Meckel's diverticulum in children

Twenty one surgically documented cases of Meckel's diverticulum in children treated at Kasturba Hospital, Manipal since 1981 are reviewed. Of them, 14 presented with intestinal obstruction, 2 with pain abdomen, 2 with Littre's hernia and 2 were found incidentally. Only one patient presented with gastrointestinal bleeding. The clinical profile of these patients is analyzed.

Lingual dermoid

Dermoid cysts are congenital lesions derived from ectodermal differentiation of multipotential cells. Only 7% of all dermoid cysts occur in the head and neck region and about a quarter of them are seen in the floor of mouth. Dermoids confined to the tongue are rare entities. Only 13 such cases, mostly in infants, have been reported in literature. One such case of an infant with intralingual dermoid and feeding difficulty, relieved following cyst excision, is reported.

Ovarian tumors in the second decade of life

A study of 28 adolescents aged 10-20 years admitted with ovarian tumors during a 5-year period revealed that 75% had malignant ovarian tumors, with germ cell tumors being most frequent. The high incidence of malignancy was due to our hospital being a referral centre. One case of mixed germ cell tumor (mainly choriocarcinoma) presented with precocious puberty, and one case of arrhenoblastoma showed signs of virilization. Tumor markers were found useful in diagnosing choriocarcinoma and endodermal sinus tumor. Amongst the malignant ovarian tumors, the best prognosis was noted with dysgerminomas. Tumors were found more frequently on the right side. Optimal surgery at initial laparotomy, followed by adjuvant chemotherapy or radiotherapy were found to offer the best change of cure.

Cysticercosis of the tongue

Cysticercosis is a condition where man forms the intermediate host for the proglottids of Taenia solium. The common sites of cysticercosis are brain, skeletal muscle and subcutaneous tissues, but they can be found at any site. An unusual case of lingual cysticercosis is being reported.

Intra-abdominal lymphatic cysts in children

Ten children with intra abdominal lymphatic cysts operated in the last 8 years are reported. They formed 0.50% of all pediatric surgical admissions and 33.3% of all intra-abdominal cystic lesions. The mean age was 5 1/2 years and the male-female ratio was 1:1. Half the cysts were in the mesentery and 30% in the omentum. The other 2 cysts were located at unusual sites. Two children having mesenteric cysts presented as abdominal emergencies. Three of them were wrongly diagnosed and treated for tuberculous ascites before laparotomy. Four mesenteric cysts were excised along with the adjoining intestinal segment, and one was drained by tube marsupialisation. All 3 omental cysts and the two cysts at unusual sites were excised in toto. There was no mortality or morbidity.

Cecal volvulus in a 2-month-old baby

A case of primary cecal volvulus in a 2-month-old boy is reported. He is probably the youngest patient to be reported with this condition.

Intraperitoneal ascariasis

Seven children with intraperitoneal ascariasis are reported. One of them had two episodes. There were four instances of free worms in the peritoneal cavity, whereas others had peritoneal abscesses containing round worms. It is suggested that peritoneal ascariasis should be suspected whenever a child presents with peritonitis and/or an inflammatory abdominal mass having evidence of ascarial infestation.

Sudoriparous angioma--regression following intravascular aethoxysclerol, a sclerosing agent

We report a case of sudoriparous angioma on the dorsum and plantar aspect of the left foot which increased in size on standing, and which was accompanied by sweating in the overlying epidermis and throbbing pain. The lesion regressed considerably following intravascular injection of 1% aethoxysclerol.

Systolic time intervals in pilots and non-pilots during 70 degree head-up tilt

Nine highly experienced Indian fighter pilots in current flying practice and 11 healthy non-pilots underwent head-up tilt (HUT) to 70 degrees for 20 min. Heart rate and blood pressure response to tilt stress was similar in the two groups as was the contractile function of the left ventricle measured by systolic time intervals. The highest PEP/LVET ratio of 0.402 seen at the end of HUT was considerably lower than the values seen in other studies (5,11). This suggests that myocardial contractility of Indians adjusts better to tilt stress than that of western subjects not adapted to heat.

Orthostatic tolerance of normal Indians and those with suspected abnormal cardiovascular reflex status

There were 143 healthy Indian males subjected to 70 degrees headup tilt (HUT) for 20 min on 166 occasions to evaluate their cardiovascular response. They responded with a significant rise in heart rate, diastolic pressure, and mean arterial pressure. Pulse pressure fell significantly. Heart rate and diastolic pressure during the tilt were significantly (p less than 0.05) and positively correlated to the height of the subjects. None of the subjects had syncope, which has been reported in normal individuals elsewhere. Of the 57 subjects with suspected abnormality of the cardiovascular reflex status, who were also investigated by the tilt test, 13 (22.8%) developed various degrees of orthostatic intolerance. Of these 13 subjects, 10 had had syncope in the past. In view of these observations, it is concluded that 70 degrees head-up tilt is an important clinicophysiological investigation in the assessment of subjects with a suspected abnormality of their cardiovascular reflex status.