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ABSTRACT ABSTRACTVarious surgical procedures are described and practiced for operative management of uncomplicated meconium ileus. In our series, we have tried an approach of minimally invasive procedure to minimize the operative stress in already sick neonates. Ten cases of meconium ileus operated between 01/01/2003 to 21/06/2004 were screened. Three cases presented with complications like peritonitis(2) and volvulus(1) and so were not included in this study. Seven cases were uncomplicated. Out of them three were managed conservatively. Operative management by minilaparotomy -enterotomy and T-tube insertion was done in the remaining four cases, which did not resolve by conservative approach. In this group, patients passed stool by approximately seventh day (range -sixth to eight day). Oral feeds begun on approximately ninth day (range -eighth to tenth day). All four babies survived. This appproach of minilaprotomy, T-tube insertion and N acetyl cysteine instillation, could be of significant benefit in an already sick neonate. Also, T-tube helps in post-operative bowel decompression, distal bowel wash and check dye study.

Budd-Chiari syndrome is an uncommon disease caused by an obstruction to hepatic venous outflow either at the level of the hepatic veins or in the hepatic part of the inferior vena cava. Clinically, it presents with ascites, abdominal pain, hepatomegaly, edema, and occasionally jaundice. The syndrome was first recognised by Lamboran1 in 1842 and later described by Budd2 in 1846 and Chiari3 in 1899. The syndrome is caused by obstruction to the hepatic veins. In the Fig 1. Photograph showing massive ascites and dilated superficial abdominal veins. majority of cases, the obstruction is ascribed to obliterative thrombophlebitis of unknown cause.4

Background: Endoscopic Endonasal Transphenoidal Pituitary Surgery (EETS), has been proved to be a preferred alternative to conventional surgery because of its salient features like wider, more panoramic field of visualization, improved illumination and mobility of instruments, and an ability to look around anatomical corners using angled lens and minimal invasiveness.The current study was done to analyse the effectiveness and morbidity in the patients operated in our centre by Endoscopic Endonasal Transphenoidal Pituitary Surgery (EETS) done by single team in single centre in15 months. Aims and Objective: To describe a case series of patients with pituitary adenomas with endoscopic endonasaltranssphenoidal approach, the technique performed and complications in our centre. Materials and Methods: The technique performed in a series of 30 consecutive patients, and description of their complications and the protocol followed to treat these complications. Results: The tumor removal was gross total in 18 (60.0%) patients, subtotal in 8 (30.7%), and partial in 4 (7.7%) patient. Two patients with growth hormone-secreting adenomas had normalization of hormonal status. Four patients developed temporary diabetes insipidus. Four patients developed post-operative CSF rhinorrhea and were managed conservatively.Two patient had recurrence of tumor.one patient had meningitis and one patient expired in perioperative periods. Conclusions: Our experience suggests that the Endoscopic transsphenoidal approach offers a potentially viable and cost economic treatment option in pituitary tumors which are difficult to remove by the standard microscopic approaches. In past one and half year we have witnessed encouraging results without much of the anticipated complications.

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