The screen-detected incidences of IRA and acute midgut volvulus were significantly greater in heterotaxy than the normal population. Prophylactic Ladd procedure was associated with less morbidity and mortality compared with emergency surgery. A long-term prospective randomized trial is needed to define the indication for screening and prophylactic treatment of IRA in heterotaxy.

PEG insertion does not appear to induce symptomatic gastro-oesophageal reflux in the majority of children, suggesting that in the majority of cases, a concurrent anti-reflux procedure is unnecessary. Parents should be counseled accordingly.

Posterior urethral valves (PUV) are the most common cause of bladder outlet obstruction (BOO) in boys. Cobb's collar, a rare narrowing of the bulbar urethra, is one of the lesser-known causes of congenital urethral obstruction. We present a case of both congenital anomalies occurring concomitantly, in a preterm baby presenting with urinary ascites.