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Abstract Background Perforation of Meckel Diverticulum (MD) is a rare cause of pneumoperitoneum in neonates. We hereby report six cases of perforation of MD in neonates, with addition of 53 cases from systematic review of the literature. A systematic review was performed using Mesh terms “Neonate, Meckel Diverticulum, Perforation, Pneumoperitoneum.” All reports of perforated MD in the English literature were identified. Details of our 6 cases were analyzed in similar fashion. Results A total of 3027 manuscripts were screened and 59 cases including 6 of our own were identified. The vast majority (78%) were female. Fifty patients (84.7%) presented in the newborn period. Half of the cases (52.5%) had associated anomalies and 13 neonates (22%) required oxygen supplementation including CPAP or ventilatory support before surgery. In 73% of the cases, a resection of gut was undertaken. Histopathological assessment in 44 cases (74.6%) revealed no ectopic gastric mucosa. Three cases demised prior to treatment. The outcome in the vast majority was excellent with 84.7% surviving and discharged well. Conclusion Perforated MD is an unusual cause of a pneumoperitoneum in the newborns. Diagnosis is established at laparotomy and it rare to find ectopic mucosa histopathologically. The overall outcome is excellent.

Abstract Background Morgagni hernia (MH) is a rare diaphragmatic hernia with nonspecific symptoms and variable presentation. MH is managed surgically via laparotomy or a thoracotomy. Recently, laparoscopy was described for the repair of MH. The objective of this study is to report our institutional experience in laparoscopic repair of MH in infants and children. Results Twenty-five patients with MH were included; 17 of them were males (68%). Their median age at the time of diagnosis was 18 months. Sixteen patients (64%) presented with a recurrent chest infection. MH was on the right side in 8 patients, left side in 2, and central in 12, and 3 patients had bilateral hernias. Eleven patients (44%) had congenital heart disease, 10 (40%) had Down’s syndrome, and 2 (4%) had malrotation of the bowel. The median size of the hernia defect was 3 × 3.5 cm2, and the most common content was the colon (n = 19). One patient with Down’s syndrome developed recurrence and underwent open repair. The median operative time was 95 min. The postoperative recovery was uneventful, and the average postoperative stay was 3 days. The median follow-up was 4.5 years, and there was no reported mortality. Conclusions Morgagni hernia is commonly associated with other congenital anomalies. Laparoscopic repair of Morgagni hernia in children is feasible with excellent postoperative outcomes.

Littoral Cell Angioma (LCA) is a benign and rare vascular tumor of the spleen. It is uncommon in children, and a comprehensive literature review has yielded only 12 published pediatric cases of LCA. Here we present a seven year old, female who was a known case of Cornelia De Lange syndrome who presented with splenic cysts and underwent splenectomy. Histopathological review revealed LCA.

Circumcisions are among the most frequently performed operations in children and numerous techniques are employed often with varying results. Use of the Plastibell™ (Hollister Incorporated, Illinois, USA), under local anesthetic, is popular for cultural and religious circumcisions but is not without its problems. Complications of Plastibell™ (slippage, migration, bleeding and serious infection) have been reported. Described is a prospective series of cases in which modifications to the standard Plastibell™ technique were utilized to improve outcomes, in particular, the risk of bleeding.

We present a 4-year-old girl who underwent a single incision laparoscopic surgery (SILS) heminephrouretectomy. The procedure was completed without intra-operative complications or conversion. The operative time was 162 min. At 3 month follow up there is no evident scar and the patient is asymptomatic. SILS upper moiety heminephrouretectomy for duplex kidney is safe and technically feasible in children.