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Idiopathic Hypertrophic Pyloric Stenosis (IHPS) has been associated with anomalies (6 to 12.1%) 1,2but has a rare association with Congenital Diaphragmatic Hernia (CDH). The association can be genetic, though it is usually sporadic. We present a case report of a 1 month child with non bilious projectile vomiting with failure to thrive. Radiological evaluation showed IHPS with left CDH which was surgically corrected. Presentation of IHPS may be atypical when associated with CDH. Early recognition of concomitant anomalies will reduce morbidity in these patients

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Tracheo-oesophageal fistula (TEF) with oesophageal atresia is a common life threatening congenital malformation. H type TEF is a rare subtype (1.8 to 4.2% of all TEF) with the least association with congenital anomalies. We report two cases of H type TEF, first patient was a 2 month old girl who presented with the classical triad of symptoms, and the second patient was a 2 year old girl who presented with recurrent attacks of pneumonia, choking on feeding and noisy breathing. After radiological confirmation, optimization of pulmonary status and nutritional improvement, both underwent right cervicotomy with disconnection of the H fistula. Both patients are doing well on regular follow up. Detection of H fistula is difficult as compared to TEF since the clinical symptoms are variable, radiological detection difficult and diagnosis is based on a high degree of clinical suspicion. We present these two cases to document the history, presentation, clinical management and surgical procedure done in these patients.

An anal membrane is categorized as a low anorectal malformation and is noted under rare malformations in the International classification. It is very rare and may present variedly in different age groups and only a handful of cases have been ever described. It is one of the few anorectal malformations in which the anal canal is at a normal position, thus concealing itself from an attendant who is not suspicious. We present two cases of anal membrane. A newborn girl presenting at birth was treated by primary excision of the membranes. The second case was a 2 year boy with chronic constipation with an obstructive web of a persistent ruptured anal membrane. Both were short procedures with almost no morbidity. Both the cases would have been diagnosed earlier if the primary attendant had done a rectal examination. There was good post-operative outcome in terms of continence and constipation in both the cases. Neither of them needed any anal dilatations. Anal membrane is a rare low anorectal malformation which needs keen suspicion for diagnosis. It is easy to miss it if the attendant omits a rectal examination. Therefore, it is imperative to do a rectal examination of all neonates with non-passage of meconium and as well as children with chronic constipation.