A Very Rare Cause of Anal Atresia: Currarino Syndrome.

Currarino syndrome (triad) is an extremely rare condition characterized by presacral mass, anorectal malformation, and sacral bone deformation. The complete form of this syndrome displays all three irregularities. Herein, we report a male case who was admitted to our hospital with symptoms of urinary system infection and persistent constipation 2 years after colostomy operation performed with the indication of rectovestibular fistula and anal atresia, diagnosed as Currarino syndrome based on imaging modalities. In a patient who was admitted because of the presence of anal atresia, in order to preclude potential complications, probable concomitancy of this syndrome should not be forgotten. Early diagnosis is important for the prevention of meningitis, urinary tract infections, and malignant change.

The passage of meconium alone is not a sign of correctly positioned anus.

OBJECTIVE: The aim of this study is to determine the consequences of delayed presentation of anorectal malformations and emphasize the causes of delayed diagnosis of these malformations. METHODS: We retrospectively reviewed 54 neonatal patients with a diagnosis of anorectal malformations. Group 1 consisted of 35 patients diagnosed within the first 48 h of life and Group 2 included 19 patients diagnosed after 48 h of life. RESULTS: Obstructive symptoms at the time of diagnosis, overall complications and the mean postoperative hospitalization period in Group 2 were markedly higher than that of Group 1. A comprehensive neonatal examination within the first 48 h of life was performed in 32 (91.4%) patients in Group 1 and 5 (26.3%) of the patients in Group 2 (p < 0.001). CONCLUSIONS: The passage of meconium is not the only sign of correctly positioned anus. A careful physical examination and awareness of this anomaly are of great importance in making a timely diagnosis of anorectal malformations.

The effect of urethral catheter size on meatal stenosis formation in children undergoing tubularized incised plate urethroplasty.

PURPOSE: Meatal stenosis is still a common problem in tubularized incised plate urethroplasty. In this study, we aimed to seek for a relationship between the size of urethral catheter and meatal stenosis formation in children undergoing tubularized incised plate urethroplasty. MATERIALS AND METHODS: We retrospectively reviewed 83 children who underwent tubularized incised plate urethroplasty for hypospadias. The whole group was classified into the groups A and B based on the catheter size. One group (group A) consisted of 44 patients (mean age, 4.82 ± 3.83 years) with tubularized neourethra over a 6 Fr catheter, while the other group (group B) included 39 patients (mean age, 5.19 ± 3.83 years) with tubularized neourethra over a 8 Fr catheter. RESULTS: There were no significant differences between the groups according to their age, location of urethral meatus, dehiscence and urethrocutaneous fistula formation. Meatal stenosis formation in group B was markedly higher than that in group A. Number of meatal dilatation was higher in group B compared to group A. CONCLUSION: We suggest that the tubularization of urethral plate over a small-sized (6 Fr) catheter, regardless of the age of the patients, prevents meatal stenosis by reducing foreign body reaction and pressure injury and by hindering secondary healing.

Congenital true pancreatic cyst: a rare case.

Congenital true pancreatic cysts are very rarely seen in children. We report magnetic resonance imaging features of a case of congenital true pancreatic cyst with a high level of enzymatic activity which, to the best of our knowledge, have not previously been reported. A 4-month-old boy was admitted to our clinic with a history of abdominal swelling for one month. A mobile, smooth, non-tender mass was palpated on the left side of the abdomen during physical examination. Ultrasonography and MR imaging revealed a bilocular cystic mass sized 9.5 x 8 x 6 cm. The spleen was displaced superiorly, whereas the left kidney was displaced posteriorly. Obliteration of the peripancreatic fat planes between the cystic mass and tail of the pancreas was observed. During abdominal surgical exploration, the pancreatic tail was larger than normal, and a pancreatic cyst arising from the tail of the pancreas was observed. Total cystectomy was performed with distal pancreatectomy. Although it is extremely rare in children, congenital true pancreatic cysts should be diagnostically considered in cases involving a cystic mass neighboring the pancreas. MR imaging is not helpful in differential diagnosis of other cysts originating from neighboring organs. Total excision with distal pancreatectomy and splenic preservation are advised for distal pancreatic cysts.