Prolapsed urachal sinus with pyourachus in an infantWe report an infant who presented with a discharging single-lumen, tubular, and mucosa-lined umbilical mass and a large central abdominal mass, inferior to the umbilicus. At operation, the mass was discovered to be a prolapsed, open, and inflamed urachal sinus leading to a pyourachus. Primary total excision from dome of the bladder to the umbilicus led to smooth recovery with excellent results.
Congenital extensive central venous thrombosis with chylous ascites and chylothoracesWe describe a case of congenital extensive central venous thrombosis presenting as polyhydramnios and massive ascites, requiring amnioreduction prenatally and refractory chylous ascites and chylothoraces postnatally. Echocardiography, computed tomography angiogram (CTA), and magnetic resonance venogram (MRV) were helpful in defining the nature and extent of the lesion. The patient underwent staged procedures of repeated abdominal paracentesis, chest drain insertion, and right internal jugular vein exploration initially.
Ureteral damage during appendicectomyA case of right ureteric damage in a 7-year-old boy who underwent appendicectomy is described. Ultrasound, magnetic resonance urography, nephrostogram, and retrograde ureterogram were helpful in defining the nature and extent of the lesion. He underwent staged procedures of percutaneous nephrostomy, elective resection and reconstruction of midureteral segment, and subsequent removal of double J stent and made a smooth recovery. Ureteric injuries, although rare, have serious consequences. A high index of suspicion is essential for diagnosis.