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© 2022 Wiley Periodicals LLC.Objectives: Postoperative ventilatory strategies in patients with esophageal atresia (EA) and tracheoesophageal fistula (TEF) may have an impact on early postoperative complications. Our national Esophageal Atresia Registry was evaluated to define a possible relationship between the type and duration of respiratory support on postoperative complications and outcome. Study Design: Among the data registered by 31 centers between 2015 and 2021, patients with esophago-esophageal anastomosis (EEA)/tracheoesophageal fistula (TEF) were divided into two groups; invasive ventilatory support (IV) and noninvasive ventilatory support and/or oxygen support (NIV-OS). The demographic findings, gestational age, type of atresia, associated anomalies, and genetic malformations were evaluated. We compared the type of repair, gap length, chest tube insertion, follow-up times, tensioned anastomosis, postoperative complications, esophageal dilatations, respiratory problems requiring treatment after the operation, and mortality rates. Results: Among 650 registered patients, 502 patients with EEA/TEF repair included the study. Four hundred and seventy of patients require IV and 32 of them had NIV-OS treatment. The IV group had lower mean birth weights and higher incidence of respiratory problems when compared to NIV-OS group. Also, NIV-OS group had significantly higher incidence of associated anomalies than IV groups. The rates of postoperative complications and mortality were not different between the IV and NIV-OS groups. Conclusion: We demonstrated that patients who required invasive ventilation had a higher incidence of low birth weight and respiratory morbidity. We found no relation between mode of postoperative ventilation and surgical complications. Randomized controlled trials and clinical guidelines are needed to define the best type of ventilation strategy in children with EA/TEF.

Objective:Bronchospasm is a very important complication that can be encountered during the post-operative and intraoperative periods. This complication may be caused by surgery, anesthesia, or patient-related issues. Many analgesics are preferred during the intraoperative period for post-operative analgesia. In this study, we aimed to investigate the effects of ibuprofen and paracetamol on rat bronchus with supramaximal tonus as a model of bronchospasm under in vitro conditions.Materials and Methods:Totally, 20 male rats were used in our study. After the ketamine anesthesia, the left main bronchus of each rat was removed and suspended in the organ bath in Krebs solution. Four rat bronchi were excluded because of not demonstrating viability with atropine and acetylcholine. After demonstrating the viability of the rats’ bronchi (n=16), acetylcholine was applied to produce supramaximal contraction. The rats’ bronchi with supramaximal contraction were randomly divided into two groups. Paracetamol was applied to group 1, and ibuprofen to group 2. The contraction responses of each group were recorded and compared statistically.Results:While a statistical significance was not detected regarding the supramaximal contraction in group 1 with a mean of 0.18±0.07% (p>0.05), tonus was reduced to 6.79±0.28% (p

Introduction: Bronchospasm is an undesirable phenomenon in all phases of operation and anesthesia.Tracheal intubation after induction of anesthesia causes a measurable increase in the resistance of the respiratory system, which often results in bronchoconstriction.Propofol and thiopental have been used as an intravenous anesthetic agent in induction of anesthesia for many years.Barbiturates are recommended not be used in patients with risks due to bronchospasm-causing effects. Propofol is generally recommended for patients with asthma and bronchospasm due to bronchodilatation and muscle relaxant effects. In our study, we aimed to demonstrate this superiority of propofol to thiopental in rat bronchi with supramaximal tonus in a bronchospasm model.Materials and methods:A total of 30 adult male rats were divided into four groups. Double-blinded group T1 received 1x10-5 M thiopental at supramaximal contraction. In Group T2, 1x10-6M thiopental was applied at supramaximal contraction while in Group P1 1x10-1M propofol was applied at supramaximal contraction and in Group P2, 1x10-2M propofol was applied. Tissue voltages were measured with MAY GTA0303 GENIUS TRANSDUCER AMPLITUDE® and recorded in the Acknowledge MP100® program.Results:In Group T1, the reduction in tonus was statistically significant (estimated mean difference, -0.41; 95% confidence interval [CI], -0.36 to 1.18; p=0.000. In Group T2, the tonus difference was statistically significant (estimated mean difference, -0.20; 95% confidence interval [CI], -0.62 to 1.03; p=0.001).There was no statistically significance between tonus levels in neither group P1 nor group P2 before and after the implementationConclusion: In our study, relaxation effect in two different doses of thiopental was shown in rat bronchus tissue in in vitro bronchospasm model. Propofol did not show any relaxation or contraction responses in two separate doses. Surprisingly, Our results suggest that propofol has no direct bronchodilatation effect and thiopental provides bronchodilation. Consequently, we noticed that the effect of thiopental dose-dependent bronchodilatation is not well debate in the literature. For this reason, bronchodilatation doses of thiopental should be determined in further clinical and experimental studies.

Introduction The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the outcome of very low birth weight (VLBW) and low BW (LWB) infants with esophageal atresia (EA). Materials and Methods The data registered by 24 centers between 2014 and 2018 were evaluated for demographic features, prenatal findings, associated anomalies, surgical treatment, and outcome. Patients were enrolled in three groups according to their BWs (VLBW 2,500 g). Results Among the 389 cases, there were 37 patients (9.5%) in the VLBW group, 165 patients (42.4%) in the LBW group, and 187 patients (48.1%) in the NBW group. Prenatal diagnosis rates were similar among the three groups (29.7, 34.5, and 24.6%, respectively). The standard primary anastomosis was achieved at a significantly higher rate in NWB cases than in the other groups (p Conclusion The national data of TEAR demonstrates that the developmental and feeding parameters are better in NBW patients. Although VLBW patients have higher risk of developing fistula canalization than the LBW and NBW groups, long-term complications, such as anastomotic strictures, weight, and height values, after 1 year are similar in both groups. According to our results, associated anomalies and LBWs are still significant risk factors for mortality in cases with EA.

Background Probiotic ingestion is associated with an increase in intestinal flora of useful bacteria, which contributes to the known protective effects it has on the intestinal barrier and thereby reducing infection. The present study aims to investigate the protective effect of Lactobacillus rhamnosus gg (LGG) as an important probiotic with gastrointestinal barrier strengthening effect in sepsis. Methods Our study was conducted in the Animal Experiments Laboratory after obtaining ethicalapproval to conduct this study.Twenty-four rats were randomly divided into threegroups and group 1 (control group n=8), group 2 (sepsis group, n=8), group 3 (sepsis + probiotic group, n=8) were planned as double-blind. LGG was used as a probiotic. For the sepsis model, E. coli (0111: B4) was injected intraperitoneally, and the rats were sacrificed 48 hours after treatment. Blood samples were collected from all animals before sacrification and sent to the biochemistry laboratory to evaluate oxidant and antioxidant parameters. Results CRP values of Group 1 were significantly lower than Group 2, and CRP values of Group 3 were significantly lower. While total thiol levels of Group 2 were significantly lower than Group 1, total thiol levels of Group 3 were significantly higher than Group 2. There was no statistically significant difference between the groups for eNOS, GPX, PON1 and MDA levels. Conclusion Prophylactic use of probiotics, such as LGG to reduce bacterial translocation and strengthen the immune system, is an inexpensive and effective method of treatment, and we recommend the repetition of studies supported by prospective clinical trials.

There are many significantfactors in testicular injury which determine the prognosis in testicular torsion. Reperfusion injury following detorsion also has a significant effect on testicular injury.This study was planned considering that with the implementation of intermittent reperfusion and hypothermia, reperfusion injury can be reduced, and such an application might have a positive effect on testicular tissue in the long term.Forty adult male rats were divided into five groups as follows: Sham(Sh)(n = 8), Torsion(T)(n = 8), Intermittent reperfusion(IR)(n = 8), Hypothermia(H)(n = 8), and Intermittent reperfusion+hypothermia(IR+H)(n = 8). Except forGroup Sh, the left testicle was taken out of the scrotum in all groups, rotated three times counterclockwise, fixed back in the scrotum, and left for four hours.After four hours, and just before reperfusion, the testicle's detorsion was performed while holding the vascular structures in the proximal part of the torsed segment with an atraumatic vessel clamp, and thus, not allowing reperfusion in Groups T, IR, H, and IR+H. In Group T, the clamp was released immediately. In Group H, an ice-bag cooling was performed around the testis, and the clamp was released when the tissue temperature was reached and kept constant at 4 °C. In Group IR, the clamp was released, allowing reperfusion of five seconds, followed by reclamping, providing an ischemic status for ten seconds; this procedure was repeated ten times. In Group H+IR,an ice-bag cooling was performed around the testis, and the clamp was released when the tissue temperature was reached and kept constant at 4 °C. Then, reperfusion was applied for 5 s, followed by 10 s ischemia with reclamping. This procedure was repeated ten times.Tissue blood flow was provided for60 days of reperfusion in all groups. After 60 days, both testicles were excised under anesthesia in all living rats, and samples ofthe left testicle werereserved for biochemical and pathological examinations. At the end of the procedure, all animals were sacrificed by a high dose of anesthesia.It was biochemically and histopathologically determined that the tissues were preserved in the experimental groups compared to Group T, which was statistically significant (p 0.05).However, no experimental group's superiority over each other was determined both biochemically and histopathologically (p 0.05).Our long-term experimental study revealed that all methods were protective in testicular torsion. The authors believe that these methods can be applied in clinical practice because of their ease of application and no additional cost. On the other hand, the results of our study should further be supported by other experimental studies.

Aim: Preservation of the azygos vein (AV) maintains normal venous drainage of the mediastinum and decreases postoperative congestion. The modification of esophageal atresia (EA) repair by preserving AV may prevent postoperative complications and may lead to better outcomes. The data from the Turkish Esophageal Atresia Registry (TEAR) were evaluated to define the effect of AV preservation on postoperative complications of patients with EA. Methods: Data from TEAR for a period of five years were evaluated. Patients were enrolled into two groups according to the preservation of AV. Patients with divided (DAV) and preserved AV (PAV) were evaluated for demographic and operative features and postoperative complications for the first year of life. The DAV and PAV groups were compared according to the postoperative complications, such as fis-tula recanalization, symptomatic strictures, anastomotic leaks, total number of esophageal dilatations, and anti-reflux surgery. In addition, respiratory problems, which required treatment, were compared between groups. Results: Among 502 registered patients; the data from 315 patients with the information of AV ligation were included. The male female ratio of DAV (n = 271) and PAV (n = 44) groups were 150:121 and 21:23, respectively (p > 0.05). The mean body weight, height, gestational age, and associated anomalies were similar in both groups (p > 0.05). The esophageal repair with thoracotomy was significantly higher in DAV group, when compared to the PAV group (p < 0.05). The rates of primary anastomosis and ten-sioned anastomosis were similar in both groups (p > 0.05). There was no difference between DAV and PAV groups for anastomotic leaks, symptomatic anastomotic strictures, fistula recanalization, and the re-quirement for anti-reflux surgery (p > 0.05). The rate of respiratory problems, which required treatment, was significantly higher in the DAV group (p < 0.05) Conclusion: The data in the TEAR demonstrated that preserving the AV during EA repair led to no sig-nificant advantage on postoperative complications, with exception of respiratory problems. AV should be preserved as much as possible to maintain a normal mediastinal anatomy and to avoid respiratory com-plications. (c) 2020 Elsevier Inc. All rights reserved.

Kongenital kistik adenomatoid malformasyon KKAM , primer bronsiyollerin duzensiz, hamartamatoz ve adenomatoid proliferasyonu ile karakterizedir.Kongenital akciger malformasyonlarinin %25’ini olusturur ve yenidoganlarda en sik solunum sikintisi ile ortaya cikar. Bu yazida prenatal tanisi olmayan ve yasamin ilk saatlerinde solunum sikintisi semptomlari gelisen bir vaka sunularak ender gorulen KKAM ‘in tartisilmasi amaclandi

Ischemia in ovarian torsion and subsequent reperfusion has significant effects on fertility in the long term. The most important reason for these changes is thought to be a reperfusion injury rather than ischemia. We aimed to evaluate whether the reperfusion injury following ovarian detorsion could be reduced by hypothermia and intermittent reperfusion.Forty adult female rats were divided into five groups as follows: Sham (Sh) (n = 8), torsion detorsion (control TD) (n = 8), progressive reperfusion "gradual detorsion" (GD) (n = 8), hypothermia (H) (n = 8) and the progressive reperfusion + hypothermia (GD + H) (n = 8). In all rats, except for the Sh group, the left ovary was rotated counter clockwise 1080° and fixed to the abdominal wall by three 5-0 non-absorbable sutures followed by the closure of the laparotomy. After 30 h, reperfusion was achieved following the detorsion of the ovaries. In both the control TD and H groups, the torsed ovaries were detorsed. H group, however, was subjected to hypothermia with ice packs 30 min before and during the detorsion. Tissue temperature was kept constant at 4 °C, controlled by a digital thermometer. In the GD group, the torsed ovary and pedicle were detorsed by 360°, followed by a 5 min pause. This procedure was repeated twice until a complete detorsion was achieved. GD + H group underwent hypothermia with ice packs 30 min before the procedure and the torsed ovary and pedicle were detorsed by 360°. After a 5 min pause, we repeated this process twice to provide full detorsion. The tissue temperature was constantly held at 4 °C. In the hypothermia groups, we applied hypothermia for an additional 30 min after detorsion and then left the rats at normal body temperature during reperfusion. We followed the rats in all groups for 60 days. Then we excised the left ovaries of all rats through laparotomy and spared some of the ovaries for biochemical and pathological examination. Intracardiac blood was taken at the end of the procedure and it was sent to the biochemical laboratory to assess oxidative stress markers. Finally, all the animals were sacrificed with high-dose of anesthesia.Evaluation of the results revealed that oxidative stress markers were significantly lower, and antioxidant parameters were higher in the experimental groups compared with the control TD group (p 0.05). Histopathologically, we found that tissues were preserved in GD, H, GD + H groups (p 0.05). When we compared the groups among each other, both biochemical and histopathological values in GD + H group showed that the tissue was preserved from oxidative damage, albeit the difference did not reach a level of significance.Several studies have shown that both hypothermia and intermittent reperfusion protect tissue from IR damage in the early period. However, as far as we know there is no study on long-term outcomes of both practices. Our study showed that both hypothermia and intermittent reperfusion alone protect tissue from IR damage in the long term. However, it did not show the superiority of the combination of both methods compared to that of individual application. The advantages of these methods lie in their easy application and cost-effectiveness. We believe that our study will serve as a base for future studies on the subject.

Aim The data of the Turkish Esophageal Atresia Registry (TEAR) was evaluated to define the survival rate and risk factors of mortality in infants with esophageal atresia (EA). Methods The data of 389 cases registered by 23 centers between 2014 and 2018 were evaluated for demographic features, associated anomalies, surgical treatment and mortality-related outcome. Each parameter was evaluated for cases with mortality (CM) and compared with the results of survivors. Also, prognostic factors were investigated in CM. Results The overall survival rate was 81.09% and the mortality was 19.02% (n = 74). The male/female ratio was 1:1 in CM and 1.2:1 in survivors. The mean weight and height measurements in CM were lower than in survivors (1956 ± 658 g- 43.2 ± 5.7 cm vs 2534 ± 609 g-46.4 ± 4.3 cm) (P 0.05). Tube feeding was more common in CM and the incidence of full oral feedings was significantly higher in survivors (P Conclusion The majority of national TEAR data comes from tertiary healthcare centers in Turkey. Therefore, the slightly increased mortality rates could be related to the inclusion of more complex and complicated cases. Birth weight–height, associated anomalies, and Spitz classification are significant risk factors of mortality in cases with EA.

Summary Introduction Reperfusion injury after detorsion in testicular torsion is a clinical problem. This study was planned to investigate the protective effect of intermittent reperfusion in hypothermia-applied testicles. Materials and methods A total of 40 adult male rats were used, and 5 groups were created: sham (Sh; n = 8), torsion (T; torsion-detorsion) (n = 8), intermittent reperfusion (IR; n = 8), hypothermia (H; n = 8), and intermittent reperfusion+hypothermia (H+IR; n = 8). The left testicle was removed in all groups except in the Sh group, and it was rotated 3 times counterclockwise, fixed in the scrotum, and left for 4 h. After 4 h, the testicle was detorsioned in the groups T, IR, H, and H+IR. During detorsion, an atraumatic vessel clamp was applied in the proximal part of the vascular structures to prevent any reperfusion of the testicle. The clamp was opened immediately in the group T. In the group IR, the clamp was opened, a reperfusion of 5 s was applied; then, the clamp was closed again, and ischemia was created for 10 s; this procedure was repeated 10 times. In the group H, an ice bag cooling was performed around the testis. The tissue temperature was kept constant at 4 °C using a digital thermometer control. The testicle was cooled using an ice bag in the group H+IR; the same procedure was applied to the IR group. In all groups, reperfusion was performed for 1 h at the end of these procedures. The left testicle was removed from all rats; a portion of each testicle was separated for biochemistry testing, and some was separated for histopathological evaluation. At the end of the procedure, intracardiac blood was taken to examine oxidative stress parameters. At the end of the procedure, all animals were sacrificed after administration of a high dose of anesthesia. Results The authors observed that the tissue was preserved in the experimental groups and this was statistically significant (p 0.05). Discussion Both hypothermia and intermittent reperfusion alone protect tissue from IR damage. But no studies have been found in which these applications were used together. And as a result of this work, the combination of both methods did not show superiority over the effect they showed when they were used separately. The authors think that these methods can be applied clinically because of their ease of application and no additional costs; however, it should be supported by other studies. Summary table . Biochemical evaluation of the left testis with mean and standard deviation scores (experimental and torsion) SOD (%) MPO (mU/mL) GPx (mU/mL) CAT (mU/mL) MDA (nmol/g tissue) T 58.00 ± 11.20 585.76 ± 35.79 587.12 ± 37.38 74.36 ± 12.98 140.66 ± 3.23 Sh 9.25 ± 3.60* 247.02 ± 22.13* 845.40 ± 57.49* 364.65 ± 33.97* 102.13 ± 2.42* H 29.25 ± 8.73* 359.60 ± 38.28* 684.05 ± 29.23* 210.85 ± 26.32* 122.04 ± 2.97* IR 37.00 ± 8.91* 395.69 ± 22.387* 709.20 ± 30.63* 212.88 ± 44.31* 122.19 ± 3.23* H + IR 34.00 ± 5.11* 376.49 ± 23.62* 661.96 ± 18.22* 209.83 ± 38.38* 119.74 ± 3.00* T, torsion; H + IR, intermittent reperfusion + hypothermia; SOD, superoxide dismutase; MPO, myeloperoxidase; GPx, glutathione peroxidase; CAT, catalase; MDA, malondialdehyde; H, hypothermia; IR, intermittent reperfusion; Sh, sham. *P

BACKGROUND Twin-to-twin transfusion syndrome (TTTS) is a significant cause of perinatal morbidity and mortality. Fetoscopic laser photocoagulation (FLP) is the optimal treatment option for twin-to-twin transfusion syndrome; but can cause central nervous system, extremity and intestinal system injury. CASE We report the case report of ileal atresia and severe cerebral infarction co-occurrence after fetoscopic laser photocoagulation treatment. It is uncertain as to whether ileal atresia occurred due to ischemia associated with TTTS, the treatment with FLP, or a combination of both. CONCLUSIONS Cases with prenatal ultrasonographic abnormalities after FLP should have a close assessment to detect bowel complications. Despite many developments in its management, TTTS remains an important risk factor for cerebral injury.

Objectives We evaluated the muscle responses of rat trachea to LA drugs, such as lidocaine and prilocaine, in terms of airway spasms. Materials and methods A total of 16 male rats were used. After ketamine anesthesia, the tracheal ring of each rat was removed and placed in the organ bath in the Krebs solution. The rat tracheal veins were randomly divided into two groups based on the LA applied at the basal tonus level: group 1 (n=8), lidocaine; group 2 (n=8), prilocaine. Second, the baths were washed. Supramaximal contraction was obtained by applying acetylcholine to the tracheal rings (n=16) at a basal tonus level. The rat tracheas with supramaximal contraction were randomly divided into two groups: group 3 (n=8), lidocaine; group 4 (n=8), prilocaine. The contraction responses of each group were recorded and statistically compared. Results Lidocaine constituted a significant relaxation response in the tracheal tissue in both basal tonus and supramaximal tonus levels. Moreover, it was observed that the relaxation of lidocaine was higher in the supramaximal contraction than in the basal tonus tension level. However, for prilocaine, no significant change was observed in both tonus levels. Conclusion This study suggests that lidocaine as a LA drug should be preferred as the first choice in patients with respiratory risk, and that its use over prilocaine should be preferred, if supported by advanced clinical studies.

Tokgoz Y, Erdem AO, Ozbey BC, Terlemez S. A rare reason in a child with feeding intolerance: Intravaginal struvite stone. Turk J Pediatr 2018; 60: 86-88. Vaginal stones are rarely seen in childhood; they are categorized as primary and secondary whether they are a foreign object focus (nidus) or not. Urethrovaginal fistula is the most common etiological cause; other etiologies are considerably rarely reported. Primary vaginal stones are formed as a result of urinary salt accumulate. A 14-year-old girl, suffering from an unidentified neurodegenerative disease, was admitted with complaints of cough, poor feeding and vomiting. Abdominal X-ray showed a large calcific mass; further evaluation revealed a vaginal struvite stone, and it was removed surgically. No anatomical reason was determined for the formation of stone and it was accepted as primary vaginal stone.

Objective Acute mesenteric ischaemia leads to intestinal damage. Restoration of blood flow results in further damage to tissue, which is called reperfusion injury. This study aimed to investigate the protective effects of short-interval postconditioning and to determine the optimal interval for reperfusion in an experimental rat model of intestinal ischaemia. Methods Forty adult male Wistar rats were grouped as follows: sham (Sh), ischaemia + reperfusion (IR), ischaemia + postconditioning for 5 seconds (PC5), ischaemia + postconditioning for 10 seconds (PC10), and ischaemia + postconditioning for 20 seconds (PC20). For postconditioning, 10 cycles of reperfusion (5, 10, or 20 seconds) interspersed by 10 cycles of 10 seconds of ischaemia were performed. Blood glutathione reductase (GR) and glutathione peroxidase (GPx) levels were measured. Intestinal tissue damage was assessed histopathologically. Results GR levels were significantly higher in the PC5 group than in the IR group (37.7 ± 9.0 vs. 18.5 ± 2.0 min/g Hb). GPx levels were significantly higher in the PC10 group than in the IR group (43.2 ± 9.2 vs. 15.9 ± 4.6 U/g Hb). The histopathological score was significantly lower in the PC5 group (1.1 ± 0.1) than in the IR group (2.1 ± 0.2). Conclusion Short-interval postconditioning reduces reperfusion injury in the ischaemic bowel and the optimal interval for reperfusion is 5 seconds. The long-term effects of short-interval postconditioning and the optimal reperfusion interval in intestinal ischaemia–reperfusion in rats need to be investigated.

Aim Even with prompt diagnosis and treatment, testicular torsion may lead to infertility and atrophy after testicular salvage. The aims of this study were to investigate the long-term protective effects of short-interval postconditioning on testicular atrophy and to optimize the reperfusion period. Materials and Methods Forty adult male rats were divided into 5 subgroups: sham operated; torsion + detorsion; torsion + postconditioning, 5 seconds (PC5); torsion + postconditioning, 10 seconds; and torsion + postconditioning, 20 seconds. Torsion was created by rotating the left testis 1080° counterclockwise and then fixing the testis to the scrotum with 3 sutures. Torsion was maintained for 4 hours. The testicular artery was visualized, and an atraumatic vascular clamp was applied to prevent reperfusion in all study groups. Detorsion of the testis was then performed. In the torsion + detorsion group, the clamp was released just after detorsion. In all the other intervention groups, the subsequent procedures were repeated 10 times. In the PC5 group, the clamp was released for 5 seconds and applied for 10 seconds; in the torsion + postconditioning, 10 seconds group, the clamp was released for 10 seconds and applied for 10 seconds; and in the torsion + postconditioning, 20 seconds group, the clamp was released for 20 seconds and applied for 10 seconds. Then, reperfusion was allowed. After 60 days, rats in all study groups were killed, both testes were removed, and the histopathology was evaluated. The χ 2 test was used for statistical analysis. Results Compared with the other groups, the extent of tissue injury determined by histopathologic grades according to Cosentino et al ( J Androl . 1986;7:23-31) was significantly less in group PC5 ( P Conclusion We conclude that short-interval postconditioning can protect against long-term testicular reperfusion injury. Furthermore, the optimal time for reperfusion during postconditioning was 5 seconds in our rat model of testicular torsion. This technique seems easily applicable, and evidence suggests that similar techniques may be useful during testicular surgery.

Omphalocele is often associated with the presence of other congenital anomalies. Isolated minor omphaloceles are known to have a favorable prognosis. Case reports have demonstrated nonclassical associations occurring in minor omphaloceles. Intestinal atresia is seldom described as being associated with minor omphaloceles. Special attention should be paid to intestinal exploration in small omphaloceles to avoid complications. Here we report a new association of a minor omphalocele, type IV ileal atresia and congenital ostomy.