A case report on penile duplication: A rare congenital anomaly

Introduction: Penile duplication or penile diphallia is a rare congenital anomaly that is mainly associated with renal, anorectal or vertebral anomalies, that is, spina bifida. This condition was first described by Johannes Jacob Wecker in 1609 in Italy. Problem: Its incidence is extremely rare, about one in millions. The aetiology of this condition is unknown up till now; however, it is considered that defect of genital tubercle leads to the formation of diphallia. Methods: The condition is diagnosed clinically, and management depends on the appearance of genitalia and the associated anomalies as well as after taking into account the social and ethical considerations. Most of the time, management involves surgical incision of the non-functioning penis. Results: In this case report, a child of age 10 years presented with double penis since childhood. The child was evaluated clinically and radiologically for any other associated abnormalities, and his non-functional urethra was surgically removed. Level of evidence: Level IV

A fetus excised from the small intestinal mesentery of a neonate (fetus in fetu): a case report

Background Fetus in fetu is a rare congenital anomaly. Its incidence is 1/500,000 births. So, pediatric surgeons may encounter this pathology only once or twice during their professional careers. Case presentation We present a rare case of a fetus extracted from the small intestinal mesentery of a healthy neonate who was explored after delivery. The extracted fetal mass included a fully differentiated skull and limbs with a celomic cavity. The fetal mass was supplied by a main feeding vessel branching from the superior mesenteric artery. Conclusion Fetus in fetu, despite being a rare variant, must be kept in mind when dealing with a neonatal abdominal mass showing bony parts on radiography.

Opening a dacryocystorhinostomy into the opposite nasal cavity in a case of hemiarhinia

Heminasal agenesis is an exceedingly rare congenital anomaly which is frequently associated with disorders of eye, lacrimal drainage system and face. At times, a proboscis may also be noted with this condition. Herein, we present a case of a 13-year-old boy who presented to us with heminasal agenesis with concomitant microphthalmos, leucomatous corneal opacity, blepharoptosis, dacryocystocoele and maxillary hypoplasia. The child underwent a modified transeptal external dacryocystorhinostomy with placement of a lacrimal stent. There was significant improvement of epiphora and discharged following surgery. Heminasal aplasia with dacryocystocoele is surgical challenge; however, a well thought out surgical approach can yield satisfactory outcomes.

Bilobed gallbladder: a rare congenital anomaly of the biliary system

Duplication of the gallbladder is a rare congenital anomaly, which Boyden first illustrated in 1926. No additional risk of cholelithiasis or malignancy with this congenital anomaly was documented. However, this congenital anomaly is associated with more risk for complications during and after laparoscopic cholecystectomy. So, preoperative diagnosis is essential in identifying anatomical abnormalities to avoid biliary injuries at the time of surgery or the performance of an incomplete operation. The removal of an asymptomatic double gallbladder remains controversial. Here, we are reporting a case of the incidentally detected duplex gallbladder in a teenager and review the literature that will enrich the reader’s knowledge regarding this rare congenital anomaly.

A rare case of double gall bladder: a case report and review of literature

Double gall bladder is a rare congenital anomaly of the Hepatobiliary system with an incidence of 1:4000 due to abnormalities resulting during the embryogenesis during fourth to sixth week of gestation. Boyden was first to describe the duplication of the gallbladder and Harlaftis classification describes three types for the duplication of the gallbladder. Preoperative diagnosis of the duplication of the gallbladder has to be confirmed to minimise the complications during the surgery and post operatively. Sometimes the duplication of the gallbladder is missed preoperatively and hence increasing the risk and complications during the cholecystectomy. MRCP is the investigation of choice for preoperative diagnosis of the duplication and the laparoscopic cholecystectomy being the treatment of choice for the double gallbladder. We encountered a 25 year old girl with duplicate gallbladder who underwent laparoscopic cholecystectomy with removal of both gallbladders successfully.

Levoatrial Cardinal Vein: In two siblings with normal heart morphology

Levoatrial cardinal vein (LACV) is anomalous connection between the left atrium or pulmonary veins and any systemic vein which is derived from cardinal venous system. Presence of the levoatrial cardinal vein without a cardiac anomaly is a very rare congenital anomaly of the systemic venous return. In the literature, no LACV anomaly was found in two siblings who were asymptomatic and did not have an additional cardiac anomaly. Therefore, we present two cases ( two siblings ) the symptoms, diagnosis (the echocardiographic finding, computed tomography (CT) and aniographic images ) and treatment modalities of isolated levoatrial cardinal vein.

Progressive Dilatation as a Successful Treatment for Y duplication of Urethra

Duplication of urethra is a rare congenital anomaly that has been reported in case reports and case series. A Y-shaped urethral duplication is the rarest variant as per the classification suggested and hence lacks a standardized treatment option. We report a case of Y-duplication of urethra diagnosed during neonatal age and presented to us at nine years of age. The patient had undegone a vesicostomy at seventh day of life for passing urine per anus and was lost to follow up thereafter. An attempt at disconnection of the duplicated urethral tract to anus after colostomy, at eight years of age had failed. The patient was managed successfully by progressive dilatation of the orthotopic urethra, which required multiple stages, followed by separation of the urethra from the rectum. At three years follow up the patient is continent and asymptomatic. Keywords: Y duplication of the urethra; PADUA technique; Rectourinary fistula; Urethral duplication.

Incidental Detection of a Rare Coronary Anomaly During Catheter Ablation for Premature Ventricular Complexes: All in One Coronary Ostium

Single coronary artery is a rare congenital anomaly associated with sudden cardiac death even though most of the cases are asymptomatic. Cardiac computerized tomography angiography plays an essential role in establishing the diagnosis of single coronary artery and designating the arterial course. Being aware of coronary anomaly is crucial in some cases scheduled for catheter ablation of premature ventricular complex neighboring to coronary arteries to prevent radiofrequency ablation related vascular injury.