Journal of Neonatal Surgery https://www.jneonatalsurg.com/ojs/index.php/jns <p class="style58" style="text-align: justify; line-height: 16.5pt; background: white; margin: 12.0pt 0in 12.0pt 0in;"><span style="font-size: 11.5pt; font-family: 'Arial',sans-serif; color: black;"><strong>Journal of Neonatal Surgery (ISSN: 2226-0439)</strong> is peer-reviewed, open access, electronic journal that promotes the dispersion of quality research in the field of Neonatal Surgery. It is the only journal, fully dedicated to Neonatal Surgery- a developing specialty. The journal also provides an opportunity for learning “Medical Writing” to young pediatric and neonatal surgeons. Our editorial team works hard to guide new writers in this field. The journal publishes quality research that will improve outcomes of neonatal surgery, especially in resource-constrained settings. Our main aim is to reduce morbidity and mortality of neonatal surgery by publishing the latest trends in this discipline, in a special context to the developing countries. We invite pediatric and neonatal surgeons for their quality contributions to the Journal of Neonatal Surgery and help us achieve these goals.</span></p> en-US <h3>You are free to:</h3> <ul class="license-properties"> <li class="license share"><strong>Share</strong> — copy and redistribute the material in any medium or format</li> <li class="license remix"><strong>Adapt</strong> — remix, transform, and build upon the material for any purpose, even commercially.</li> </ul> <p><strong>Terms:</strong></p> <ul> <li><strong>Attribution</strong> — You must give <a id="appropriate_credit_popup" class="helpLink" tabindex="0" title="" href="https://creativecommons.org/licenses/by/4.0/" data-original-title="">appropriate credit</a>, provide a link to the license, and <a id="indicate_changes_popup" class="helpLink" tabindex="0" title="" href="https://creativecommons.org/licenses/by/4.0/" data-original-title="">indicate if changes were made</a>. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.</li> <li><span id="by-more-container"></span><strong>No additional restrictions</strong> — You may not apply legal terms or <a id="technological_measures_popup" class="helpLink" tabindex="0" title="" href="https://creativecommons.org/licenses/by/4.0/" data-original-title="">technological measures</a> that legally restrict others from doing anything the license permits.</li> </ul> blmirza@gmail.com (Dr. Muhammad Bilal Mirza) drusamaaziz@gmail.com (Usama Aziz) Tue, 21 Jul 2020 00:00:00 -0400 OJS 3.2.1.1 http://blogs.law.harvard.edu/tech/rss 60 Esophageal elongation using Foley catheter in long-gap esophageal atresia https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/555 <p>Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a rare congenital anomaly that poses major surgical challenges, particularly when the distance between the two esophageal ends exceeds 3 cm. Many surgical techniques are advocated for bridging the gap between the two esophageal ends. In this paper, we propose a simple and effective technique to elongate the esophagus in the long gap EA. This technique has successfully been applied in two infants with type C EA/TEF, where a primary end to end esophageal anastomosis was not feasible. The technique uses two Foley catheters for traction of upper and lower esophageal ends in long-gap EA/TEF. This method helps preserve the native esophagus, providing comfortable suction of the upper esophageal pouch, and assuring postoperative continuous feeding through the lower esophageal segment.</p> Maher alzaiem Copyright (c) 2020 Maher alzaiem https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/555 Sat, 17 Oct 2020 00:00:00 -0400 Where are we in pediatric colorectal and pelvic reconstructive surgery? New insights and the future https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-520 Marc A Levitt Copyright (c) 2020 Marc A Levitt https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-520 Mon, 27 Jul 2020 00:00:00 -0400 Anorectal malformations in newborn females https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-529 Naima Rasool Copyright (c) 2020 Naima Rasool https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-529 Sun, 26 Jul 2020 00:00:00 -0400 Primary iliopsoas abscess in a neonate: A diagnostic dilemma https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-525 Soumyodhriti Ghosh, Abhijit Kundu, Padma Lochan Rath, Abhishek Kumar Copyright (c) 2020 Soumyodhriti Ghosh, Abhijit Kundu, Padma Lochan Rath, Abhishek Kumar https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-525 Wed, 29 Jul 2020 00:00:00 -0400 Gastric perforation in a neonate with Hirschsprung disease https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-538 Parveen Kumar, Yogesh Kumar Sarin, Shramana Mandal Copyright (c) 2020 Parveen Kumar, Yogesh Kumar Sarin, Shramana Mandal https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-538 Tue, 04 Aug 2020 00:00:00 -0400 Congenital orbital teratoma: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-523 <p>Background: Teratoma originates from all three germinal layers and commonly found at the sacrococcygeal region. The orbit is an unusual site of occurrence, but they grow rapidly and cause massive proptosis.</p> <p>Case Presentation: A 9-day-old female neonate presented with marked unilateral proptosis of the right eye. Imaging workup gave a suspicion of a complex mass with internal hemorrhage or a teratoma. Modified exenteration was performed. Histopathological examination revealed mature cystic teratoma.</p> <p>Conclusion: Orbital teratoma presents with marked disfiguring proptosis in neonatal life. Prompt complete surgical excision is curative in the case of mature lesions.</p> Ahmed Raza, Asma Mushtaq, Seema Qayyum, Fiza Azhar, Ahmad Imran, Ashvinah Qayyum Copyright (c) 2020 Ahmed Raza, Asma Mushtaq, Seema Qayyum, Fiza Azhar, Ahmad Imran, Ashvinah Qayyum https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-523 Tue, 28 Jul 2020 00:00:00 -0400 Ileo-colonic tubular duplication with distal sigmoid colon stenosis in a neonate: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-535 <p>Background: Though the duplication cysts presenting with intestinal obstruction are not uncommon in neonates, tubular duplications may pose a significant diagnostic and management challenge.</p> <p>Case Presentation: We present the successful management of a neonate presenting with intestinal obstruction. The diagnosis of ileocolonic tubular duplication cyst was made intra-operatively. The cyst was managed with a novel technique.</p> <p>Conclusion: Tubular duplications of the alimentary tract rarely encounter in neonates. The surgeons should improvise the surgical technique to manage such anomalies.</p> Raghunath BV, Veerabhadra Radhakrishnan, Varsha Jinnenahalli Srinivas, Janaki Raghavan, Prasad Nagadevanahalli Ashokkumar, Naresh Kumar Copyright (c) 2020 Raghunath BV, Veerabhadra Radhakrishnan, Varsha Jinnenahalli Srinivas, Janaki Raghavan, Prasad Nagadevanahalli Ashokkumar, Naresh Kumar https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-535 Mon, 03 Aug 2020 00:00:00 -0400 Acute appendicitis causing small intestinal band obstruction in a premature baby: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-533 <p>Background: Bilious vomiting is a common symptom of neonatal intestinal obstruction. The etiology is mostly related to congenital anomalies and other conditions causing intestinal obstruction.</p> <p>Case Presentation: We report a case of a seven days male premature baby (35 Weeks) that presented with features of intestinal obstruction including bilious vomiting and abdominal distention. X-ray abdomen showed features of complete small bowel obstruction. On laparotomy, the baby had acute appendicitis causing multiple adhesions, and an adhesion band was responsible for intestinal obstruction. Adhesions were divided, and appendectomy performed. Postoperatively the baby had an uneventful recovery and was discharged in a stable condition.</p> <p>Conclusion: Neonatal appendicitis causing intestinal obstruction is a rare phenomenon and should be considered in the differential diagnosis of babies presenting with bilious vomiting.</p> Iftikhar Ahmad Jan, Sarah Bin Hariz, Faisal Al Zidgali, Zahid Latif Saqi, Ghazy Habeeb Lutf Copyright (c) 2020 Iftikhar Ahmad Jan, Sarah Bin Hariz, Faisal Al Zidgali, Zahid Latif Saqi, Ghazy Habeeb Lutf https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-533 Thu, 30 Jul 2020 00:00:00 -0400 Diagnostic dilemma of congenital segmental jejunal pseudo-dilatation associated with immature ganglion cells in the colon: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-532 <p>Background: Neonatal intestinal obstruction is one of the emergency conditions with many etiologies, amongst which congenital segmental dilatation of small intestine is one, which is characterized by three to four folds increase in diameter of the bowel. Immaturity of ganglion cells of large intestine is also one of the congenital intestinal neuronal malformations which may cause neonatal intestinal obstruction. Prompt diagnosis of these conditions is very difficult as clinical and radiological features are non-specific to them.</p> <p>Case Presentation: A 3-day-old male baby presented with failure to pass meconium, abdominal distension, and bilious vomiting. At surgery, the baby had congenital segmental pseudo-dilatation of jejunum with immature ganglion cells in colon. Since it was not typical of a congenital segmental dilatation, it was left as such. The baby needed another laparotomy for resection of segmental pseudo-dilatation along with ileostomy.</p> <p>Conclusion: Because of rarity and diagnostic dilemma, re-laparotomy with ileostomy, which could have been avoided, were performed in the baby. Lack of typical features of congenital segmental dilatation along with presence of immature ganglion cells in the colon were unusual findings in this case</p> Suman Bikram Adhikari, Shovita Rana, Sanat Chalise Copyright (c) 2020 suman Bikram, Shovita Rana, Sanat Chalise https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-532 Sun, 26 Jul 2020 00:00:00 -0400 Giant pedunculated hepatic hemangioma necessitating surgical excision in a neonate: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-531 <p>Background: Hepatic hemangioma (HH) is the most common hepatic tumor in small infants. It rarely presents during the neonatal period. Fetal giant hepatic hemangiomas tend to result in hydrops fetalis and cardiac failure due to cardiovascular overload. The purpose of this case report is to demonstrate the importance of pre and postnatal diagnosis of liver hemangioma with unusual presentation in neonatal life with huge mass causing respiratory compromise, and bowel compression.</p> <p>Case Presentation: We present a rare case of giant pedunculated hepatic hemangioma, diagnosed prenatally as a huge intra-abdominal mass. Patient developed respiratory distress due to large abdominal mass, thrombocytopenia, anemia and bowel compression thus necessitated surgical excision. Postoperative recovery was uneventful.</p> <p>Conclusion: Giant hepatic hemangioma may become fatal due to a huge mass effect on respiration and bowel function, along with associated thrombocytopenia and anemia. Adequate monitoring and support are mandatory in such cases and surgical excision at times becomes lifesaving.</p> Abdulrahman Almuawi, Mohammed Daboos, Ramakrishna Prasad Copyright (c) 2020 Mohammed Daboos, Abdulrahman Almuawi, Ramakrishna Prasad https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-531 Thu, 13 Aug 2020 00:00:00 -0400 A fatal combination of duodenal atresia with preduodenal portal vein, malrotation, and hypoplastic left heart syndrome: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-550 <p>Background: Duodenal atresia (DA) is often associated with anomalies that include annular pancreas, cardiac anomalies, intestinal malrotation, situs inversus, or splenic anomalies. Association of duodenal atresia with complex cardiac anomalies is scarcely reported in the literature.</p> <p>Case Presentation: A term neonate was diagnosed with duodenal atresia and found to have a preduodenal portal vein and malrotation. A gastro jejunostomy was added to the procedure, due to the pre duodenal portal vein. On post-operative day 4, the patient had sudden desaturation. The respiratory system was normal and there was no evidence of septicaemia. On the post-operative echocardiogram, the diagnosis of hypoplastic left heart was made and the patient eventually succumbed to his complex cardiac disease.</p> <p>Conclusion: This is a rare combination of multiple anomalies and we report the clinical and anatomical findings of this patient.</p> Priyanka Mittal, Nitin James Peters, Ram Samujh Copyright (c) 2020 Priyanka Mittal, Nitin James Peters, Ram Samujh https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-550 Mon, 24 Aug 2020 00:00:00 -0400 Duodenal atresia with absence of superior mesenteric artery and apple peel appearance of small gut: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/566 <p>Background: Though duodenal atresia is relatively common among intestinal atresias, its association with apple peel type of jejunoileal atresia and absent superior mesenteric artery (SMA) is very rare. This association contradicts the well-known embryo pathology of duodenal atresia and could be a management challenge.</p> <p>Case presentation: A 4-day-old preterm male baby presented with bilious vomiting. The X-ray abdomen showed a double bubble sign. Laparotomy revealed atresia of the 3<sup>rd</sup> part of the duodenum. The SMA was absent and the remaining small gut was short, narrow, and twisted around a narrow vascular pedicle arising from the marginal artery. We resected the most distal part of the dilated duodenum and made a wide end to side anastomosis with distal chimney stoma (Bishop Koop enterostomy). The baby did well in the postoperative period.</p> <p>Conclusion: The surgical management of this rare entity was technically challenging. Bishop Koop enterostomy is a safe option when the primary anastomosis is not possible.</p> Samiul Hasan, Dr. Jiaul Reza, Dr. Fatema Sayeed Copyright (c) 2020 Samiul Hasan, Dr. Jiaul, Dr. Fatema Sayeed https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/566 Mon, 05 Oct 2020 00:00:00 -0400 Imaging pearls of the annular pancreas on antenatal scan and its diagnostic dilemma: A case report https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/669 <p>Background: Annular pancreas is an uncommon cause of duodenal obstruction and rarely causes complete duodenal obstruction. Due to its rarity of identification in the antenatal period and overlapping imaging features with other causes of duodenal obstruction; it is often misdiagnosed.</p> <p>Case presentation: A 33-year-old primigravida came for routine antenatal ultrasonography at 28 weeks and 4 days of gestational age. On antenatal ultrasonography, dilated duodenum and stomach were seen giving a double bubble sign and a hyperechoic band surrounding the duodenum. Associated polyhydramnios was also present. Fetal MRI was also done. Postpartum ultrasonography demonstrated pancreatic tissue surrounding the duodenum. The upper gastrointestinal contrast study showed a non-passage of contrast beyond the second part of the duodenum. Due to symptoms of obstruction, the neonate was operated on, and the underlying cause was found to be the annular pancreas.</p> <p>Conclusion: Diagnosis of duodenal obstruction due to the annular pancreas is very important in the antenatal period to plan for appropriate therapeutic interventions after birth. A double bubble sign is seen due to various etiologies however the presence of a hyperechoic band in the antenatal ultrasound may point to the diagnosis of the annular pancreas.</p> Pradeep Kumar Roul, Ashish Kaushik, Manish Kumar Gupta, Poonam Sherwani Copyright (c) 2020 Pradeep Kumar Roul, Ashish Kaushik, Manish Kumar Gupta, Poonam Sherwani https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/669 Sat, 17 Oct 2020 00:00:00 -0400 Colonic atresia in neonates: Management dilemma in a developing country https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-526 <p>Background: Colonic atresia is one of the rarest causes of congenital intestinal obstructions. Its diagnosis is difficult, but prenatal investigations can improve it. The management of colonic atresia is not codified and depends on the resources available and surgeon’s experiences.</p> <p>Case Series: We report three neonates presented with intestinal obstruction. At surgery, the diagnosis of colonic atresia was made. Two neonates were managed with an initial stoma. One baby died intraoperatively.</p> <p>Conclusion: Management of colonic atresia is challenging in a developing country. Staged management with a stoma as initial procedure suits best to such settings.</p> Moufidath Sounkere-Soro, Jean-Baptiste Yaokreh, Yapo Guy Serge Kouame, Helen Audrey Thomas, Samba Tembely, Eric Koffi, Thierry Odehouri-Koudou, Dibi Bertin Kouame, Ossenou Ouatarra Copyright (c) 2020 Moufidath Sounkere-Soro https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-526 Wed, 29 Jul 2020 00:00:00 -0400 Colonic stenosis in neonates is not always congenital or complication of necrotizing enterocolitis https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-524 <p>Background: Bowel obstruction in early infancy may results from variety of congenital anomalies involving small and large bowel. Colonic stenosis (CS) congenital or acquired is among the rare causes of chronic bowel obstructions in early infancy.</p> <p>Methods: Medical record of 4 patients with colonic stenosis secondary to Hirschsprung’s disease was reviewed.</p> <p>Results: A total of 4 cases were included in the study. Age of presentation ranged from 25 days to 96 days. Most common presentation was gross abdominal distension with visible bowel loop, vomiting, difficulty in passing stool followed by history of passing recurrent loose stools and failure to thrive. In one case there was suspicion of bowel perforation and was operated in emergency. Initial operative findings and histopathology was not suggestive of Hirschsprung’s Disease, but a full thickness rectal biopsy confirmed HD in all 4 cases.</p> <p>Conclusion: Hirschsprung should be considered as underlying pathology in cases of colonic stricture/stenosis in children.</p> Vijai Datta Upadhyaya, Ashwani Mishra, Yusuf Md, Basant Kumar Copyright (c) 2020 Vijai Datta Upadhyaya, Ashwani Mishra, Yusuf Md, Basant Kumar https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-524 Wed, 29 Jul 2020 00:00:00 -0400 In-utero segmental volvulus around vitellointestinal duct remnants leading to ileal atresia and stenosis: A case series https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-522 <p>Background: The etiology of intestinal atresia is multifactorial with vascular accidents being the most common event in its development. In-utero volvulus is a well-known type of vascular accident leading to intestinal atresia. Segmental volvulus around vitellointestinal duct remnants is rarely described vascular accident leading to ileal atresia.</p> <p>Case Series: We report two cases of segmental ileal volvulus around vitellointestinal duct remnants in neonates leading to ileal atresia in one case and intestinal stenosis in the other one. Both neonates presented with signs of neonatal intestinal obstruction. X-ray abdomen performed in both neonates showed air-fluid levels. Both neonates were operated with suspicion of intestinal atresia. At surgery, a segment of the small bowel was found twisted around vitellointestinal duct remnants in both cases. The first case also had intestinal atresia whereas the second one had intestinal stenosis secondary to the segmental volvulus.</p> <p>Conclusion: Segmental volvulus around vitellointestinal duct remnants can also cause ileal atresia or stenosis.</p> Vidyanand Deshpande, Rajgopal Totla, Arjun Pawar, Pravin Suryawanshi Copyright (c) 2020 Vidyanand Deshpande, Rajgopal Totla, Arjun Pawar, Pravin Suryawanshi https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-522 Fri, 14 Aug 2020 00:00:00 -0400 Congenital granular cell epulis: A case series https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-541 <p>Background: Congenital granular cell epulis (CGCE) is an extremely rare intraoral tumor of the newborn with a potential to disrupt feeding and produce respiratory distress.</p> <p>Case Series: We report two newborns presented with mass protruding off the mouth since birth. The mass was arising from alveolar ridge in both cases and dealt with surgical excision. Histopathology revealed it congenital granular cell epulis. Postoperative recovery and follow-up are uneventful.</p> <p>Conclusion: Congenital granular cell epulis is a benign lesion though not quite uncommon, may cause diagnostic challenges. Early excision and histopathology rule out malignant lesions.</p> Mustafa Okumuş, Adil Umut Zubarioğlu, Uğuray Payam Hacısalihoğlu Copyright (c) 2020 Mustafa Okumuş, Adil Umut Zubarioğlu, Uğuray Payam Hacısalihoğlu https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-541 Tue, 25 Aug 2020 00:00:00 -0400 Kluth type I3 and intra-abdominal variants of esophageal atresia: A case series https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-530 <p>Background: Esophageal atresia (EA) encompasses a group of congenital anomalies (one in 2500 live births) comprising an interruption in the continuity of the esophagus combined with or without a persistent communication with the trachea. It is confirmed by passing no. 10 sterile, blunt‑tipped red rubber catheter into the esophagus, which gets failed to pass beyond 10 cm.</p> <p>Case Series: We describe two male neonates in whom the infant feeding tube could be passed to 18-20 cm in the upper esophageal pouch. A babygram with a blunt-tipped soft red rubber catheter in situ confirmed the esophageal atresia (EA) with the long upper pouch in the first case and EA with obstruction at the gastroesophageal junction in the second one.</p> <p>Conclusion: The importance of recognizing rare Kluth variants of EA is stressed. A low threshold for performing a red rubber catheter test is stressed.</p> Rahul Gupta, Rozy Paul, Manika Boipai, Priya Mathew, Ankit Singh, Bhairu Lal Gurjar, Arun Kumar Gupta Copyright (c) 2020 Rahul Gupta, Rozy Paul, Manika Boipai, Priya Mathew, Ankit Singh, Bhairu Lal Gurjar, Arun Kumar Gupta https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-530 Sun, 23 Aug 2020 00:00:00 -0400 Comparison of early surgical outcomes following anoplasty and limited PSARP for perineal fistula https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-521 <p>Background: To present the early surgical outcomes of two different surgical methods for the treatment of perineal fistula in patients with anorectal malformation.</p> <p>Material and Methods: Retrospective chart analysis of patients treated with any of the two surgical approaches for perineal fistula treatment during the newborn period, without a colostomy at Academic and Community Pediatric Surgery Reference Hospital during October 1st, 2015 to December 31st, 2018.</p> <p>Results: Twenty-six out of 57 patients of our database met inclusion criteria during the study period. 15 in the anoplasty group and 11 in the Minimal Posterior Sagittal Anorectoplasty (MPSARP); the anoplasty group had more rate of anoplasty dehiscence (4 partial, 6 total – requiring additional stitches, p = 0.027), versus zero in the MPSARP group, albeit there was 1 superficial perineal dehiscence. All surgeries were performed without a previous colostomy. There were no other surgical complications reported, and there was no difference in age, weight, sacral ratio, and associated malformations.</p> <p>Conclusion: Minimal PSARP can be safely done in the newborn patient with a patent perineal fistula.</p> Bruno Martinez-Leo, Vicente Herrera-Del Prado, Victor Portugal-Moreno, Arturo Godoy-Esquivel, Adriana Castillo-Aguirre, Luis Velasco-Soria, Luis Garcia-Cabello, Miguel Vargas-Gomez Copyright (c) 2020 Bruno Martinez-Leo, Vicente Herrera-Del Prado, Victor Portugal-Moreno, Arturo Godoy-Esquivel, Adriana Castillo-Aguirre, Luis Velasco-Soria, Luis Garcia-Cabello, Miguel Vargas-Gomez https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-521 Mon, 27 Jul 2020 00:00:00 -0400 Comparison of frequency of complications in loop versus divided colostomy in patients with high variety anorectal malformation https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-528 <p>Background: The objective of this study was to compare frequency of stoma related complications of loop versus divided sigmoid colostomy for the management of high variety anorectal malformations.</p> <p>Methodology: This RCT was conducted in the department of Pediatrics Surgery Department of the Children’s Hospital and the Institute of Child Health Lahore, for the period of one year from 1<sup>st</sup> May 2016 to 1<sup>st</sup> June 2017. One hundred and twenty patients (Sixty patients in each group) of anorectal malformation meeting inclusion criteria were taken in this study. Patients were divided into two groups randomly using lottery method; loop sigmoid colostomy in Group-A and divided sigmoid colostomy in Group-B. After surgeries patients were followed weekly up till 8 weeks. Stoma related complications (as per operational definition) were noted.</p> <p>Results: The mean age in group –A and group-B were 3.34 ± 1.12 days and 3.36 ± 0.97 days, respectively. In group – A there were 52(86.67%) male and 8(13.33%) females, and in group-B there were 45(75%) male and 15(25%) female patients. In group-A 22(36.66%) patients had complications [3(5.00%) patients had retraction, 8(13.33%) had prolapse, 4(6.67%) had stoma obstruction, parastomal hernia were seen in 4(6.67%), stoma necrosis were seen in 3 (5.00%)] and in group-B, 16(26.66%) patients had different complications [1(1.67%) patients had retraction, 3(5.00%) had prolapse, 5(8.33%) had stoma obstruction, parastomal hernia were seen in 2(3.3%), stoma necrosis were seen 5(8.33%)]. The complications in group-A were higher when compared to group-B, but (p-value = 0.650) were not significant statistically except for stoma prolapse.</p> <p>Conclusion: Though complication rate in both techniques is not statistically different but frequency of stoma prolapse is more in loop colostomy group. Therefore, divide colostomy should be opted as preferred technique.</p> Masood Shah, Nabi Bux Napar, Faryal Ilyas Jhammat, Hafiza Shehla Arshad, Mohammed Saleem Copyright (c) 2020 Masood Shah, Nabi Bux Napar, Faryal Ilyas Jhammat, Hafiza Shehla Arshad, Mohammed Saleem https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-528 Mon, 27 Jul 2020 00:00:00 -0400 Unusual obstetric trauma in newborn https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/543 <p>Background: Birth injuries during delivery are rare but can be the most common cause of morbidity and mortality. All parts of the body can be damaged. The aim of this study is to determine the impact of these uncommon injuries on the newborn. This is a retrospective chart review of 11 newborn babies who had concurrent birth trauma. Pertinent data on the cause of injury treatment and the outcome were recorded.</p> <p>Methods: It is a retrospective chart review of newborns who sustained a birth trauma during delivery. These patients presented to the Department of Pediatric Surgery, SETIF, Algeria from 2010 to 2020.</p> <p>Results: A total of 11 cases with birth trauma occurred during delivery were managed during the study tenure. Of these 11, 9 were males and 2 females. Two cases sustained scalp laceration including one extensive laceration exposing the brain tissue with uncontrollable hemorrhage. One newborn sustained facial trauma secondary to the forceps delivery. One newborn who needed resuscitation and ventilation at birth developed bilateral pneumothorax secondary to the barotrauma. One patient sustained a femur fracture whereas another had a humerus fracture along with brachial plexus injury during delivery. Three cases had umbilical cord injury including two cases of clamped hernia of the umbilical cord resulting in neonatal intestinal obstruction. Two cases had scrotal trauma including one with testicular evisceration. Two cases were expired in this cohort.</p> <p>Conclusion: We have presented a diversity of birth trauma in newborns and their management. Proper antenatal follow-up and better planning for the delivery can avoid such injuries in newborns which often require surgical interventions for the management and at times can lead to mortality as well.</p> Assia Haif, Ketfi Mounir, Achouri Djelloul, Sinacer Samira, Soualili Zineddine Copyright (c) 2020 Haif Assia, Ketfi Mounir, Achouri Djelloul, Sinacer Samira, Soualili Zineddine https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/543 Fri, 25 Sep 2020 00:00:00 -0400 Necrotizing enterocolitis in term neonates: Possible risk factors https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/537 <p>Background: Necrotizing enterocolitis (NEC) is a common surgical disease in premature neonates, however, it may occasionally occur in term neonates. The etiology of NEC in prematurity is multifactorial but is still not well understood in term neonates. In this study, the maternal and neonatal risk factors, along with underlying pathology that may precipitate NEC in term neonates are investigated. </p> <p>Methods: A retrospective study investigating the maternal and neonatal risk factors for NEC in term neonates (G.A ≥37 weeks) was performed over an 8-years period (January 2009 to March 2017). We used the second group of healthy term neonates over the same period as a control group. The data were collected from medical records. Term babies with the primary diagnosis of NEC were included in the review. Premature neonates (G.A &lt;37 weeks) and NEC secondary to intestinal obstruction (e.g. Hirschsprung’s disease) were excluded from the study.</p> <p>Results: Of 194 babies with NEC, 14 were term neonates. Maternal risk factors: maternal age, Rhesus status, nicotine use, medication use, chronic and gestational illness were not found to be significant, however, maternal methamphetamine (MA) abuse was found to be a significant risk factor. Neonatal risk factors: genetic disorder, mode of delivery, type of milk, and invasive procedure were not found to be significant, but the presence of congenital heart disease (CHD) was a significant risk factor. Three neonates with CHD (3/4) in the group of term neonates with NEC also had maternal MA use.</p> <p>Conclusion: NEC in term neonates is rarely encountered. CHD is well known to precipitate the disease in premature or full-term neonates, as also noted in this cohort. MA usage was also noted as a possible underlying cause.</p> Ayman Elhosny, Corné de Vos, Behrouz Banieghbal Copyright (c) 2020 Ayman Elhosny, Corné de Vos, Behrouz Banieghbal https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/537 Tue, 29 Sep 2020 00:00:00 -0400 Ileocecal web with central perforation in a neonate: A peculiar inclusion to the scarce literature of ileocecal valve anomaly https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-546 Rashi Rashi, Mohd. Mokarram Ali, Amit Kumar, Amit Kumar Sinha, Bindey Kumar Copyright (c) 2020 Rashi Rashi, Mohd. Mokarram Ali, Amit Kumar, Amit Kumar Sinha, Bindey Kumar https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/jns-546 Sun, 13 Sep 2020 00:00:00 -0400 Idiopathic congenital chylothorax treated with povidone-iodine https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/663 Berna Hekimoğlu, Sefa Sağ, Dilek Başar, Şebnem Kader Copyright (c) 2020 Berna Hekimoğlu, Sefa Sağ, Dilek Başar, Şebnem Kader https://creativecommons.org/licenses/by/4.0 https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/663 Mon, 12 Oct 2020 00:00:00 -0400