Diagnoses and Surgical Management. (Personal Case)

Congenital broncho-esophageal fistula; presenting as recurrent pneumonia in a 10-years-old child: A case report

Congenital posterior urethroperineal fistula (CUPF) is a very rare anomaly of the genitourinary tract. It usually presents with perineal urine dribbling during micturition. Most of the patients present in early childhood although there are reports of adults with this condition. The diagnosis is made with a cystourethrography showing a separate fistulous tract opening to the perineum. Cystourethroscopy with a dye injected via the external fistula opening is confirmatory showing the proximal opening in the prostatic urethra just proximal to the striated sphincter muscle complex. This disease has to be differentiated from the urethral duplication as the two have opposite principles of management. Here we present the clinical presentation, diagnosis and management of CUPF in Ethiopia presented in a 29-years-old otherwise healthy adult male patient and reviewed the previously reported cases of the same condition.Clinical trial number: Not applicable since it is a case report.

Congenital external auditory canal atresia (EACA) is a rare developmental anomaly in dogs with limited information to guide management. This report describes the clinical presentation, diagnostic work-up, surgical technique, and long-term outcome in two young dogs with unilateral congenital EACA. An 8-month-old Caucasian Shepherd and a 9-month-old Maltese presented with left-sided otalgia and absence of the external canal opening. Computed tomography identified segmental atresia of the vertical canal with intraluminal soft-tissue attenuating material and mild otitis externa and media in both dogs. Cytology and culture of canal contents were unremarkable, supporting a congenital, non-infectious origin. Both dogs underwent a canal-preserving vertical canal-to-external acoustic meatus anastomosis using a pull-through approach. Minor postoperative complications (partial wound dehiscence, mild canal stenosis) were successfully managed. At the 5-year and 1.5-year follow-up, respectively, both dogs remained free of clinical signs, with preserved hearing, supporting this procedure as a functional, cosmetically acceptable option in carefully selected dogs.

Successful coil embolization of the congenital intrahepatic arteriovenous fistula associated with intrahepatic portal vein aneurysm in an infant

Congenital anterior urethrocutaneous fistulas with chordee: A case report

Background Congenital lumbar hernia is a rare anomaly with only 45 cases reported in the English-language literature, usually presents since birth either isolated or, less commonly, in association with other congenital malformations. Objectives This study done to record the prevalence rate of this very rare congenital anomaly at Sulaimani province, with reviewing the important clinical and anatomical aspects, along with the current surgical management of this malformation. Methods A case series study on just four cases presented over period of 10 years (May 2007 to June 2017), data were collected regarding the age at presentation, sex, associated anomalies, surgical management, and outcome, with measuring the prevalence rate. Results During the study period only four patients were recorded to have congenital lumber hernia. Male to female ratio was 1:1. All of them presented during infancy, with unilateral, and right sided CLH. One female presented with recurrence after a previous surgical correction. Lumbocostvertiberal syndrome was an associated anomaly in a female patient; bilateral undescended testes in a male patient. Three cases were managed with open surgical repair; without post operative morbidity and mortality. The recurrent case’s father declined further surgery. Conclusion CLH is a rare condition. The diagnosis is usually clinical. Due to the high frequency of associated congenital anomalies, a proper physical examination supplemented by plain X-ray and US study is important in every case. The treatment is surgical repair as soon as possible. There is a high chance of recurrence if big defect not corrected with meshplasty.

While most of the causes of urethrocutaneous fistulae are complications caused by hypospadias repair surgery, congenital anterior urethrocutaneous fistula (CAUF), in the isolated form, is an extremely rare anomaly that had been reported only a few times in literature. In this study, we report the case of 3-year-old uncircumcised boy, who presented with the condition of passing urine through an opening located on the ventral side of his penis since birth. On local examination, a clearly apparent fistula measuring 4 × 3 mm was observed on the ventral side of the shaft of the penis. Distal to that fistula, the glans was intact with a normal wide urethral meatus at its tip, and the prepuce was intact. Voiding cystourethrogram findings were suggestive of a partial duplication of the urethra. On examination under anesthesia, a urethroscopy revealed isolated congenital anterior penile urethrocutaneous fistula. For treatment of this condition, he underwent a single-stage closure of the fistula in layers with the tunica vaginalis as a waterproofing layer. Postoperatively, the catheter was removed on day 10, and he voided well with no fistula. In addition to awareness about the condition, a careful clinical examination, evaluation, and an appropriate surgical technique are required to achieve an optimal functional and esthetic outcome.

Congenital urethral fistula with a scrotal cyst in a seven-month-old male

Congenital prepubic sinus is an exceptional disorder of uncertain origin. These sinuses may represent a variant of epispadiac duplication or dorsal urethral duplication of the urethra.We present a case of isolated blind ending prepubic congenital sinus in a 5-year-old male child, which revealed transitional epithelium lining proximally, and squamous epithelium distally. This entity presents with either an opening in the prepubic region and/or persistent mucoid discharge. Excision leads to a permanent cure. Keywords :Congenital prepubic sinus, Urethral duplication, Epispadias. African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 49-50

Pure arterial malformations (PAMs) of the brain are rare vascular anomalies, typically identified incidentally and characterized by tortuous arterial loops. Their unclear etiology and management pose diagnostic and therapeutic challenges. A systematic review of Medline, EMBASE, and Web of Science databases (1900-present) identified 15 studies involving 54 patients with PAM. Data on demographics, clinical presentations, diagnostic modalities, and treatments were extracted. The mean age was 37.2 years (range: 10-77), with a female predominance (69%). Severe headaches were the most common symptom (43%), though some cases presented with neurological deficits (20%) or incidentally (32%). Imaging modalities such as digital subtraction angiography, MRI, and CT were pivotal in diagnosis. Most cases (81%) were managed conservatively, while 19% had interventions, including clipping and embolization. Surgical management was effective in alleviating symptoms in select cases of symptom progression. Our findings highlight the variability in clinical presentations ranging from benign to acute emergencies, emphasizing the challenges associated with the diagnosis and management of PAMs. This review underscores the need for larger studies that explore the etiology, treatment efficacy, and long-term patient outcomes.

Congenital lacrimal fistula is a developmental abnormality. This is a case of a patient with an external congenital lacrimal sac fistula. Surgical treatment was used to correct the condition. Immediate postoperative results were seen. To present a case of a patient with an external congenital lacrimal sac fistula, in which surgical treatment was applied and immediate postoperative results with a good outcome were seen. A 3-year-old boy with an external congenital lacrimal sac fistula presented to our clinic. The skin orifice was observed on the left eye in a typical place – located in the inferomedial aspect of the medial canthal angle. The patient was treated in the at the Eye clinic, at university hospital “Dr. Georgi Stranski” – Pleven, Bulgaria. He underwent a surgical procedure – simple fistula excision (closed fistula excision). The surgical technique was a successful closed fistula excision. In the immediate postoperative period there were no complications such as infection, recurrence or worsening of the epiphora, poor cosmetic results, bleeding or damage to the lid structures or nose. The prognosis for patients with congenital lacrimal fistulas is quite good. Many are asymptomatic and those who have symptomatic epiphora or mucoid discharge can be successfully treated by surgery. Several surgical options exist – closed fistula excision, dacryocystorhinostomy (DCR) with fistula excision and fistula excision with nasolacrimal intubation. Symptomatic congenital lacrimal sac fistulas can be treated successfully with excision alone.

Facing the challenge maxillofacial penetrating teta injury: A case report.

Abnormal interventricular septal motion following cardiac surgery: Clinical, surgical, echocardiographic and radionuclide correlates

Although the majority of patients with patellar tendinopathy (PT) can be treated nonoperatively, operative management may be indicated for recalcitrant cases. While several surgical techniques have been described, there is limited understanding of postoperative outcomes and expectations regarding return to activity and sport. The purpose of this study was to characterize the clinical outcomes associated with the surgical management of PT with an emphasis on return to sport (RTS) rates. We hypothesized that surgical management would lead to clinically important improvements in patient-reported outcomes (PROs) with high rates of RTS and RTS at the same level. A comprehensive search of the PubMed, Medline, and Embase databases was performed in December 2020. Level of evidence studies I through IV, investigating results of surgical management for PT (PRO, functional outcomes, pain, and/or RTS), were included. The search was performed in accordance with the Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Forty clinical studies reporting on surgery for PT satisfied inclusion criteria, with 1,238 total knees undergoing surgery for PT. A comparison of pre- and postoperative Victorian Institute of Sport Assessment, patellar tendon (VISA-P) scores (mean difference: 41.89, p < 0.00001), Lysholm scores (mean difference: 41.52, p < 0.00001), and visual analogue scale (VAS) pain scores (mean difference: 5, p < 0.00001) demonstrated clinically and statistically significant improvements after surgery. The overall RTS rate following operative management was 89.8% (95% confidence interval [CI]: 86.4-92.8, I 2 = 56.5%) with 76.1% (95% CI: 69.7.5-81.9, I 2 = 76.4%) of athletes returning to the same level of activity. Surgery for PT provides meaningful improvement in patient reported outcomes and pain while allowing athletes to RTS at high rates with levels of participation similar to that of preinjury. Comparative studies of open and/or arthroscopic surgery are still limited but current evidence suggests better rates of RTS for arthroscopic surgery compared with open surgery. This is a systematic review of level-I to -IV studies.

54 STABCric 3: Surgical Technique Against Bougie Cricothyrotomy