A BSTRACT Context: Gastrointestinal (GI) duplications are rare congenital malformations with diverse presentations. They usually present in the pediatric age, especially in the first 2 years of life. Aims: To present our experience with GI duplication (cysts) at a pediatric surgery tertiary care teaching institute. Settings and Design: It is a retrospective observational study undertaken in the department of pediatric surgery at our center between 2012 and 2022 for GI duplications. Materials and Methods: All children were analyzed for their age, sex, presentation, radiological evaluation, operative management, and outcomes. Results: Thirty-two patients were diagnosed with GI duplication. Slight male predominance was present in the series (M: F ≈ 4:3). Fifteen (46.88%) patients presented in the neonatal age group; 26 (81.25%) patients were under 2 years. In the majority of cases ( n = 23, 71.88%), the presentation was acute onset. Double duplication cysts on opposite sides of the diaphragm were present in one case. The most common location was ileum ( n = 17), followed by gallbladder ( n = 6), appendix ( n = 3), gastric ( n = 1), jejunum ( n = 1), esophagus ( n = 1), ileocecal junction ( n = 1), duodenum ( n = 1), sigmoid ( n = 1), and anal canal ( n = 1). Multiple associations (malformations/surgical pathologies) were present. Intussusception ( n = 6) was the most common, followed by intestinal atresia ( n = 5), anorectal malformation ( n = 3), abdominal wall defect ( n = 3), hemorrhagic cyst ( n = 1), Meckel's diverticulum ( n = 1), and sacrococcygeal teratoma ( n = 1). Four cases were associated with intestinal volvulus, three cases with intestinal adhesions, and two with intestinal perforation. Favorable outcomes were present in 75% of cases. Conclusion: GI duplications have varied presentations depending on site, size, type, local mass effect, mucosal pattern, and associated complications. The importance of clinical suspicion and radiology cannot be underrated. Early diagnosis is required to prevent postoperative complications. Management is individualized as per the type of duplication anomaly and its relation with the involved GI tract.

Background: Neural tube defects (NTDs) are congenital malformation resulting from failure of complete or partial closure of the neural tube in developing embryo. Aims and Objectives: The aim of this study is to present our experience, management and early outcomes (one month post-operatively) of neural tube defects presenting in neonatal period at our high volume tertiary care teaching Institutions. Materials and methods: This retrospective cohort study was conducted over a period of 10 years from January 2007 to December 2016. Medical records of neonates treated for neural tube defects were recorded in a pre-designed Performa. Results: A total of 286 patients with clinically diagnosed neural tube defects presenting in the neonatal period were studied. Male: female ratio was 1.11. The mean birth weight was 2350g. History of peri-conceptional use of folic acid was found in 15 (5.24%) mothers. One hundred seventeen (40.90%) of the patients had multiple system involvement. Most common was orthopedic deformities. Associated hydrocephalus was appreciated in 259 (90.56%) patients. Meningomyelocele was the most common anomaly seen in 239 (83.57%), 24 (8.39%) as meningocele and 23 (8.04%) were diagnosed as having Encephalocele. Surgery with decapping and repair was performed in 277 (96.85%) of the patients. Ventriculoperitoneal (VP) shunt operation before repair of meningomyelocele was performed in 9 (3.15%) patients, while in 19 (6.64%) patients, VP shunt operation was performed after the repair of NTD's in the early (one month) postoperative period. Clinical sepsis developed in the postoperative period in twenty one (7.58%) out of 277 patients, for which antibiotics were stepped up. Thirteen patients (4.69%) died postoperatively due to sepsis and associated anomalies. Conclusions: We present our retrospective report on neural tube defects from Indian subcontinent with accurate baseline data. Meningomyelocele was the most common type of NTD's. We recommend that folic acid supplementation should begin before marriage to raise its serum levels before the conception. Antenatal care especially antenatal ultrasonography must be contemplated as early as possible in early detection of NTDs.