A 15-day-old female presented with a healed omphalocele and a triangular musculoskeletal defect in the hypogastric area similar to the defect seen in classic bladder exstrophy. The bladder was normal on exploration. The defect was successfully closed using a bilateral anterior pubic ramotomy. Only ten cases of pseudoexstrophy have been reported in the world literature.

A 2-month-old, full-term male presented with a left scrotal faecal fistula due to spontaneous bursting of an incarcerated inguinal hernia for 8 days, with complete decompression of the small bowel through it. Resection and end-to-end anastomosis of the engaged ileal loop was successfully done after incising the ring via the inguinal approach. Only two such cases have been reported in the world literature to date.

Between January 1997 and December 1998, 30 consecutive children with suspected biliary atresia (BA) were selected to assess whether duodenal intubation (DI) and testing of aspirate for bile would help to rule out BA. Duodenal fluid was aspirated every 2 h for 24 h and tested for bile. A HIDA scan was also done in all cases. Every patient underwent a peroperative cholangiogram (POC) and liver biopsy; a Kasai portoenterostomy was done in indicated cases. In 22 cases all three investigations (DI, HIDA scan, POC) suggested BA. In 3 the HIDA scan ruled out BA, but DI and POC suggested BA. In 2 other cases, both the HIDA scan and DI suggested BA, but POC ruled it out and suggested biliary hypoplasia; in 3 others the HIDA scan suggested BA, but DI and POC both, ruled it out. There was no case where DI ruled out BA (i.e., showed bile in aspirate) and POC suggested BA. A liver biopsy confirmed BA in all proven cases. DI and testing the aspirate for bile is a very reliable means to rule out BA if the aspirate tests positive. It is an inexpensive, noninvasive, and quick bedside test that may be especially useful in developing countries where biliary scintigraphy is not available.