Child had antenatally diagnosed progressively increasing bilateral hydroureteronephrosis .Delivered at term and diagnosed to have bilateral duplex kidneys with severe bilateral VUR to lower moieties and cecoureterocele on right upper moiety. Cystoscopic deroofing of ureterocele and laparoscopic ureterostomy were performed successfully to protect the kidney functions
An extremely rare case of Fetal intestinal volvulus has been successfully managed The 32 weeker fetus was diagnosed to have Classical triad of Echogenic bowel with Whirl pool sign, polyhydramnios and fetal anaemia . A thorough counselling with the parents enabled them to take the most difficult decision of urgent delivery of the baby by Cesarean Section. Post natal evaluation confirmed the small bowel volvulus. After stabilization emergency laparotomy was performed. Segmental volvulus involving whole of ileum with gangrene and distal ileal atresia, malrotaion of gut was detected. Resection of gangrenous bowel , correction of malrotation and double barrel ileostomy was performed. Baby recovered from the physiological and surgical stress quite satisfactorily, started to pass stool per stoma and started feeding.
Fetal volvulous is an extremely rare condition and a challenge to diagnose and manage. Only few cases have been reported in the world literature with instances of fetal death , still births in neglected cases. It’s a complex multidisciplinary approach with state of the art NICU care which helps in survival of potentially morbid and lethal condition.
Dr. Kamalesh Pal has performed more than 7000 neonatal and 15000 pediatric surgical procedures. Has more than 40 indexed publications, 5 chapters in Pediatric Surgical Textbooks, recipient of Young Scientist Award (2004), Mohanlal Wig Gold Medal (2003)
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