This 4 month 6 day baby came to us with repeated episodes of choking and turning blue following feeds. He had spent more than 3 months since his birth in the NICU (neonatal intensive care unit). The parents were very courageous and had trained themselves in administering suction and oxygen whenever required at home.
He underwent bronchoscopy and was diagnosed to suffer from laryngotracheobronchomalacia (congenital softening of cartilage ). This is a peculiar situation where natural resolution often occurs with time. Till that time, we need to feed the baby in a safe way so that the baby grows and gains weight. Traditionally this has been done by placing a large tube in the stomach by an operation (gastrostomy).
SCROTAL SWELLING DUE TO TESTICULAR TORSION
A 12 yr boy presented with a history of trivial trauma to his left scrotum and severe swelling of the same for 2 days. The scrotum was examined and found to have a left testicular torsion. USG revealed no blood flow to the left testis. The child was immediately taken to the OT and explored. The testis was found to be completely necrosed and bereft of blood supply due to torsion. Detorsion was done but blood flow could not be restored. It had to be removed.
She presented with a cluster of the following anomalies:
1. Anorectal malformation (anovestibular fistula)
2. Right sided crossed renal ectopia.
3. Multiple congenital heart defects
4. Typical face
5. Fused cranial fontanalles
- WHAT IS INFANTILE HEMANGIOMA (IH)?
These are the commonest tumor of infancy. They are benign tumors. Females are more affected than males. You can read more about it here.
Infantile hemangioma recurrence in a child who had to be operated for severe bleeding
- WHAT IS THE USUAL AGE WHEN INFANTILE HEMANGIOMA IS SEEN AND WHAT IS THE USUAL COURSE OF EVENTS?
Infantile hemangioma is seen when the baby is 1 to 2 weeks old. A faint mark may be present since birth. Commonly it is single. These are most commonly seen in the head and neck region (60%), followed by the trunk and the extremities. If they are multiple, internal organ involvement is a possibility. Usually it grows for the first 10 to 12 months. Then it stops growing and starts to involute. The colour fades, the center becomes pale and the volume diminishes. By 5-7 years, 70% of the lesions involute. The residual cometic result is often excellent, but sometimes, there is residual mass of fibrofatty tissue.
This is a radiological procedure wherein the urinary bladder is filled with a contrast material and then the patient is encouraged to pass urine lying on the table. The process of micturition is studied by an overlying camera to note the following:
- The contour of the urinary bladder and its evacuation.
- The anatomy of the urethra, especially in males, to rule out any congenital blockage of the urethra.
- Any defect of the ureterovesical junction which leads to free flow of urine back towards the kidneys when one tries to pass urine. (normally urine should not go back from the bladder to the kidneys).
- Assessment of the amount of residual urine (urine which stays back in the bladder after evacuation).
Pediatric Surgery facility is available in the following Governemnt hospitals in west bengal, kolkata. This is issued in public interest.
A. Emergency and Elective Pediatric Surgery
i) Nil Ratan Sarkar Medical College and Hospital
Website : http://nrsmch.org/
ii) Medical College, Kolkata
Website : http://www.medicalcollegekolkata.org/
B. Only Elective Pediatric Surgery
i) R. G. Kar Medical College and Hospital
Website : http://rgkarmedicalcollege.org/
ii) IPGMER SSKM Hospital
Website : http://www.ipgmer.gov.in/
Laparoscopic Pyeloplasty first patient of Dr. Saha in Kolkata
Recently our consultant pediatric surgeon Dr. Subhasis Saha performed two successive laparoscopic pyeloplasties (done for hydronephrosis due to PUJ obstruction) in 2 children aged 7 years and 4 years with wonderful outcome. The tentative budget / cost involved is 60,000 – 80,000 INR and it includes medicine, hospital stay, surgeon fees, anaestetist fees etc. There are no hidden costs involved. We are going to publish a video of exerpts from the surgery very soon. Laparoscopic pyeloplasty in children in Kolkata is not very commonly done but Dr Subhasis Saha is routinely doing it now.
Most of the surgeons treat phimosis with circumcision
But now we know that the cause of congenital phimosis is a ring located in the inner layer of the prepuce. This ring can be disrupted by a vertical incision reaching upto the Buck’s fascia and suturing it horizontally. This procedure is called preputialplasty. This is a cosmetically more acceptable procedure, as the appearance of the prepuce remains almost unchanged.
Constipation in neonates and infants – scenario 1
This was a 3 month baby presented with abdominal distension since birth, and very constipated. The Pediatricians advised laxatives, and enemas which sometimes worked.
barrium enema showing Hirschsprungs disease
Then Barium enema examination was done which showed a narrowing at the junction of the descending and the sigmoid colon and proximal dilatation.
An inguinal hernia is a communication of the groin with the abdominal cavity. The testes in the male and the ovaries in female migrate from the abdomen to the groin or to the scrotum in the fetal life. The communication with the peritoneal cavity normally is sealed off before birth, but in some individuals, the communication persists. This leads to
development of inguinal hernia. The swelling in the groin may develop anytime after birth.