ABSTRACT
Congenital intrathoracic kidney (ITK) is a rare condition, which is usually discovered incidentally in asymptomatic children who do not need any intervention. However, it may be associated with congenital diaphragmatic hernia (CDH), in which case it requires urgent surgical intervention. We present a case of prenatally diagnosed ITK associated with a left CDH that was operated on day 5 of life. The neonate is currently well at 15 months of age.
Subject(s)
Choristoma/diagnostic imaging , Hernias, Diaphragmatic, Congenital/diagnostic imaging , Kidney/diagnostic imaging , Child , Choristoma/embryology , Choristoma/surgery , Female , Hernias, Diaphragmatic, Congenital/surgery , Humans , Infant, Newborn , Kidney/abnormalities , Kidney/embryology , Kidney/surgery , Male , Pregnancy , Thoracic Diseases/diagnostic imaging , Thoracic Diseases/embryology , Thoracic Diseases/urine , Ultrasonography, Prenatal/methodsABSTRACT
OBJECTIVE: To prospectively evaluate the Bianchi single scrotal incision technique for orchiopexy in boys with palpable undescended testis. METHODS: A total of 35 orchiopexies were performed in 28 patients. The patent processus vaginalis was dissected and cut high without ligation, while in Bianchi's original procedure, the patent processus vaginalis is dissected up to the external inguinal canal, ligated high and divided. Testicular size and position were assessed at 2 and 6 weeks and 6 months. RESULTS: The single incision technique was successful in all cases. All testes were satisfactorily positioned in the scrotum. All testes showed good anatomical and cosmetic results at 6-month follow-up. CONCLUSION: Single scrotal incision orchiopexy without ligation of the patent processus vaginalis has proved to be simple, safe and effective in selected cases compared with the standard two-incision approach in the treatment of palpable undescended testis.
Subject(s)
Cryptorchidism/surgery , Scrotum/surgery , Urologic Surgical Procedures, Male/methods , Child , Child, Preschool , Humans , Infant , Male , Prospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: Laparoscopic examination of the contralateral inguinal ring has been advocated to exclude contralateral hernia in young children. We used the size of the open internal ring and the depth of the patent processus vaginalis as a parameter to decide whether laparoscopic herniotomy was indicated. METHODS: Records of all laparoscopic procedures in children performed in a large tertiary care hospital over a 2.5-year period were retrospectively analysed. RESULTS: Laparoscopy in 346 children revealed the presence of an incidental asymptomatic patent processus vaginalis in 47 cases. Of these, 38 were present as a contralateral hernia among 171 laparoscopies for inguinal hernias. CONCLUSION: The presence of an incidentally detected, asymptomatic but significant-sized open internal ring is not uncommon. The authors recommend that a 1-cm diameter and a 2-cm depth of open internal ring be taken as a significant indication for herniotomy. The authors also emphasize that a reported incidence of contralateral patent processus vaginalis of up to 56.2% justifies the procedure of laparoscopic herniotomy in all children.
Subject(s)
Hernia, Inguinal/pathology , Hernia, Inguinal/surgery , Incidental Findings , Laparoscopy , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective StudiesABSTRACT
BACKGROUND: Narrowing of the internal ring around the pulled through spermatic cord in cases of laparoscopic orchiopexy is the norm. AIM: To carry out a prospective study to see if closure of the internal ring is really necessary, hypothesis being that mobilization of the impalpable testis leaves a raw surface, which, coupled with the presence of the spermatic cord results in effective closure of the internal ring. METHODS AND MATERIALS: 51 patients with 65 impalpable testes underwent laparoscopic orchiopexy between July 1998 and June 2003. An impalpable testis was present in 21 cases on the left, 16 cases on the right and bilateral in 14 cases. Following complete mobilization required for orchiopexy, all testes with adequate length of spermatic cord were pulled down into the scrotum through the inguinal canal. No suture was applied to narrow the internal ring around the pulled through spermatic cord. Five testes were pulled down by an opening in the medial end of the inguinal canal due to inadequate length of the spermatic cord. In these cases the internal ring was closed by a suture. RESULTS: Follow up of all cases ranged between 1.5 years to 6.5 years. Not a single case has reported with recurrence of a hernia. CONCLUSION: The results suggest that narrowing of the internal ring around the pulled through spermatic cord may not be necessary.
Subject(s)
Cryptorchidism/surgery , Laparoscopy/methods , Urologic Surgical Procedures, Male/methods , Child , Child, Preschool , Humans , Infant , Male , Prospective StudiesABSTRACT
Lymphangiomas are congenital malformations of the lymphatic system, and 90% have manifested by the end of the second year of life. While 75% of these are located in the cervical region, only 2% to 3% are associated with an intrathoracic extension. An isolated mediastinal lymphangioma without a cervical component is an uncommon occurrence. Presented here is an isolated mediastinal lymphangioma that herniated through the intercostal space to present as a cystic mass in the parasternal region, which has not been reported so far.
