Oesophageal duplication cyst causing neonatal haemoptysis.

Duplication anomalies of the alimentary tract often present with myriad clinical symptoms and signs. There have been no reports of haemoptysis as the presenting feature and oesophageal duplication cyst is not considered as a cause for haemoptysis. An infant presented with this unusual manifestation. Chest X-ray showed persistent right upper zone haziness and contrast enhanced computed tomographic scan showed a multiloculated mass on the right side of the chest. The cystic mass was excised via a right thoracotomy and dense adhesions were noted with the oesophagus. The postoperative period was uneventful and histopathological examination revealed it to be a duplication cyst with ectopic gastric mucosa. Thus, the diagnosis was made retrospectively.

Successful separation of thoracopagus conjoined twins.

The first successful separation of thoracopagus conjoined twins in Eastern Saudi Arabia with 2-year follow up is presented. Physical examination and radiographic studies revealed a conjunction that extended from midsternum to a common umbilicus. The shared internal organs included liver and pericardium. The separation was performed at the age of 4 months. The resulting chest wall defects in both twins were covered by dacron-reinforced silastic prosthesis. The abdominal wall defect was primarily closed in the "left twin," and covered with a dacron reinforced silastic sheet in the "right". Primary skin closure was achieved in both, following extensive mobilization of the skin. The musculoskeletal deformities in the neck, chest and vertebral column showed marked improvement 20 months after separation.

Visceral myopathy causing chronic intestinal pseudoobstruction and intestinal failure in a child with Sanjad-Sakati syndrome.

Sanjad-Sakati syndrome is a rare autosomal recessive disorder mainly occurring in the Arab Peninsula. This condition is associated with metabolic and septic complications starting in the neonatal period. Chronic intestinal pseudoobstruction owing to visceral myopathy is a rare disabling condition. We report a rare concurrence of Sanjad-Sakati syndrome and chronic intestinal pseudoobstruction in a Saudi child complicated by intestinal failure, sepsis, and early mortality.

Occult enterorrhagia from jejunal duplication causing diagnostic dilemma in an infant.

Occult enterorrhagia in infancy may become obscured and lead to diagnostic dilemma. Abnormal findings on investigative modalities, if not properly interpreted and clinically correlated, might complicate the matter leading to missed diagnosis and chronic anaemia. Occult enterorrhagia is an uncommon presentation of intestinal duplications. We describe the intriguing case of chronic anaemia in an infant, where concomitant endoscopic findings misled the diagnosis of jejunal duplication cyst as the cause of enterorrhagia.

Successful laparoscopic treatment of hemorrhage from ileal duplication cyst in a 10-year-old Saudi boy.

Lower gastrointestinal hemorrhage often produces diagnostic difficulty in children. Endoscopy, radionuclide scans, computed tomography/magnetic resonance angiography, and conventional angiography have been the usual armamentarium for locating the site of bleeding. In recent times, laparoscopy has offered an effective tool for diagnosing various intra-abdominal, especially extraluminal, pathologies elusive to other modalities of diagnosis. In this paper, we present a case of massive hemorrhage from an ileal duplication cyst in a 10-year-old Saudi boy diagnosed and treated by laparoscopy. We believe this is the first such reported case from the Kingdom of Saudi Arabia.

Myxoid neurothekeoma: a rare soft tissue tumor of hand in a 5 month old infant.

Myxoid Neurothekeoma is a rare benign nerve sheath tumor, commonly seen in young females. Patients usually present with a small nodule in different anatomical sites, commonly involving the face and the upper limb. We present the case of a five-month-old boy, who presented with a nodule on the left thumb. Punch biopsy and immunostaining confirmed the diagnosis of myxoid neurothekeoma. We believe this is the first reported case of myxoid neurothekeoma below 12 months of age.

Congenital diaphragmatic eventration associated with massive hiatal hernia.

Congenital eventration of the diaphragm is uncommon. Its association with a hiatal hernia has not been reported earlier. We report a case of such an association in a 2-month-old boy who presented with tachypnea aggravated by feeding and recurrent vomiting. Diagnostic uncertainty and a unique course of postoperative recovery complicated by gastric volvulus are described. The patient underwent surgical plication of the right diaphragm, followed by an emergency hiatal repair on the first postoperative day. Timely recognition, and repair of the hiatal hernia averted a fatal complication.