediastinal shift. Pleural drainage. NPO, TPN. After 1 week daily outcome from drainage about 20 ml\kg. plurodesis with 4% iodine. no effect. After 3 weeks - Rt thoracoscopic supra-diaphragmatic Thoracic duct ligation. Uneventful recovery. Discharged with MCT formula feeding. After 2 weeks - mild pericardial effusion ( 10 mm) on Echocardiogarphy. After 1 month > 2 sm pericardial effusion, tachicardia. Lt thoracoscopic creation of pericardial window done. Uneventful recovery.

Case discussion 1.8 years old case of DSD. Raised as a female and later chromosomal study revealed male pattern 46 xy. Perineal hypospadias, bifid scrotum, bilateral undescended testes. Recent us revealed a rudementary uterus. Lap exploration revealed midline rudementary uterus only. No fallopian tubes and no ovaries. Both vas deferens are normally oriented coming from internal rings and going back the urinary bladder to the ? Prostate. Inguinal canal exploration revealed bilateral undescended testes and orchidopexy was done. What else to be done. What is the diagnosis

Original case of prof Mohamed A Baky Fahmy: https://pediatricsurgery.club/member/46-mohamed-fahmy Female patient 3.5 years old, presented with large abdominal mass, found attached to the umbilicus and histopathology is an embryonal rhabdomyosarcoma [center] [/center] [center][/center] [center][/center] [center][/center] [center][/center] [center][/center]

This case originally submitted by dr Arwa https://pediatricsurgery.club/member/13-arwa Feminizing Genitoplasty in two different girls with CAH; 2 & 5 years old respectively before/intra/after images. Vaginoplasty has been postpond till near puberty , as in our experience the younger age group don’t do very well ... For discussion: What age in your experience is best for vaginoplasty ?.

[ATTACH=JSON]{"data-align":"none","data-size":"full","data-tempid":"temp_361_1608490297273_953"}[/ATTACH]

[center]Congenital Perineal hernia in neonate originally submitted by dr Gunduz Aghayev https://pediatricsurgery.club/member/202-gunduz-aghayev [/center]

I came across a 4 years old girl with bilateral inguinal hernia. On laparoscopic inspection turned up to be testicular feminizations syndrome. The familiy are simple illiterate farmers The question is do you tell the family that their beautiful girl is a male?! will the simple family understand and be able to cope. or there is another Way to communicate the information. waiting for your response.

I have a 15 years old boy from Afghanistan who is the only Male in a family of 7 girls. He also was engaged to get married next summer He was referred because of sudden hematuria which on investigation proved to be the menstrual blood and finally diagnosed as adrenogenital syndrome with complete virilization. He has very good size penis . The question I would like to ask what is best for the child to be reared as the real female sex or to rear him as a boy (functional and social sex)??? waiting for your answer

Untwist, leveling colostomy and pull through later on