Congenital colonic stenosis is a rare condition with less than 20 cases reported in the literature since 1966. We report an interesting case of a 7-month-old baby girl who presented with features suggestive of acute intestinal obstruction. On exploration, it was a case of ascending colon stenosis with absence of caecum and appendix. A double barrel ileocolostomy was performed. The histopathology confirmed the diagnosis of colonic stenosis and ruled out the presence of Hirschsprung’s disease in the distal colon. The child underwent second stage surgery (stoma closure) after 9 months. In complex cases of congenital colonic stenosis, an early decompressive surgery followed by a delayed second stage closure is recommended in patients with poor general condition.

No abstract

Introduction: The extraction of smooth spherical objects is challenging as they are difficult to grasp within the jaws of the forceps and tend to slip distally. Objective: The authors herein have shared their experience with the use of a Fogarty catheter (FC) for safe extraction of smooth and spherical “foreign body (FB) with a hole.” Materials and Methods: Report on pediatric cases ( n = 4) of airway “FB with a hole” wherein the FC was used for their extraction. Mean age was 27.5 months (range: 17 months–39 months). The male: female ratio was 3:1. The technique of FB extraction with a FC has been described, including the principle of the technique, indications, and contra-indications, technical problems and troubleshooting. Results: The FB spectrum included a necklace bead ( n = 2), nonnecklace bead ( n = 1) and a fragmented end-piece of the housing of a ball-pen ( n = 1). The locations of the FBs were right main bronchus ( n = 1), secondary bronchus on the right ( n = 1), and in the left main bronchus ( n = 2). Successful removal of FB with use of FC during rigid broncoscopy was possible. The bead had to be rotated in n = 2 patients to align the hole with the FC. Problems associated with threading the hole and disimpaction of the FB have been highlighted. No complications were observed. The advantages and limitation of the technique have been discussed. Conclusions: The use of FC with the described technique offers a safe, effective and reproducible method for removal of airway “FB with a hole” in a controlled environment while minimizing the possibility of iatrogenic injury to the wall of the surrounding airways.

Introduction: The etiopathogenesis of pelviureteric junction obstruction (PUJO) has been debated. Recently, the role of interstitial cells of Cajal-like cells (ICC-LC)has been studied and reported to be the cause of this functional obstruction. We studied the histopathology and ICC-LC density at PUJ and compared it with that of PUJ of the control group and distal ureteric margin of the study group. Methods: A prospective study was conducted which included PUJO patients in the study group and the renal tumor patients in the control group. Histopathological examination (muscle hypertrophy and fibrosis) and immunohistochemistry (ICC-LC density) were done. The muscle hypertrophy, fibrosis, and ICC-LC density at the PUJ in both the groups were compared. A similar comparison was performed between the findings at the PUJ and the distal margin in the study group. Results: The study and control groups included 37 PUJO patients and 13 Wilms tumor patients. The ICC-LC density at PUJ in the study group was significantly lower than that in the control group (P < 0.001) and that at the distal resected margin of the study group (P < 0.001). Significantly increased muscle hypertrophy (P < 0.001) and fibrosis (P = 0.002) were seen at PUJ in the study group compared to the control group. No significant association was noted between the ICC-LC density and muscle hypertrophy at PUJ and the distal resected margin in the study group. Conclusion: A significant decrease in the density of ICC-LC and increased fibrosis and muscle hypertrophy at PUJ in children with PUJO play a role in the etiopathogenesis of the disease.

A 126-day female child presented with jaundice since day 7 of life. She was icteric and had hepatosplenomegaly. Radiological investigations revealed three extrahepatic and multiple intrahepatic biliary cysts, absent gall bladder and portal vein. These findings were confirmed on laparotomy. To the best of our knowledge, this is the first report of cystic biliary atresia associated with congenital absence of portal vein.