Rajendra K Ghritlaharey

Mahaveer Institute of Medical Sciences and Research, Bhopal

Introduction: Lymphatic cystic malformations occur in the mesentery of the small and large bowel, omentum and retroperitoneal area and are rare, benign, intra-abdominal cystic lesions. Aim: To review the demographics, clinical presentation and surgical outcomes of children’s mesenteric and omental lymphatic cystic lesions. Materials and Methods:...

Extrusion of the distal end of the cerebrospinal fluid (CSF) shunt catheter through the mouth is a rare complication of shunt surgery performed to treat hydrocephalus. A two-year-old girl had her first CSF shunt inserted when she was six months old to treat congenital hydrocephalus. The shunt became infected 2-months later and had to be removed. A...

Patent vitellointestinal duct (PVID) is the rarest of all vitelline duct anomalies, resulting from the complete failure of regression of the vitelline duct. Approximately three-fourths of the PVID cases are clinically present during the neonatal period. The present report is a series of three neonates (all boys) operated upon by the author, for the...

Keratinous cysts, the most common kind of epidermal cysts, are filled with keratin originating from the epidermis, most often from the hair follicle. Keratinous cyst is one of the most common skin lesions and occurs most commonly in the face, head, trunk, extremities, and genitals. A 7-year-old girl reported to the pediatric surgery department with...

Sacrococcygeal teratomas (SCTs) are the most common germ cell tumor in neonates occurring in approximately 1 in 30,000 to 40,000 births. Here in reporting a 3-month-old girl presented with rapid distension of the abdomen and a tumor-like growth at her right gluteal area, since birth. She also had features suggestive of intestinal obstruction. Clini...

BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt (VPS) catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion. AIM To identify the demographics, clinical presentation, clinical findings, and results of surgical therapy offered for the treatment of int...

Congenital diaphragmatic hernia (CDH) is the most common developmental defect of the diaphragm. Ten to 20% of CDH cases may clinically present later in life, after the neonatal period. This study aims to review the demographics, clinical characteristics, various radiological investigations carried out for the diagnosis, and outcome of the surgical...

I read with interest the preprint article titled “Mesenteric cystic lymphangioma - A rare entity with an unusual presentation". Med J DY Patil Vidyapeeth (Epub ahead of print), written by Jose M, et al. [cited 2021 Aug 5], available from: https://www.mjdrdypv.org/preprint article.asp?id = 321295.[1] Herein I am presenting a child who was surgically...

The persistent vitellointestinal duct is the rarest of all vitelline duct anomalies. This systematic literature review was undertaken to investigate and review the demographics, clinical presentation, surgical procedure performed, and outcome of infants who were operated upon for the persistent vitellointestinal duct. Infants with incomplete desire...

The persistent vitellointestinal duct (PVID) is the rarest of all vitelline duct anomalies. The enteric end of the vitelline duct mostly connects to the terminal ileum. The appendico‑umbilical fistula (appendiceal‑umbilical fistula) in which the proximal end of the vitelline duct connects to the appendix is a rare clinical entity. This systematic l...

Objectives: The primary objective of this study was to analyse the demographics of the children who presented with ventriculoperitoneal shunt (VPS) complications. The secondary objectives were to review the clinical characteristics, surgical procedures performed for the management of VPS complications and the final outcome. Materials and Methods:...

A 7-day-old boy was admitted with a history of swelling involving his left lower limb since birth. He was born normally to a Gravida 1, Para-0, to a 22-years-old mother. Antenatal history was nothing significant. His clinical examination revealed left lower limb swelling and was suggestive of primary lymphedema. It involved from the ankle area up t...

Background: The objectives of this study were to review the demographics, clinical characteristics, surgical procedures executed, and the outcome of children operated upon for trans-anal extrusion of the distal VPS (ventriculoperitoneal shunt) catheter.Methods: Case records of children under 12-years, operated upon for the trans-anal extrusion of t...

Ventriculoperitoneal shunt (VPS) insertion is the most widely performed surgical procedure for the treatment of hydrocephalus across all age groups but is associated with several complications. The objectives of the present review were to review the demographics, clinical characteristics, operative procedures executed, postoperative major complicat...

Perforation of the colon with or without transanal extrusion of the distal ventriculoperitoneal shunt (VPS) catheter is a well-known but a serious complication after VPS insertion done for the treatment of hydrocephalus. The objectives were to review the demographics, clinical characteristics, operative procedures performed, postoperative complicat...

Dear sir, I read with great interest the preprint article by Agrawal et al.,[1] titled “Inguinal herniotomy in children: Retrospective three decades experience”. Med J DY Patil Vidyapeeth [Epub ahead of print, cited March 18, 2022]. In the above retrospective manuscript, authors also reported Amyand's hernia in seven (0.09%) children.[1] I'm prese...

Trans-umbilical extrusion of the distal ventriculoperitoneal shunt catheter is a rare complication of the VPS insertion. The objectives of this review were to analyze various variables like the age, sex, indication for VPS insertion, clinical presentation, the operative therapy offered for the management, and outcome of the cases published/managed...

Objectives The primary objective of the present study was to review the demographics of infants and children operated upon for Meckel's diverticulum. The secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and the outcome. Materials and Methods This study is a single-institut...

Trans-vaginal extrusion of the distal ventriculoperitoneal shunt (VPS) catheter is a rare complication of VPS insertion done for the treatment of hydrocephalus. The primary purpose was to review the demographics. The secondary objectives were to review the clinical presentation, operative intervention executed, and outcome of the cases published on...

Objectives The primary objective of this study was to analyze and review the demographics of children operated upon for intussusception. Secondary objectives were to review the clinical characteristics, surgical procedures performed, postoperative complications, and outcome. Materials and Methods It is a single-institution, retrospective study and...

This is a review of the literature related to the progress in the management of intussusception. Literature and other publication on the topic of “intussusception” were retrieved from 1674 to August 2021. The online literature search was – performed using various websites, i e, PubMed, PubMed central, ResearchGate, and Google - eBooks, Google Schol...

Objectives: This study was undertaken to investigate and review the clinical presentation, surgical procedures executed, and the final outcome of infants managed for the patent vitellointestinal duct. Materials and Methods: This is a single-institution, retrospective study and included infants who were operated for the patent vitellointestinal duct...

Achalasia cardia is an idiopathic, motility disorder of the esophagus, characterized by failure of the lower esophageal sphincter to relax during the deglutition.[1],[2] Achalasia is rare in children with an estimated annual incidence of only 0.02–0.11 cases per 100,000 children, and below 5-year of age, it is more infrequent.[1],[2],[3] Most commo...

Objectives This study was undertaken to investigate and review the age, sex, clinical presentation, surgical procedures done, major postoperative complications, and the final outcome of infants and children operated for intussusceptions secondary to pathological lead points (PLPs). Materials and Methods This is a single-institution, retrospective s...

Liver abscess occurs across all the age groups.[1],[2] The incidence of liver abscess has significantly declined in developed countries; however, still, the incidence is high in developing countries.[1],[2],[3] Liver abscess occurring in pediatric population are relatively uncommon in developed countries; however, the incidence is still considerabl...

A 10‑year‑old boy was admitted with chest wall infection around the implanted ventriculoperitoneal shunt (VPS) catheter of 5 days. He had received a right‑sided, medium pressure, whole‑length VPS for hydrocephalus, following tubercular meningitis at the age of 3 years. Seven years, 9 months following VPS implantation, he was admitted with shunt tra...

Foreign body ingestion is not uncommon in pediatric age group. Foreign bodies including coin retention/impaction at the colorectal regions are less frequently reported in children and extremely rare in the operated cases of anorectal malformation (ARM). The present case is a 5.8-year-old boy who had retention of ingested foreign body (coin) in his...

An encephalocele is a congenital neural tube defect (NTD) characterized by herniation/protrusion of the intracranial contents (meninges, brain, and part of the ventricles) through a defect in the cranium.[1] Encephalocele is caused by failure of the closure of the cranial part of the developing neural tube during the first few weeks of fetal life....

Introduction: Mesenteric cysts are rare, benign, intra-abdominal entities with diverse clinical presentation, and most frequently located in the mesentery of the small bowel. Complete excision of the mesenteric cysts is a therapy of choice, although more than 50% require bowel resection and anastomosis during complete excision. Aim: To review the c...

Background: Although not being licensed for the treatment of infantile hemangiomas (IHs) on pediatric patient 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience on pediatric patients with efficacy and a...

Ventriculo Peritoneal Shunt (VPS) implantation for hydrocephalus is associated with several complications. Proximal migration of the VPS catheter is a rare complication following ventriculo-peritoneal shunting. This is a report of a management of 8-month-old-boy who had extrusion of peritoneal end of VPS catheter through scalp wound. VPS was placed...

Common location of teratomas in children are sacrococcygeal, gonadal, mediastinal and retroperitoneal, but teratomas may also occur at very unusual locations. A six-month-old boy presented with a large swelling at his left lumbar region. He presented with gradually increasing lump at his back, involving more on left lumbar region and midline since...

Introduction: Peroral extrusion of peritoneal part of Ventriculoperitoneal Shunt (VPS) catheter is an extremely rare complication following VPS implantation. Aim: To review the options available for the management of peroral extrusion of VPS catheter. Materials and Methods: PubMed, Medline, PMC (PubMed Central), Embase, Google scholar databases s...

Cystic lymphangiomas are also called as cystic hygromas and are benign, congenital malformation of the lymphatic system, and reported to occur in the head and neck regions in 90% of the cases. This is a report of two cases of large cystic hygromas involved at the neck in both the cases, while in the second case also involved the face along with the...

Book Contents (1). Meckel's Diverticulum and Patent Vitelline Duct in Children, by Rajendra K Ghritlaharey (2). Progress of Pediatric Surgery: A Brief Review by Rajendra K Ghritlaharey (3). Congenital Pouch Colon by Rajendra K Ghritlaharey (4). Intussusception in Children by Rajendra K Ghritlaharey (5). Neural Tube Defects by Rajendra K Ghritlahare...

Neural tube defects (NTDs) are among the most common of all birth defects in human, affecting over 300,000 births globally each year. The worldwide incidence of NTDs ranges from 1.0 to 10.0 per 1,000 live births, and varies within the country to other part of the world. During the last few decades, there is significant decline in the incidence of N...

The word “intussusception” is derived from the Latin words “intus” (within) and “suscipere” (to receive). Intussusception is the invagination of one part of the intestine into another. Intussusception remains a common cause of bowel obstruction in infants and young children and results in significant morbidity and mortality, if not promptly treated...

ABSTRACT Congenital pouch colon (CPC) is a congenital anomaly associated with anorectal malformations (ARM) in which whole or part of the colon is replaced by a pouch like dilatation which communicates distally to the urogenital tract with a fistula. This anomaly is also referred as congenital short colon and pouch colon syndrome. Narsimha Rao, et...

ABSTRACT Pediatric surgery includes care of the children from the neonatal period to adolescence with surgical disorders. This also includes, counseling for antenatal diagnosed surgical disorders, and fetal interventions. Like adults, every infant and child who suffers from an illness (medical or surgical) or disease, has the right to be treated in...

Hippocrates, 5 th Century B.C. (460-377 BC), Greek physician and surgeon, the father of medicine, is thought to be the first physician to attempt and document the treatment of hydrocephalus. [1] Vesalius (1514-1564) clarified many of the anatomical and pathological characteristics of hydrocephalus. [1] Hydrocephalus is a common pediatric disorder i...

Hippocrates, 5th Century B.C. (460-377 BC), Greek physician and surgeon, the father of medicine, is thought to be the first physician to attempt and document the treatment of hydrocephalus.[1] Vesalius (1514-1564) clarified many of the anatomical and pathological characteristics of hydrocephalus.[1] Hydrocephalus is a common pediatric disorder in w...

Ventriculoperitoneal (VP) shunting used in the treatment for hydrocephalus is associated with several complications. Gastric perforation and extrusion of peritoneal part of VP shunt catheter through mouth is an extremely rare complication. This is a report of a management of a two-year-old girl who had extrusion of peritoneal part of VP shunt cathe...

Meckel’s diverticulum is one of the most common congenital anomaly of the gastrointestinal tract. Although, it is considered as a disease of children but also present in the adults. Omphalomesenteric duct (vitelline duct) is an embryonic structure that connects the midgut to yolk sac. A wide variety of the anomalies may occur due to the partial or...

Mesenteric cysts are rare benign intra peritoneal tumor and more than half of the mesenteric cysts involve the mesentery of the terminal ileum. We present 8 year-old boy, who presented with features of acute intestinal obstruction. Ultrasonography (USG) of the abdomen revealed a cystic mass in the peritoneal cavity with dilated loops of bowel. Expl...

Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury abdomen with haematuria following fall from motorcycle. He had pallor, and features of hypovolumic...

Children younger than 14 years of the age accounts for 25% of the world’s population. In India, the population of the children up to 14 years accounts for 35.3%, and of these 0 - 6 year accounts for 19.4% of the total population. In India, mortality of children below 5 years of the age in the year 2013 was 56, which was 64 in the year 2009 (World B...

This is a case report of a 10-year-old boy who presented with features of acute intestinal obstruction. Clinical examination revealed distended abdomen, visible bowel loops, and a lump in the right upper quadrant of the abdomen. Clinically, the diagnosis of intussusception was suspected and confirmed on sonography examination. Exploration of the ab...

Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury abdomen with haematuria following fall from motorcycle. He had pallor, and features of hypovolumic...

Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury abdomen with haematuria following fall from motorcycle. He had pallor, and features of hypovolumic...

Lymphangiomas are benign lesions with a marked predilection for the head and neck region. Giant lymphangiomas of head and neck may occur and they may present with life threatening complications. The author is presenting here, a three month-old boy who presented with a giant cystic lymphangioma on left side of neck, which extended to the head as wel...

Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC). Patients and methods: This retrospective study included CPC cases that were managed with two-staged procedures in the Department of Paediatric Surgery, over a period of 12 years from 1 January 2000 to 31 Decemb...

Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC). Patients and Methods: This retrospective study included CPC cases that were managed with two-staged procedures in the Department of Paediatric Surgery, over a period of 12 years from 1 January 2000 to 31 December...

The aim of this study was to review our experience with tube thoracostomy in the management of empyema thoracis in children. This retrospective study included 46 children (26 boys and 20 girls) who were admitted and managed for empyema thoracis, between January 1, 2010 and December 31, 2010 at the author's department of paediatric surgery. During t...

The aim of this study was to review the management of ventriculoperitoneal (VP) shunt complications in children. During the last 5 years (January 1, 2006 to December 31, 2010), 236 VP shunt operations were performed in children under 12 years of age; of these, 40 (16.94%) developed shunt complications and those who underwent VP shunt revisions were...

Aim: The aim of this study was to review the management of symptomatic Meckel’s diverticulum and patent vitello-intestinal duct (PVID) in children. Patients and Methods: This retrospective study included 46 children (39 boys and 7 girls) who underwent exploratory laparotomy for the management of symptomatic Meckel’s diverticulum and PVID between J...

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We report a case of a large mature teratoma with rare microscopic foci of the immature elements of the mesentery of the jejunum and ileum, which were diagnosed by histology in an infant. She presented with an abdominal lump since birth. Her clinical examination revealed a non tender, mobile, mass, occupying the right hypochondrium and the epigastri...

We report a case of intrauterine bowel perforation presenting as ileal atresia with calcification. A seven-day-old girl presented with abdominal distension, bilious vomiting and not passing meconium. A provisional diagnosis of distal ileal atresia was made on clinical examination and investigations. Exploratory laparotomy revealed distal ileal atre...

This is a report of a case of congenital pouch colon (CPC) type II, who was managed by a single stage procedure (exploratory laparotomy, ligation of the colo-vesical fistula, excision of the pouch and abdomino-perineal pull-through of the colon) which was done on the 2nd day of life. He developed severe stricture of the pulled colon and needed thre...

Ectopia cordis (EC) is defined as the complete or partial displacement of the heart outside the thoracic cavity. It is a rare congenital defect in the fusion of the anterior chest wall, resulting in the extra thoracic location of the heart. We are describing here, two cases of thoracoabdominal EC. One died after emergency surgery and another is awa...

Ectopia cordis (EC) is defined as the complete or partial displacement of the heart outside the thoracic cavity. It is a rare congenital defect in the fusion of the anterior chest wall, resulting in the extra thoracic location of the heart. We are describing here, two cases of thoracoabdominal EC. One died after emergency surgery and another is awa...

This is a report of a case of congenital pouch colon (CPC) type II, who was managed by a single stage procedure (exploratory laparotomy, ligation of the colo-vesical fistula, excision of the pouch and abdomino-perineal pull-through of the colon) which was done on the 2nd day of life. He developed severe stricture of the pulled colon and needed thre...

The aim of this study was to review 10 years of experience in the management of children with acute intestinal conditions requiring exploratory laparotomy. This retrospective study included 334 children (244 boys and 90 girls) who underwent laparotomy for acute intestinal conditions between Jan 1, 2000 to Dec 31, 2009. Patients were grouped into tw...

We would like to report an interesting case of an epidermal inclusion cyst of the terminal phalanx of the right thumb as diagnosed by histopathology. A 10 year-old boy presented to us with the complaint of a progressive painful swelling at the terminal phalanx of his right thumb for one year. There was no history of trauma, or foreign body injury t...

Split notochord syndrome (SNS) is an extremely rare congenital anomaly and 33 such cases have been reported in literature, till date. Of these 33 cases of SNS; 20 presented with associated dorsal enteric fistula. We are reporting here a 2.5 kg male neonate, born normally at hospital, to a 24 yrs old Gravida II Para I mother. Clinical examination an...

Split notochord syndrome (SNS) is an extremely rare congenital anomaly and 33 such cases have been reported in literature, till date. Of these 33 cases of SNS; 20 presented with associated dorsal enteric fistula. We are reporting here a 2.5 kg male neonate, born normally at hospital, to a 24 yrs old Gravida II Para I mother. Clinical examination an...

Sir, A set of female ischiopagus tetrapus conjoined twins was born to a Gravida V Para IV 30 years old mother. The pregnancy & vaginal home delivery were uneventful. There was no history of infection, intake of any teratogens, drugs or exposure to radiation, etc in antenatal period. There was no family history of any congenital anomalies. Her ante...

Blunt injury liver associated with diaphragmatic tear and bilious pleural effusion is a rare clinical finding in children. A 12 years old boy was referred to us for respiratory distress following blunt injury abdomen. Investigations revealed liver contusion, tear in right dome of the diaphragm, bilious collection in subphrenic space and right pleur...

Ventriculo-peritoneal (VP) shunting used in the treatment for hydrocephalus is associated with several complications. Mechanical failure of shunt is the commonest complication of all. Visceral/bowel perforation is an unusual but serious complication of VP shunting. This article reports our experience in the management of ten children who had VP Shu...

A one month old infant presented with an irreducible right inguino-scrotal swelling and faecal discharge from the scrotum for a week. Inguinal exploration revealed an incarcerated right inguinal hernia containing loop of small intestine, Meckel’s diverticulum and a perforation of the small intestine measuring 3 cm. Resection of part of ileum contai...

I’m herein presenting a one-day, 2.4 kg old newborn, who presented with a single constriction mark over her right arm due to a congenital amniotic band. She was a full-term baby, born normally at home to a G1 P0, 22 years old mother, on May 15, 2007. Her antenatal history was nothing significant. Antenatal ultrasonography was done in the third mont...

A Prune Belly syndrome with VATER/VACTERL association is an extremely rare. They are either stillborn or die within few days of life, only few such cases have been reported in literature. We are presenting here a male neonate of Prune Belly syndrome associated with incomplete VACTERL with brief review of literature.

A full term female baby of 2.3 kg was born to a Gravida I Para 0, 22-years-old mother on June12, 2006. She was brought to us one hour after birth. The pregnancy and hospital delivery were uneventful. There was no history of infection, intake of any teratogens, drugs or exposure to radiation, etc. in antenatal period. Clinical examination revealed p...

A Prune Belly syndrome with VATER/VACTERL association is an extremely rare. They are either stillborn or die within few days of life, only few such cases have been reported in literature. We are presenting here a male neonate of Prune Belly syndrome associated with incomplete VACTERL with brief review of literature.

Ventriculo-peritoneal (VP) shunting used in the treatment for hydrocephalus is associated with several complications. Mechanical failure of shunt is the commonest complication of all. Visceral/bowel perforation is an unusual but serious complication of VP shunting. This article reports our experience in the management of ten children who had VP Shu...

Aim : The aim of this study was to analyze the clinical and management aspect of congenital pouch colon. Materials and Methods : This retrospective study was carried out on 40 cases of congenital pouch colon managed in the department of paediatric surgery from 01, January 2000 to 31, December 2005. Results : The incidence of congenital pouch colon...

Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon complication following ventriculo-peritoneal (VP) shunt. The following report′s our experience with three cases of CSF pseudocyst in children. VP shunt was done earlier for communicating hydrocephalus following tubercular meningitis (TBM) in all cases. Clinical presentation was with prog...

A 10 months old girl child was admitted on June 05 2005, with a history of blunt injury of chest and respiratory distress for 2 days. Chest skiagram showed effusion on right side of chest, with shift of mediastinum to opposite side. Right intercostal chest drainage was done for pyopneumothorax. Rupture of esophagus was suspected, when the chest dra...

Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon complication following ventriculo-peritoneal (VP) shunt. The following report's our experience with three cases of CSF pseudocyst in children. VP shunt was done earlier for communicating hydrocephalus following tubercular meningitis (TBM) in all cases. Clinical presentation was with prog...

A 10 months old girl child was admitted on June 05 2005, with a history of blunt injury of chest and respiratory distress for 2 days. Chest skiagram showed effusion on right side of chest, with shift of mediastinum to opposite side. Right intercostal chest drainage was done for pyopneumothorax. Rupture of esophagus was suspected, when the chest dra...

We have recently published an article on adenocarcinoma of sigmoid colon (left colon) in an eleven year-old male child1. Herein we are presenting another case of mucinous adenocarcinoma of rectosigmoid (left colon) in an eight-year-old male child. He was admitted on May 15, 2003 with complaints of pain & distension of abdomen for 2 months & feature...

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Colorectal cancer is rare in children, with an incidence of 1.3 to 2/million in the U.S.A. Presentation is usually vague & the diagnosis is delayed for few weeks to several months. The prognosis of colorectal carcinoma in children is extremely poor as compared to adults. We describe here an 11 years old male child who presented with features of int...

A full term female baby of 2.6 kgs delivered by Caesarean section for obstructed labour to a 30 yrs old mother. There were no history of antenatal infection, drug ingestion , exposure to radiation etc. She was brought to hospital 7 hrs. after birth. Examination revealed peri-oral cyanosis with heart rate of 140/min, regular & respiratory rate was 4...

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Omphalopagus parasite is a very rare congenital anomaly. Presented here is a case in which an extra truncus was attached to an infant in the region of the epigastrium. The truncus had well-formed extremities, an abdomen, and a hypoplastic thorax. The infant had a small omphalocoele in addition to the truncus. Surgery performed in the neonatal perio...

A one month old infant presented with an irreducible right inguino-scrotal swelling and faecal discharge from the scrotum for a week. Inguinal exploration revealed an incarcerated right inguinal hernia containing loop of small intestine, Meckel's diverticulum and a perforation of the small intestine measuring 3 cm. Resection of part of ileum contai...

A Prune Belly syndrome with VATER/VACTERL association is an extremely rare. They are either stillborn or die within few days of life, only few such cases have been reported in literature. We are presenting here a male neonate of Prune Belly syndrome associated with incomplete VACTERL with brief review of literature.