Despite various theories to explain the pathogenesis of atresias, the exact mechanism is still controversial. Currently, atresias are believed to result from vascular accidents and less likely due to the failure of recanalization. We report a case which challenges this belief. A 1-day-old neonate was explored for suspected jejunal atresia. Apart from Type III jejunal atresia, 15 cm from DJ junction, there was surprisingly no distal lumen in the intestine from jejunum till rectum. Multiple enterotomies revealed the whole of the remaining jejunum, ileum, and large colon to be a solid cord-like structure. No distal luminal contents or histopathological evidence of ischemic damage was seen, thus suggesting the probable etiology to be a failure of recanalization of the gut cord rather than a late vascular accident. Such rare cases provide insights into possible embryogenetic mechanisms which can then aid in formulating preventive measures.
Chylolymphatic cyst, variant of mesenteric cyst, is a rare entity. Clinical presentation and radiological features are not characteristic, so diagnosis can be made finally on histopathology. We report an extremely rare case of giant chylolymphatic cyst measuring >15 cm. A 2-year-old female presented with abdominal pain and vomiting. On examination, a ill-defined and firm mass was palpable just below umbilicus. Positron emission tomography-computed tomography scan revealed a large ill-defined lesion, which measured 16 × 13.2 × 6.7 cm in size and was seen in relation to the abdominal mesentery. Provisional diagnosis of mesenteric cyst was made. Laparotomy revealed multiple lymphatic cysts of variable size arising from the mesentery of proximal ileum. Histopathology examination confirmed the presence of a giant chylolymphatic cyst. Chylolymphatic cysts are rare entity and should be kept in mind while diagnosing a pediatric case of abdominal cysts.
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