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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 ; 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 ; Online: Commentary

Rajendra K Ghritlaharey

Journal of Neurosciences in Rural Practice, Vol 6, Iss 1, Pp 99-

2015 Volume 101

Keywords	Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	English
Publishing date	2015-01-01T00:00:00Z
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 Giant Cystic Lymphangioma in an Infant

Rajendra K. Ghritlaharey

Journal of Clinical and Diagnostic Research, Vol 7, Iss 8, Pp 1755-

2013 Volume 1756

Abstract: Lymphangiomas are benign lesions with a marked predilection for the head and neck region. Giant lymphangiomas of head and neck may occur and they may present with life threatening complications. The author is presenting here, a three month-old boy who ... ...

Abstract	Lymphangiomas are benign lesions with a marked predilection for the head and neck region. Giant lymphangiomas of head and neck may occur and they may present with life threatening complications. The author is presenting here, a three month-old boy who presented with a giant cystic lymphangioma on left side of neck, which extended to the head as well. His clinical diagnosis of a cystic lymphangioma was confirmed on a Ultrasonography (USG) examination. Complete surgical excision of the lesion was achieved, without damaging any vital structures. His post-operative recovery was uneventful. A follow-up at two months after his surgery showed a cosmetically acceptable scar and no recurrence was noted.
Keywords	cystic hygroma ; cystic lymphangioma ; giant cystic hygroma ; Medicine ; R
Language	English
Publishing date	2013-08-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Chylolymphatic Cyst of Mesentery of Terminal Ileum

Rajendra K Ghritlaharey / Santosh More

Journal of Clinical and Diagnostic Research, Vol 8, Iss 11, Pp ND05-ND

A Case Report in 8 Year-old Boy

2014 Volume 07

Abstract: Mesenteric cysts are rare benign intra peritoneal tumor and more than half of the mesenteric cysts involve the mesentery of the terminal ileum. We present 8 year-old boy, who presented with features of acute intestinal obstruction. Ultrasonography (USG) ... ...

Abstract	Mesenteric cysts are rare benign intra peritoneal tumor and more than half of the mesenteric cysts involve the mesentery of the terminal ileum. We present 8 year-old boy, who presented with features of acute intestinal obstruction. Ultrasonography (USG) of the abdomen revealed a cystic mass in the peritoneal cavity with dilated loops of bowel. Exploration of the abdomen revealed a solitary cyst of the mesentery of the terminal ileum measured 10 x 8 cm. There was twisting of the part of the ileum (volvulus) due to the cyst. It also involved the wall and lumen of the adjacent ileum and there were dilated bowel loops proximal to the cyst. Complete cyst excision and resection of the part of the ileum involved with the cyst was done en bloc. An ileostomy was created due to gross disparity in the lumen of the ileum, which was closed two and half month later. Histopathology of the excised cyst was consistent with the chylolymphatic cyst (mesenteric cyst).
Keywords	abdominal cysts ; children ; chylolymphatic cysts ; intestinal obstruction ; mesenteric cysts ; Medicine ; R
Language	English
Publishing date	2014-11-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of Ruptured Occult Left Hydronephrotic Kidney in 7-Year - old Boy

Rajendra K Ghritlaharey / Santosh More

Journal of Clinical and Diagnostic Research, Vol 8, Iss 10, Pp ND12-ND

A Case Report

2014 Volume 14

Abstract: Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury ... ...

Abstract	Pre-existing, occult, congenital renal anomalies are often discovered during evaluation of children for blunt injury of the kidney and abdomen, presenting with or without haematuria. This is a report of 7-year-old boy; who presented with blunt injury abdomen with haematuria following fall from motorcycle. He had pallor, and features of hypovolumic shock and peritonitis. Skiagram of the abdomen showed haziness of the abdomen, without free gas under diaphragm. Ultrasonography (USG) of the abdomen revealed significant hemoperitoneum and gross hydronephrosis of the left kidney, which was undiagnosed previously. Exploratory laparotomy was done for peritonitis and the findings were hemoperitoneum, hematoma at the left mesocolon and left retroperitoneum. Postoperative computed tomography (CT) scan of the abdomen reported left hydronephrosis due to pelvi-ureteric junction (PUJ) obstruction with rupture of the renal pelvis. The ruptured hydronephrotic kidney was successfully managed by nephrostomy followed by delayed open dismembered Anderson-Hynes pyeloplasty. His postoperative recovery following pyeloplasty was uneventful and he was doing well at follow-up after a month of pyeloplasty.
Keywords	abdominal trauma ; nephrostomy ; puj obstruction ; Medicine ; R
Language	English
Publishing date	2014-10-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Two-staged management for all types of congenital pouch colon

Rajendra K Ghritlaharey / K S Budhwani

African Journal of Paediatric Surgery, Vol 10, Iss 1, Pp 17-

2013 Volume 23

Abstract: Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC). Patients and Methods: This retrospective study included CPC cases that were managed with two-staged procedures in the ...

Abstract	Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC). Patients and Methods: This retrospective study included CPC cases that were managed with two-staged procedures in the Department of Paediatric Surgery, over a period of 12 years from 1 January 2000 to 31 December 2011. Results: CPC comprised of 13.71% (97 of 707) of all anorectal malformations (ARM) and 28.19% (97 of 344) of high ARM. Eleven CPC cases (all males) were managed with two-staged procedures. Distribution of cases (Narsimha Rao et al.′s classification) into types I, II, III, and IV were 1, 2, 6, and 2, respectively. Initial operative procedures performed were window colostomy (n = 6), colostomy proximal to pouch (n = 4), and ligation of colovesical fistula and end colostomy (n = 1). As definitive procedures, pouch excision with abdomino-perineal pull through (APPT) of colon in eight, and pouch excision with APPT of ileum in three were performed. The mean age at the time of definitive procedures was 15.6 months (ranges from 3 to 53 months) and the mean weight was 7.5 kg (ranges from 4 to 11 kg). Good fecal continence was observed in six and fair in two cases in follow-up periods, while three of our cases lost to follow up. There was no mortality following definitive procedures amongst above 11 cases. Conclusions: Two-staged procedures for all types of CPC can also be performed safely with good results. The most important fact that the definitive procedure is being done without protective stoma and therefore, it avoids stoma closure, stoma-related complications, related cost of stoma closure and hospital stay.
Keywords	Anorectal malformation ; congenital pouch colon ; congenital short colon ; staged procedures ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Two-staged management for all types of congenital pouch colon

Rajendra K Ghritlaharey / K S Budhwani

African Journal of Paediatric Surgery, Vol 10, Iss 1, Pp 17-

2013 Volume 23

Abstract	Background: The aim of this study was to review our experience with two-staged management for all types of congenital pouch colon (CPC). Patients and Methods: This retrospective study included CPC cases that were managed with two-staged procedures in the Department of Paediatric Surgery, over a period of 12 years from 1 January 2000 to 31 December 2011. Results: CPC comprised of 13.71% (97 of 707) of all anorectal malformations (ARM) and 28.19% (97 of 344) of high ARM. Eleven CPC cases (all males) were managed with two-staged procedures. Distribution of cases (Narsimha Rao et al.′s classification) into types I, II, III, and IV were 1, 2, 6, and 2, respectively. Initial operative procedures performed were window colostomy (n = 6), colostomy proximal to pouch (n = 4), and ligation of colovesical fistula and end colostomy (n = 1). As definitive procedures, pouch excision with abdomino-perineal pull through (APPT) of colon in eight, and pouch excision with APPT of ileum in three were performed. The mean age at the time of definitive procedures was 15.6 months (ranges from 3 to 53 months) and the mean weight was 7.5 kg (ranges from 4 to 11 kg). Good fecal continence was observed in six and fair in two cases in follow-up periods, while three of our cases lost to follow up. There was no mortality following definitive procedures amongst above 11 cases. Conclusions: Two-staged procedures for all types of CPC can also be performed safely with good results. The most important fact that the definitive procedure is being done without protective stoma and therefore, it avoids stoma closure, stoma-related complications, related cost of stoma closure and hospital stay.
Keywords	Anorectal malformation ; congenital pouch colon ; congenital short colon ; staged procedures ; Pediatrics ; RJ1-570 ; Medicine ; R ; Surgery ; RD1-811
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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