Nonavailability of Ultrasound: Try Stethoscope in Pneumatic Reduction.

AIM AND OBJECTIVE: This study aimed to finding alternative ways for centers with nonavailability of ultrasonography or fluoroscopy for nonoperative pneumatic reduction of intussusceptions. MATERIALS AND METHODS: A total of 48 cases of intussusceptions were included in the study in-between October 2016 and March 2018. We tried stethoscope-guided pneumatic reduction using locally assembled equipment. The intraluminal pressure was monitored and maintained below 100 mmHg. A total of two attempts of 3 min each were allowed. We compared our results with the control group who have been performing laparotomy for every case of intussusception. RESULTS: There were 35 males and 13 females in our study. The average age of the patients was 7.5 months. Intussusceptions were reduced in 38 (80%) patients but could not be reduced in 10 (20%) patients. Majority of the intussusceptions had symptoms of at least 2 days. There were no complications such as perforation in our study. CONCLUSION: Stethoscope-guided pneumatic reduction seems to be a feasible and alternative effective method for the treatment of intussusceptions in children where availability of ultrasonography and skilled radiologist with overburden of work is a great issue.

Testicular Mixed Germ Cell Tumor in a Newborn Child: A Rare Case.

Testicular tumors are rare in children but highly treatable and usually curable. Seminomas are extremely rare in prepubertal children. Among nonseminomatous germ cell tumors, the most common are teratomas and yolk sac tumors. Mixed germ cell tumor (MGCT) contains more than one germ cell component. MGCT is very rare in prepubertal age group. Here, we are presenting a case of MGCT in a newborn child with a review of literature. It is the first reported case in the world literature.

Perianal and Perineal Spindle Cell Variant of Embryonal Rhabdomyosarcoma in an Infant.

We present a case of a perianal and perianal spindle cell variant of embryonal rhabdomyosarcoma (RMS). A 3-month-old male child presented with a firm mass in the perianal region. The mass measured 5 cm × 3 cm × 2 cm was surgically removed. Biopsy was performed; it showed embryonal RMS. Immunohistochemical (IHC) stains were performed using vimentin, myogenin, spinal muscular atrophy, and muscle-specific actin, which all showed positive results. The histological examination and IHC stains were consistent with a spindle cell variant of embryonal RMS.

Foreign Body in Duodenum Mimicking a Duplication Cyst on Imaging.

Paediatric age group is most vulnerable for the accidental foreign body (FB) ingestion which may go unnoticed. These patients present with symptoms or complications as a result of FB and may mimic other conditions on various investigations. We describe a 9-month old infant who ingested crystal gel ball and presented with vomiting for a month. On radiological imaging it was interpreted as duplication cyst of the duodenum. At operation, crystal gel ball was retrieved. Our case vindicates importance of keeping various possibilities in mind as differential diagnoses during evaluation and management of surgical ailments such as the duplication cyst of duodenum.

Low Voltage Electric Current Causing Ileal Perforation: A Rare Injury.

Post-electric burn ileal perforation is a rare but severe complication leading to high morbidity and mortality if there is delay in diagnosis and management. We are describing a case of electric current injury of left forearm, chest, and abdominal wall with perforation of ileum in an 8-year old boy. Patient was successfully managed by primary closure of the ileal perforation.