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Article ; Online: Systematic literature review of the management of transanal extrusion of distal ventriculoperitoneal shunt catheter

Rajendra K Ghritlaharey

Medical Journal of Dr. D.Y. Patil Vidyapeeth, Vol 15, Iss 5, Pp 629-

1966–2020

2022 Volume 659

Abstract: 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 ...

Abstract	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 complications, and the final outcome of the published cases, relating to the transanal extrusion of the distal VPS shunt catheter. Electronic database search was performed to retrieve the published/available literature relating to the transanal extrusion of VPS catheter. The manuscripts relating to the above-mentioned complication were retrieved from 1966 to December 2020. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines are followed for this review. This review included 210 cases comprising 142 (67.6%) males and 68 (32.3%) females. In two-third (n = 141) of the cases, the indication for the initial VPS insertion was the congenital hydrocephalus. In 60% of the cases, the initial VPS insertion was done during infancy. In 70% of the cases, the interval from VPS insertion to the diagnosis of transanal extrusion of the distal VPS catheter was within 12 months. Transanal extrusion of the distal VPS catheter was the chief complaint. In two-third of the cases, it was asymptomatic transanal extrusion of distal VPS catheter. In remaining one-third of the cases, it was symptomatic transanal extrusion of the distal VPS catheter, and they had either symptoms relating to the central nervous system or gastrointestinal tract. Three-fourth of the cases were managed by the removal of the entire or the distal VPS catheter with or without external ventricular drainage (EVD). Fifty percent of the above-mentioned complication was managed by doing percutaneous surgical procedures, and another one-third of them were managed by doing laparotomy. Complications were also evident in 16 (7.6%) of the cases during the postoperative period. This review revealed only 6 (2.8%) ...
Keywords	children ; complication ; extrusion ; hydrocephalus ; infants ; meningitis ; ventriculoperitoneal shunt ; Medicine ; R
Subject code	940
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of Symptomatic Meckel's Diverticulum in Infants and Children

Rajendra K. Ghritlaharey

Annals of the National Academy of Medical Sciences (India), Vol 58, Iss 01, Pp 011-

2022 Volume 016

Abstract: 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, ... ...

Abstract	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-institutional, retrospective study and descriptive in nature. It consisted of infants and children below 12 years who were operated upon for Meckel's diverticulum at the author's institute and included data from January 1, 2000 to December 31, 2020. Results Eighty-four children below 12 years were operated upon for Meckel's diverticulum during the study period. The ratio for males to females was 3:1. This study consisted of infants, (n = 22, 26.19%), children of 1 to 5 years of age (n =19, 22.61%), and children of 6 to 12 years of age (n = 43, 51.19%). Clinically, children with Meckel's diverticulum presented in the following order of frequency: (1) intestinal obstruction (n = 59, 70.23%), (2) perforation peritonitis (n = 17, 20.23%), (3) lower gastrointestinal bleeding (n = 4, 4.76%), and (4) incidental finding (n = 4, 4.76%). In 35 (41.66%) children, bowel gangrene was detected. One-fifth (n = 17) of Meckel's diverticulum was responsible for the secondary intussusception. The surgical procedures were performed in the following order of frequency: (1) resection of Meckel's diverticulum, an adjacent segment of ileum and ileoileal anastomosis (n = 36, 42.85%); (2) Meckel's diverticulectomy (n = 32, 38.09%); (3) resection of Meckel's diverticulum, an adjacent segment of ileum with or without cecum and an ileostomy (n = 12, 14.28%); and (4) resection of Meckel's diverticulum, an adjacent segment of ileum, cecum, part of the colon, and ileocolic anastomosis (n = 4, 4.76%). In 8 (9.52%) children, complications were documented during the postoperative period. The present study observed three (3.57%) deaths during the postoperative period. Conclusion Meckel's diverticulum was one of ...
Keywords	children ; infants ; intestinal obstruction ; intussusception ; meckel's diverticulum ; meckel's diverticulectomy ; perforation peritonitis ; General works ; R5-130.5 ; Science ; Q
Subject code	610 ; 360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Surgical Management of Intussusception in Children: A Retrospective Review of 212 Cases

Ghritlaharey, Rajendra K.

Annals of the National Academy of Medical Sciences (India)

2021 Volume 57, Issue 04, Page(s) 226–231

Abstract: 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 ... ...

Abstract	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 consists of children below the age of 12 years. This study was conducted at the author’s department of pediatric surgery for the past 21 years, from January 1, 2000 to December 31, 2020. Results: During the study period, 212 children were operated upon for intussusceptions and included 146 (68.86%) boys and 66 (31.13%) girls. This review consisted of infants 158 (74.52%), and children of 1 to 5 years of age (30; 14.15%), and 6 to 12 years of age (24; 11.32%). Clinically, 177 (83.49%) children presented with the features of acute intestinal obstruction, and the remaining 35 (16.5%) presented with features of perforation peritonitis. Primary (idiopathic) intussusception was documented in 188 (88.67%) of the cases. Gangrenous bowel was evident in 98 (46.22%) children. Sixty-two percent of the cases required bowel resection. Surgical procedures were executed in children for intussusception in the following order of frequency: (1) operative reduction with or without serosal tear/bowel perforation repair, n = 81 (38.2%); (2) resection of diseased ileum and ileoileal anastomosis, n = 52 (24.52%); (3) resection of diseased ileum ± part of colon and an ileostomy, n = 36 (16.98%); and (4) resection of diseased ileum, cecum, part of colon, and ileocolic (ileo-ascending or ileo-transverse) anastomosis, n = 43 (20.28%). Postoperatively, 9 (4.24%) children required reexploration for the management of their complications. Twenty-one (9.9%) children died during the postoperative period. Conclusion: Intussusception remains the most common cause of acute intestinal obstruction in infants and young children. Delay in the referral, diagnosis, and seeking treatment were significantly associated with bowel gangrene, required bowel resection during the surgical therapy, and also culminated in significantly higher mortalities.
Keywords	children ; infant ; intestinal obstruction ; intussusception ; bowel gangrene ; pathological lead point
Language	English
Publishing date	2021-10-01
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	632986-x
ISSN	2454-5635 ; 0379-038X
ISSN (online)	2454-5635
ISSN	0379-038X
DOI	10.1055/s-0041-1739034
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Article: Management of Symptomatic Meckel's Diverticulum in Infants and Children

Ghritlaharey, Rajendra K.

Annals of the National Academy of Medical Sciences (India)

2021 Volume 58, Issue 01, Page(s) 11–16

Abstract: 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, ... ...

Abstract	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-institutional, retrospective study and descriptive in nature. It consisted of infants and children below 12 years who were operated upon for Meckel's diverticulum at the author's institute and included data from January 1, 2000 to December 31, 2020. Results: Eighty-four children below 12 years were operated upon for Meckel's diverticulum during the study period. The ratio for males to females was 3:1. This study consisted of infants, ( n = 22, 26.19%), children of 1 to 5 years of age ( n =19, 22.61%), and children of 6 to 12 years of age ( n = 43, 51.19%). Clinically, children with Meckel's diverticulum presented in the following order of frequency: (1) intestinal obstruction ( n = 59, 70.23%), (2) perforation peritonitis ( n = 17, 20.23%), (3) lower gastrointestinal bleeding ( n = 4, 4.76%), and (4) incidental finding ( n = 4, 4.76%). In 35 (41.66%) children, bowel gangrene was detected. One-fifth ( n = 17) of Meckel's diverticulum was responsible for the secondary intussusception. The surgical procedures were performed in the following order of frequency: (1) resection of Meckel's diverticulum, an adjacent segment of ileum and ileoileal anastomosis ( n = 36, 42.85%); (2) Meckel's diverticulectomy ( n = 32, 38.09%); (3) resection of Meckel's diverticulum, an adjacent segment of ileum with or without cecum and an ileostomy ( n = 12, 14.28%); and (4) resection of Meckel's diverticulum, an adjacent segment of ileum, cecum, part of the colon, and ileocolic anastomosis ( n = 4, 4.76%). In 8 (9.52%) children, complications were documented during the postoperative period. The present study observed three (3.57%) deaths during the postoperative period. Conclusion: Meckel's diverticulum was one of the common causes of acute intestinal obstruction in infants and older children. Ninety percent of children with Meckel's diverticulum presented with features of an acute abdomen. Forty percent of children evidenced bowel gangrene during the surgical procedures. In these children, early diagnosis, timely referral, and institution of surgical therapy for acute abdomen/intestinal obstruction may prevent the development of bowel gangrene and the requirement of bowel resections to some extent.
Keywords	children ; infants ; intestinal obstruction ; intussusception ; Meckel's diverticulum ; Meckel's diverticulectomy ; perforation peritonitis
Language	English
Publishing date	2021-11-05
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	632986-x
ISSN	2454-5635 ; 0379-038X
ISSN (online)	2454-5635
ISSN	0379-038X
DOI	10.1055/s-0041-1739190
Database	Thieme publisher's database

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Article: Management of Patent Vitellointestinal Duct in Infants

Ghritlaharey, Rajendra K.

Annals of the National Academy of Medical Sciences (India)

2021 Volume 57, Issue 02, Page(s) 94–99

Abstract: 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- ... ...

Abstract	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. This study was conducted at author’s Department of Paediatric Surgery during the last 20 years; from January 1, 2000 to December 31, 2019. Results: A total of 24 infants were operated for the patent vitellointestinal duct during the study period and comprised 20 (83.3%) boys and 4 (16.6%) girls. The age of infants ranged from 7 days to 10 months, with a mean of 88.41 ± 64.9 days. Twenty-three (95.8%) infants were operated within 6 months of the age, 17 (70.8%) of them were operated within 3 months of the age. Only one (4.1%) infant was operated at the age of 10 months. Among 24 infants, 13 (54.1%) were presented with features suggestive of acute intestinal obstruction and remaining 11 (45.8%) were presented with fecal discharges through the umbilicus without intestinal obstruction. Among 13 infants who presented with acute intestinal obstruction, 12 had prolapsed bowel and 6 of them also had gangrenous bowel. Operative procedures were executed ( n = 24) in the following order of frequency: (1) resection of patent vitellointestinal duct, wide wedge resection of ileum,and ileal repair ( n = 13, 54.1%); (2) resection of patent vitellointestinal duct, small segment of ileum, and ileoileal anastomosis ( n = 9, 37.5%); and (3) resection of patent vitellointestinal duct, segment of ileum, and an ileostomy ( n = 2, 8.33%). Postoperatively, two (8.3%) infants developed anastomotic leak and peritonitis one each, later on, both of them died. Conclusion: Patent vitellointestinal duct not only present with fecal discharges through the umbilicus but half of the infants presented with prolapsed bowel and with features of acute small bowel obstruction. Delay in seeking treatment for such cases was associated with considerable morbidity and mortality and therefore the patent vitellointestinal duct should be excised at the earliest.
Keywords	infants ; intestinal obstruction ; omphalomesenteric duct ; patent vitelline duct ; patent vitellointestinal duct ; vitelline duct ; vitellointestinal duct
Language	English
Publishing date	2021-02-17
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	632986-x
ISSN	2454-5635 ; 0379-038X
ISSN (online)	2454-5635
ISSN	0379-038X
DOI	10.1055/s-0041-1722836
Database	Thieme publisher's database

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Article: Management of Intussusceptions Secondary to Pathological Lead Points in Infants and Children

Ghritlaharey, Rajendra K.

Annals of the National Academy of Medical Sciences (India)

2021 Volume 57, Issue 01, Page(s) 53–57

Abstract: 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 ... ...

Abstract	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 study and included infants and children below the age of 12 years who were operated for the secondary intussusceptions. This study was conducted at author’s Department of Paediatric Surgery during the last 20 years; from January 1, 2000 to December 31, 2019. Results: During the study period, 200 infants and children were operated for the intussusceptions, and 23 (11.5%) of them were operated for the intussusceptions secondary to PLPs. This review comprised 18 (78.26%) boys and 5 (21.73%) girls, and consisted of infants ( n = 9, 39.13%) and children of 1 to 5 years of age ( n = 7, 30.43%) and 6 to 12 years of age ( n = 7, 30.43%). The age at presentation ranged from 3 months to 10 years, with the mean age of 41.47 ± 40.06 months. Clinically, all the children presented with features of acute intestinal obstruction. Ultrasonography (USG) examination of the abdomen revealed the diagnosis of intussusception in all of them but not able to document the PLPs as a cause for it. During the exploratory laparotomies, gangrenous bowel was detected in 15 (65.21%) cases. PLPs causing intussusceptions were Meckel’s diverticulum ( n = 17, 73.91%), begin ileal growth ( n = 4, 17.39%), benign ileal polyp ( n = 1, 4.34%), and caecal lymphoma ( n = 1, 4.34%). Surgical procedures were executed in the following order of frequency: (1) resection of segment of ileum including PLP, and ileoileal anastomosis ( n = 13, 56.52%); (2) resection of segment of ileum including PLP, caecum and part of ascending colon, and ileoascending anastomosis ( n = 5, 21.73%); (3) Meckel’s diverticulectomy ( n = 3, 13.04%); and (4) resection of segment of ileum including PLP and terminal ileostomy ( n = 2, 8.69%). This study documented two (8.69%) deaths in postoperative period. Conclusion: Meckel’s’ diverticulum was the commonest pathology for the secondary intussusceptions in infants and children and documented most frequently during infancy. Half of the secondary intussusceptions occurred within 24 months of age. Bowel resection was required in more than 85% of the cases during the surgical procedures.
Keywords	children ; infants ; intestinal obstruction ; intussusception ; Meckel’s diverticulum ; pathological lead points ; secondary intussusception
Language	English
Publishing date	2021-01-01
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	632986-x
ISSN	2454-5635 ; 0379-038X
ISSN (online)	2454-5635
ISSN	0379-038X
DOI	10.1055/s-0040-1722536
Database	Thieme publisher's database

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Article ; Online: Management of Intussusceptions Secondary to Pathological Lead Points in Infants and Children

Rajendra K. Ghritlaharey

Annals of the National Academy of Medical Sciences (India), Vol 57, Iss 01, Pp 53-

2021 Volume 57

Abstract: 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 ... ...

Abstract	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 study and included infants and children below the age of 12 years who were operated for the secondary intussusceptions. This study was conducted at author’s Department of Paediatric Surgery during the last 20 years; from January 1, 2000 to December 31, 2019. Results During the study period, 200 infants and children were operated for the intussusceptions, and 23 (11.5%) of them were operated for the intussusceptions secondary to PLPs. This review comprised 18 (78.26%) boys and 5 (21.73%) girls, and consisted of infants (n = 9, 39.13%) and children of 1 to 5 years of age (n = 7, 30.43%) and 6 to 12 years of age (n = 7, 30.43%). The age at presentation ranged from 3 months to 10 years, with the mean age of 41.47 ± 40.06 months. Clinically, all the children presented with features of acute intestinal obstruction. Ultrasonography (USG) examination of the abdomen revealed the diagnosis of intussusception in all of them but not able to document the PLPs as a cause for it. During the exploratory laparotomies, gangrenous bowel was detected in 15 (65.21%) cases. PLPs causing intussusceptions were Meckel’s diverticulum (n = 17, 73.91%), begin ileal growth (n = 4, 17.39%), benign ileal polyp (n = 1, 4.34%), and caecal lymphoma (n = 1, 4.34%). Surgical procedures were executed in the following order of frequency: (1) resection of segment of ileum including PLP, and ileoileal anastomosis (n = 13, 56.52%); (2) resection of segment of ileum including PLP, caecum and part of ascending colon, and ileoascending anastomosis (n = 5, 21.73%); (3) Meckel’s diverticulectomy (n = 3, 13.04%); and (4) resection of segment of ileum including PLP and terminal ileostomy (n = 2, 8.69%). This study ...
Keywords	children ; infants ; intestinal obstruction ; intussusception ; meckel’s diverticulum ; pathological lead points ; secondary intussusception ; General works ; R5-130.5 ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Surgical Management of Intussusception in Children

Rajendra K. Ghritlaharey

Annals of the National Academy of Medical Sciences (India), Vol 57, Iss 04, Pp 226-

A Retrospective Review of 212 Cases

2021 Volume 231

Abstract: 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 ... ...

Abstract	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 consists of children below the age of 12 years. This study was conducted at the author’s department of pediatric surgery for the past 21 years, from January 1, 2000 to December 31, 2020. Results During the study period, 212 children were operated upon for intussusceptions and included 146 (68.86%) boys and 66 (31.13%) girls. This review consisted of infants 158 (74.52%), and children of 1 to 5 years of age (30; 14.15%), and 6 to 12 years of age (24; 11.32%). Clinically, 177 (83.49%) children presented with the features of acute intestinal obstruction, and the remaining 35 (16.5%) presented with features of perforation peritonitis. Primary (idiopathic) intussusception was documented in 188 (88.67%) of the cases. Gangrenous bowel was evident in 98 (46.22%) children. Sixty-two percent of the cases required bowel resection. Surgical procedures were executed in children for intussusception in the following order of frequency: (1) operative reduction with or without serosal tear/bowel perforation repair, n = 81 (38.2%); (2) resection of diseased ileum and ileoileal anastomosis, n = 52 (24.52%); (3) resection of diseased ileum ± part of colon and an ileostomy, n = 36 (16.98%); and (4) resection of diseased ileum, cecum, part of colon, and ileocolic (ileo-ascending or ileo-transverse) anastomosis, n = 43 (20.28%). Postoperatively, 9 (4.24%) children required reexploration for the management of their complications. Twenty-one (9.9%) children died during the postoperative period. Conclusion Intussusception remains the most common cause of acute intestinal obstruction in infants and young children. Delay in the referral, diagnosis, and seeking treatment were significantly ...
Keywords	children ; infant ; intestinal obstruction ; intussusception ; bowel gangrene ; pathological lead point ; General works ; R5-130.5 ; Science ; Q
Subject code	360 ; 610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Commentary.

Ghritlaharey, Rajendra K

Journal of neurosciences in rural practice

2014 Volume 6, Issue 1, Page(s) 99–101

Language	English
Publishing date	2014-06-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2601242-X
ISSN	0976-3155 ; 0976-3147
ISSN (online)	0976-3155
ISSN	0976-3147
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Commentary

Ghritlaharey, Rajendra K

Journal of Neurosciences in Rural Practice

2015 Volume 6, Issue 01, Page(s) 99–101

Language	English
Publishing date	2015-01-01
Publisher	Thieme Medical and Scientific Publishers Private Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2601242-X
ISSN	0976-3155 ; 0976-3147
ISSN (online)	0976-3155
ISSN	0976-3147
DOI	10.4103/0976-3147.143213
Database	Thieme publisher's database

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