Wilkie's syndrome.

Wilkie's syndrome is a rare variant of small intestinal obstruction resulting from compression of third part of the duodenum by the superior mesenteric artery. A girl 15 years of age, presented with postprandial abdominal pain, bilious vomiting and weight loss. Radiological imaging revealed vascular duodenal compression which was relieved by timely surgical intervention.

Combined persistent Mullerian Duct Syndrome, Transverse Testicular Ectopia and Mosaic Klinefelter's Syndrome.

Persistent Mullerian Duct Syndrome (PMDS), a rare form of male pseudohermaphroditism, is characterized by the persistence of Mullerian duct structures (uterus, fallopian tubes and upper two-thirds of vagina) in otherwise normallyvirilized males (Karyotype 46XY). Patients suffering from PMDS present with cryptorchidism, inguinal hernia and infertility. Diagnosis is established when Mullerian duct structures are discovered either during ultrasonography for localization of undescended testis(s), during surgical exploration for cryptorchidism or herniorrhaphy (hernii uteri inguinalis). Presence of both testes on one side of the scrotum is known as Transverse Testicular Ectopia (TTE). Co-existence of PMDS and transverse testicular ectopia in a patient of mosaic Klinefelter's syndrome (Karyotype 46XY/47XXY) is a unique genetic association.

Bouveret's syndrome.

Gastric Outlet Obstruction (GOO) due to impaction of a gallstone in the duodenum after migration through a bilioduodenal fistula is known as Bouveret's syndrome. Its clinical symptoms are entirely vague and nonspecific. Because of its rarity, insidiousness and unpredictable symptomatology, Bouveret's syndrome is never thought of in the differential diagnosis as aetiology of gastric outlet obstruction. Recent advances in fiberoptics technology, advent of modern imaging modalities and minimally-invasive techniques like endoscopy and laparoscopy has brought a great revolution in the management of Bouveret's syndrome and have tremendously decreased morbidity and mortality associated with this rare clinical entity.

Hypertrophic pyloroduodenal tuberculosis.

Hypertrophic pyloroduodenal tuberculosis is a rare cause of Gastric Outlet Obstruction (GOO) often forgotten in the differential diagnosis of gastric outlet obstruction. Since laboratory and radiological investigations often prove inconclusive in reaching the diagnosis of hypertrophic pyloroduodenal tuberculosis, surgery has a key role in the management of hypertrophic pyloroduodenal tuberculosis. Postoperative anti-tuberculosis chemotherapy (ATT) becomes imperative for complete resolution of hypertrophic pyloroduodenal tuberculosis. This case report describes the condition and management in a young girl.