Search

Abstract Background Neonatal intestinal obstruction is a complex condition that poses challenge in management. Prompt recognition and appropriate management are crucial to prevent complications. We present a case of a term neonate with intermittent bilious vomiting. Case presentation The baby underwent routinely performed investigations, including abdominal radiography and ultrasound, which provided inconclusive results. However, contrast-enhanced computed tomography revealed a web at duodenojejunal flexure. Exploratory laparotomy confirmed the diagnosis, and surgical intervention was performed. The baby’s postoperative course was prolonged with a gradual transition from parenteral nutrition to enteral feeds. Conclusion This case highlights a rare cause of intestinal obstruction, the unusual location of duodenal web, the importance of maintaining a high index of suspicion for intestinal obstruction, even in the absence of classical signs, and the value of utilizing contrast-enhanced computed tomography when initial investigations are inconclusive.

Background. Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, having a varied clinical presentation in the pediatric age group. It can manifest with life-threatening complications when symptomatic. However, very few studies have been reported from Eastern India. In this study, we aim to analyze the demographics, clinical presentation, associated characteristics, laboratory and histopathological features, various modalities of diagnosis, and treatment for pediatric Meckel’s diverticulum. Results. 18 children were diagnosed with Meckel’s diverticulum. Children below five years of age accounted for the majority of cases, with almost 50% presenting before age two. A male predominance was seen in the study with a male-tofemale ratio of 4:1. The presentation was usually acute with lower gastrointestinal bleeding being the most common symptom in our study. Open diverticulectomy was the most common surgical procedure performed. MD was found on the mesenteric surface of the distal ileum in two cases. Simultaneous endo colon (upper GI endoscopy & colonoscopy) followed by laparoscopic surgery was done in a single setup in two actively bleeding cases with negative Meckel’s scan. There was no mortality, and no complications were noted on follow-up. Conclusion. MD had an acute presentation with lower GI bleeding being the commonest presenting symptom. It can be found on the mesenteric surface of the distal ileum. Open diverticulectomy was the treatment of choice for symptomatic patients. Surgical removal of incidentally detected MD was not associated with adverse outcomes.

Diaphragmatic defects involving the right side of the diaphragm are less common but represent a distinct entity. The clinical presentation, management, and prognosis differ significantly from a left-sided defect. We report a case of a term neonate who was diagnosed to have a congenital diaphragmatic hernia during the third trimester of pregnancy, operated at 36 h of life and subsequently found to have an associated mediastinal cyst in 1st week of life.

An 11-years-old girl with a polyp in the gallbladder is reported. Laparoscopic cholecystectomy was curative.