Congenital pouch colon: A comparative study between two modalities of management.

BACKGROUND: Congenital pouch colon (CPC) is an unusual anomaly with an unique geographical distribution. The aim of this study was to find out the incidence of CPC among anorectal malformation (ARM) cases in our institute and to compare the outcome between conventional three-staged surgery versus two-staged management approach. MATERIALS AND METHODS: This study was conducted in the department of pediatric surgery over a period of 7 years from 1st April 2013 to 31st March 2020. RESULTS: Out of 754 cases of ARMs, 43 cases of CPC were detected. The incidence of pouch colon among patients with high ARMs was found to be 7.6% with a male predominance (M:F = 4.4:1). The anomaly was diagnosed in 72% of our patients preoperatively and Type IV variety was the most common intra-operative finding. The survival after initial hospitalisation was 82% and 88% in three-stage and two-stage surgical procedures, respectively. However, the final clinical outcome after the completion of all stages of surgery and follow-up was better in two-staged approach (54% vs. 47%). CONCLUSION: Although, CPC is a rare anomaly, the incidence in our institute is 7.6% among high ARM cases. As compared to conventional three-staged surgery, the two-staged management approach has the advantage of better survival and decreased morbidity.

Apple-Peel Intestinal Atresia Along with Isolated Jejunal Duplication Cyst in a Newborn - An Extremely Rare Case Report and Brief Review.

Apple-peel type of intestinal atresia and non-communicating jejunal duplication cyst are rare congenital malformations. The coexistence is not reported in English literature. A five-day-old female neonate having intestinal obstruction and was found to have both the anomalies during laparotomy and was successfully managed. Being an extremely uncommon association between two congenital anomalies of gastrointestinal tract and surgical emergencies, it is reported with review of relevant literature.

Pheochromocytoma in a Child without Hypertension: A Contribution to the "Rule of 10s".

Pheochromocytoma (PCC) is a neuroendocrine tumor originating from chromaffin tissue in adrenal medulla. Its diagnosis and treatment are well defined in adults, but experience in children is limited. Children constitute only 10% of reported cases, the average age at presentation being 11 years. The most common presentation is sustained hypertension, which is absent in only 10% of children. We managed a 14-month-old female child with PCC, but she was not hypertensive. We report two unusual features, in this case, an extremely young age at presentation and a childhood case of nonhypertensive PCC contributing for "rule of 10s."