bijay suman - Academia.edu (original) (raw)
Papers by bijay suman
Advances in Pediatric Surgery
Jejuno-ileal atresia is often associated with various other gut pathologies. A 5-day male present... more Jejuno-ileal atresia is often associated with various other gut pathologies. A 5-day male presented with bilious vomiting, abdominal distension and non-passage of stools. Exploratory Laparotomy showed a type IIIA ileal atresia with midgut volvulus and atypical malrotation for which Ladd's Procedure and anastomosis of atretic bowel was done. A fleshy tubular structure extracted from distal bowel showed ileal duplication. In JIA, the vascular theory of pathogenesis is widely accepted with multiple studies to suggest the same. The mechanism being mesenteric ischemia leading to intestinal necrosis, resorption, and atresia. It has been found that abdominal duplication cyst often occurs simultaneously with short bowel, intestinal atresia, stenosis and enteric duplication for which a common vascular pathogenetic mechanism has been suggested. Our case serves as an in vivo description of the proposed theory where the findings may be described elegantly. We describe and discuss the mesenteric ischemia theory in bowel atresia and hope to further our understanding about the same.
International Journal of Contemporary Pediatrics, Apr 27, 2023
International Journal of Contemporary Pediatrics, Mar 27, 2023
International Journal of Contemporary Pediatrics
Congenital bilateral scrotal agenesis is very rare anomaly and characterized by the absence of sc... more Congenital bilateral scrotal agenesis is very rare anomaly and characterized by the absence of scrotal rugae. It may be associated with other extra-genital anomalies as a part of a syndrome. Etiology is unknown but may be due to primary failure of labioscrotal folds development or secondary to localized 5-alpha-reductase type 2 deficiency. Various surgical techniques used for neoscrotum construction with different types of complications. In index case, we performed bilateral orchidopexy without creating neoscrotum.
International Journal of Contemporary Pediatrics
Urethral catheterisation is a common routine procedure. Knotting of infant feeding tube in genito... more Urethral catheterisation is a common routine procedure. Knotting of infant feeding tube in genitourinary tract is a rare complication. Various methods have been used in the removal of a knotted catheter. The methods include gentle but sustained traction under general anaesthesia, open cystostomy and endoscopic retrieval.
International Journal of Contemporary Pediatrics
Lymphatic malformations are benign lesions, found in children, most common locations are neck and... more Lymphatic malformations are benign lesions, found in children, most common locations are neck and axillary regions. We report here a case of bilateral Peri-renal macrocystic lymphatic malformation in a 12-year-old female, masquerading as bilateral renal cysts. A 12-year-old female presented with complaints of pain in right flank for one week associated with fullness in right flank. On evaluation a provisional diagnosis of right perirenal lymphangioma was made and ultrasound guided pigtail drainage done. The pigtail output was 200-300ml daily for a week and it was removed and child was discharged. However, on follow up, CT was done and bilateral peri-renal lymphatic malformation(right>left) was diagnosed. Patient was then planned for exploratory laparotomy which revealed bilateral perirenal cyst, circumscribing both the kidneys completely. Excision of bilateral cysts was done and sent for histopathological evaluation. Cyst Fluid analysis revealed normal creatinine, LDH, total chol...
International Journal of Contemporary Pediatrics
The term “Ranula” originates from the Latin Word Rana which means “underbelly of a frog.” Ranula ... more The term “Ranula” originates from the Latin Word Rana which means “underbelly of a frog.” Ranula are epithelial retention cyst or mucus extravasation pseudo cyst arising from the sublingual glands. They are rare in children. A one-year-old female was brought to paediatric surgery emergency OPD by her mother with complaints of swelling arising from oral cavity since birth, gradually increased in size to attain current size. Mother also gives History of difficulty in feeding. Clinical examination revealed a large protruded tongue, with a cystic swelling in the floor of the mouth measuring around 6×4 cm, with elevation of the tongue. Child was further evaluated; ultrasound was suggestive of ranula. Marsupialisation of the cyst was done. Intraoperatively, cyst fluid was aspirated for analysis and cyst wall was opened and excised, lateral margins of cyst were sutured to base of mouth. Cyst fluid analysis revealed elevated amylase and normal LDH levels. The post-operative period was uneve...
International Surgery Journal
Congenital uterovaginal prolapse in a newborn is a rare entity. It is usually associated with neu... more Congenital uterovaginal prolapse in a newborn is a rare entity. It is usually associated with neural tube defects. Some cases are managed conservatively while others require more invasive management.
International Surgery Journal, Jan 27, 2023
Accidental acid ingestion is more common in children as compared to adults. It is an important la... more Accidental acid ingestion is more common in children as compared to adults. It is an important late morbid complication of the upper gastrointestinal tract. 1 The severity of injury usually mild in children because they have tendency to vomit out ingested content immediately. In Indian population alkali ingestion is more common because it is cheaper and easily available in house as toilet cleaners. 2 Immediate complications of corrosive ingestion occur in approximate 10% of cases which are oesophageal perforation, laryngeal trauma, bleeding, and fistula formation but stricture is a delayed complication. Acid ingestion usually cause injury around the antrum and pylorus because of acid stasis which leads to stricture and cause gastric outlet obstruction. Management depending upon severity and location of strictures and options are endoscopic dilatation, gastrojejunostomy, Billroth-1 partial gastrectomy, Heineke-Mikulicz pyloroplasty, Finney pyloroplasty and Antroplasty. 3-5 We wish to report six cases of gastric outlet obstruction due to acid ingestion and five patients managed by Heineke-Mikulicz pyloroplasty and one patient by gastrojejunostomy. CASE SERIES Case 1 A 7 years male child presented to emergency with upper abdominal pain and non-bilious vomiting. Child not tolerating oral feed and vomit after each feed. H/o battery water ingestion 20 days ago. No h/o fever, cough and breathing difficulty. On examination child was lethargic, thin built, mild tenderness present in left hypochondrium and lumbar region. Routine blood examination within normal limit. Barium swallow and meal follow through shows stenosis of gastric antrum with outflow obstruction (Figure 1). In upper GI endoscopy, oesophagus was normal, stomach contracted, pyloric opening not seen, scope could not be negotiated beyond pylorus, duodenum not seen. On exploratory laparotomy stomach was dilated, antral wall thickened approx. 3 cm, oedematous and friable. Antral lumen was narrow with fibrotic mucosa. Posterior wall of antrum was fibrotic and thinned out. Subsequently, we conducted Heineken Mikulicz pyloroplasty with feeding jejunostomy was done. The patient was discharged on eleventh postoperative day uneventfully.
Journal of Pediatric Surgery Case Reports
Journal of Pediatric Surgery Case Reports
Advances in Pediatric Surgery
Jejuno-ileal atresia is often associated with various other gut pathologies. A 5-day male present... more Jejuno-ileal atresia is often associated with various other gut pathologies. A 5-day male presented with bilious vomiting, abdominal distension and non-passage of stools. Exploratory Laparotomy showed a type IIIA ileal atresia with midgut volvulus and atypical malrotation for which Ladd's Procedure and anastomosis of atretic bowel was done. A fleshy tubular structure extracted from distal bowel showed ileal duplication. In JIA, the vascular theory of pathogenesis is widely accepted with multiple studies to suggest the same. The mechanism being mesenteric ischemia leading to intestinal necrosis, resorption, and atresia. It has been found that abdominal duplication cyst often occurs simultaneously with short bowel, intestinal atresia, stenosis and enteric duplication for which a common vascular pathogenetic mechanism has been suggested. Our case serves as an in vivo description of the proposed theory where the findings may be described elegantly. We describe and discuss the mesenteric ischemia theory in bowel atresia and hope to further our understanding about the same.
International Journal of Contemporary Pediatrics, Apr 27, 2023
International Journal of Contemporary Pediatrics, Mar 27, 2023
International Journal of Contemporary Pediatrics
Congenital bilateral scrotal agenesis is very rare anomaly and characterized by the absence of sc... more Congenital bilateral scrotal agenesis is very rare anomaly and characterized by the absence of scrotal rugae. It may be associated with other extra-genital anomalies as a part of a syndrome. Etiology is unknown but may be due to primary failure of labioscrotal folds development or secondary to localized 5-alpha-reductase type 2 deficiency. Various surgical techniques used for neoscrotum construction with different types of complications. In index case, we performed bilateral orchidopexy without creating neoscrotum.
International Journal of Contemporary Pediatrics
Urethral catheterisation is a common routine procedure. Knotting of infant feeding tube in genito... more Urethral catheterisation is a common routine procedure. Knotting of infant feeding tube in genitourinary tract is a rare complication. Various methods have been used in the removal of a knotted catheter. The methods include gentle but sustained traction under general anaesthesia, open cystostomy and endoscopic retrieval.
International Journal of Contemporary Pediatrics
Lymphatic malformations are benign lesions, found in children, most common locations are neck and... more Lymphatic malformations are benign lesions, found in children, most common locations are neck and axillary regions. We report here a case of bilateral Peri-renal macrocystic lymphatic malformation in a 12-year-old female, masquerading as bilateral renal cysts. A 12-year-old female presented with complaints of pain in right flank for one week associated with fullness in right flank. On evaluation a provisional diagnosis of right perirenal lymphangioma was made and ultrasound guided pigtail drainage done. The pigtail output was 200-300ml daily for a week and it was removed and child was discharged. However, on follow up, CT was done and bilateral peri-renal lymphatic malformation(right>left) was diagnosed. Patient was then planned for exploratory laparotomy which revealed bilateral perirenal cyst, circumscribing both the kidneys completely. Excision of bilateral cysts was done and sent for histopathological evaluation. Cyst Fluid analysis revealed normal creatinine, LDH, total chol...
International Journal of Contemporary Pediatrics
The term “Ranula” originates from the Latin Word Rana which means “underbelly of a frog.” Ranula ... more The term “Ranula” originates from the Latin Word Rana which means “underbelly of a frog.” Ranula are epithelial retention cyst or mucus extravasation pseudo cyst arising from the sublingual glands. They are rare in children. A one-year-old female was brought to paediatric surgery emergency OPD by her mother with complaints of swelling arising from oral cavity since birth, gradually increased in size to attain current size. Mother also gives History of difficulty in feeding. Clinical examination revealed a large protruded tongue, with a cystic swelling in the floor of the mouth measuring around 6×4 cm, with elevation of the tongue. Child was further evaluated; ultrasound was suggestive of ranula. Marsupialisation of the cyst was done. Intraoperatively, cyst fluid was aspirated for analysis and cyst wall was opened and excised, lateral margins of cyst were sutured to base of mouth. Cyst fluid analysis revealed elevated amylase and normal LDH levels. The post-operative period was uneve...
International Surgery Journal
Congenital uterovaginal prolapse in a newborn is a rare entity. It is usually associated with neu... more Congenital uterovaginal prolapse in a newborn is a rare entity. It is usually associated with neural tube defects. Some cases are managed conservatively while others require more invasive management.
International Surgery Journal, Jan 27, 2023
Accidental acid ingestion is more common in children as compared to adults. It is an important la... more Accidental acid ingestion is more common in children as compared to adults. It is an important late morbid complication of the upper gastrointestinal tract. 1 The severity of injury usually mild in children because they have tendency to vomit out ingested content immediately. In Indian population alkali ingestion is more common because it is cheaper and easily available in house as toilet cleaners. 2 Immediate complications of corrosive ingestion occur in approximate 10% of cases which are oesophageal perforation, laryngeal trauma, bleeding, and fistula formation but stricture is a delayed complication. Acid ingestion usually cause injury around the antrum and pylorus because of acid stasis which leads to stricture and cause gastric outlet obstruction. Management depending upon severity and location of strictures and options are endoscopic dilatation, gastrojejunostomy, Billroth-1 partial gastrectomy, Heineke-Mikulicz pyloroplasty, Finney pyloroplasty and Antroplasty. 3-5 We wish to report six cases of gastric outlet obstruction due to acid ingestion and five patients managed by Heineke-Mikulicz pyloroplasty and one patient by gastrojejunostomy. CASE SERIES Case 1 A 7 years male child presented to emergency with upper abdominal pain and non-bilious vomiting. Child not tolerating oral feed and vomit after each feed. H/o battery water ingestion 20 days ago. No h/o fever, cough and breathing difficulty. On examination child was lethargic, thin built, mild tenderness present in left hypochondrium and lumbar region. Routine blood examination within normal limit. Barium swallow and meal follow through shows stenosis of gastric antrum with outflow obstruction (Figure 1). In upper GI endoscopy, oesophagus was normal, stomach contracted, pyloric opening not seen, scope could not be negotiated beyond pylorus, duodenum not seen. On exploratory laparotomy stomach was dilated, antral wall thickened approx. 3 cm, oedematous and friable. Antral lumen was narrow with fibrotic mucosa. Posterior wall of antrum was fibrotic and thinned out. Subsequently, we conducted Heineken Mikulicz pyloroplasty with feeding jejunostomy was done. The patient was discharged on eleventh postoperative day uneventfully.
Journal of Pediatric Surgery Case Reports
Journal of Pediatric Surgery Case Reports