SummaryCongenital duodenal anomalies like atresia, stenosis and web or diaphragm commonly present in the neonatal age with signs of intestinal obstruction. Duodenal webs can sometimes present in early infancy and very rarely beyond infancy. The authors present a case of congenital duodenal web with a very small central aperture in a 2-year-old child with presenting features of persistent vomiting and resultant failure to thrive without any overt signs of intestinal obstruction.

Eccrine angiokeratomatous hamartoma is a rare newly defined vascular lesion of the skin, the first case of which was reported in 2006 (Kanitakis J, Ly A, Claudy A. Eccrine angiokeratomatous hamartoma: a new variant of eccrine hamartoma with angiokeratoma. J Am Acad Dermatol 2006; 55: S104–6). On web Literature Search, Only three previously documented cases of the lesions were found. A 1.5-year-old female child presented with a painless lesion on her right leg since birth which has been gradually increasing in size and recently developed central ulceration. Histological examination of the excised lesion confirmed the diagnosis. This is the first of the cases to be reported in paediatric age-group (<2 years)

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BCG adenitis, the enlargement of regional lymph nodes after BCG vaccination is one of the common complications seen. BCG adenitis may present at varied time interval after the vaccine administration. Different medical and surgical treatment modalities have been reported for its management. We report our management experience of BCG adenitis seen over a period of 1 year.

The condition achalasia cardia is rare in paediatric age group, especially in infants. An 11-month-old female infant presented with complaints of oronasal regurgitation since birth and failure to thrive. Upper GI contrast study was conducted which demonstrated massive dilatation of lower 2/3(rd) of oesophagus with abrupt narrowing at lower oesophageal sphincter and positive 'bird beak sign'. On the basis of radiological findings infantile achalasia cardia was diagnosed and patient underwent modified Heller's Oesophagocardiomyotomy with anti reflux procedure. Post operatively the symptoms subsided and weight gain was noted after six month follow up. Although functional infant regurgitation and Gastro-oesophageal reflux (GER) is common in infancy, uncommon causes like achalasia cardia should also be considered as a differential when symptoms are persisting.