Journal of Indian Association of Pediatric Surgeons最新文献

{"title":"Dermatofibrosarcoma Protuberans of the Scalp in a 15-year-old Boy: A Rare Pediatric Surgical Challenge.","authors":"Yogesh Kumar Sarin, Meghna Kinjalk, Abu Suraih Sakhri, Priti Singh","doi":"10.4103/jiaps.jiaps_4_26","DOIUrl":"10.4103/jiaps.jiaps_4_26","url":null,"abstract":"<p><p>Dermatofibrosarcoma protuberans (DFSP), a seldom-seen, intermediate-grade sarcoma of the skin, carries a substantial risk of local recurrence when surgical removal is insufficient. We document a case of a 15-year-old boy who presented with a painless scalp swelling, initially diagnosed elsewhere, as benign. Wide local excision confirmed fibromatous DFSP. The significance of early detection and appropriate surgical margins is underscored by this case.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"851-853"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rupture in Silence: A Life-threatening Neonatal Adrenal Bleed.","authors":"Shweta Singh, Priyanka Dua, Prabhat Kumar, B D Bhatia","doi":"10.4103/jiaps.jiaps_17_26","DOIUrl":"10.4103/jiaps.jiaps_17_26","url":null,"abstract":"<p><p>Neonatal adrenal hemorrhage (NAH) is a rare condition that commonly presents with retroperitoneal bleeding in neonates. We report a term male neonate born through vaginal delivery who presented with respiratory distress and shock on the first day of his life. Examination revealed pallor, abdominal distension and a tender lumbar mass. Laboratory tests showed severe anemia, and imaging studies confirmed a large perirenal hematoma with absent adrenal shadow. The diagnosis was right adrenal rupture causing hemorrhagic shock. Prompt resuscitation and conservative management led to a favorable outcome. NAH should be considered in neonates presenting with shock and abdominal mass, mimicking renal disorders.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"861-863"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unplanned Pediatric Surgical Readmissions: Insights from a 3-year Study at a Tertiary Care Center.","authors":"Apurva Gupta, Rahul Saxena, Manish Pathak, Kirtikumar J Rathod, Avinash S Jadhav, Shubhalaxmi Nayak, Arvind Sinha","doi":"10.4103/jiaps.jiaps_73_26","DOIUrl":"10.4103/jiaps.jiaps_73_26","url":null,"abstract":"<p><strong>Aims: </strong>To determine the rate and patterns of unplanned 30-day readmissions (ReAd), compare readmission rates and examine the readmission trends in the context of quality-of-care measure assessment in pediatric surgery.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary pediatric surgical center in Western India over a 3-year period. Children aged ≤18 years readmitted within 30 days of discharge following an elective or emergency surgical admission requiring an overnight stay were included and categorized in Group A and Group B, respectively. Data on demographics, index diagnosis, surgical procedures, comorbidities, postoperative complications, wound class, and management during readmission were analyzed.</p><p><strong>Results: </strong>Among 5230 pediatric surgical admissions, 56 unplanned readmissions were identified (readmission rate 1.07%). Readmissions were significantly higher following emergency admissions than elective procedures (3.1% vs. 0.6%; <i>P</i> < 0.000001). Gastrointestinal, colorectal, neurosurgical, and hepatobiliary procedures accounted for most readmissions. Nearly half of the readmitted patients required further surgical intervention, with no statistical difference between the two groups. Postoperative complication severity and wound class during the index admission were not significantly associated with operative management during readmission. Most readmissions were due to disease-specific factors, including Hirschsprung-associated enterocolitis, cholangitis following Kasai portoenterostomy, and ventriculoperitoneal shunt malfunction.</p><p><strong>Conclusions: </strong>Unplanned pediatric surgical readmissions in our setting were low (1.07%) and comparable with the international literature. Readmissions were driven mostly by emergency presentations and disease biology rather than by perioperative factors, supporting a cautious interpretation of readmission metrics as tools for quality improvement rather than standalone indicators of care quality.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"732-738"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Experiences in Caring for Children with Surgically Treated Hydrocephalus: A Phenomenological Study from Eastern India.","authors":"Susojeeta Goudo, Hepsi Bai Joseph, Kanishka Das, Asha Prabhakar Shetty","doi":"10.4103/jiaps.jiaps_367_25","DOIUrl":"10.4103/jiaps.jiaps_367_25","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies may be structural or functional and manifest at birth or be detected later in life. One such condition, hydrocephalus, is commonly managed with a Ventriculo-peritoneal (VP) shunt. As children grow with a shunt <i>in situ</i>, parents play a vital role in recognizing the symptoms of shunt malfunction and reporting for medical care. The possible complications are unpredictable and require a keen awareness of the associated symptoms and signs.</p><p><strong>Materials and methods: </strong>A qualitative descriptive phenomenological design explored experiences of parents caring for children with VP shunts at a tertiary care teaching hospital and specialty follow-up clinic. Ten purposively selected participants underwent an in-depth, face-to-face, semi-structured interview that was audio-recorded and transcribed verbatim. The qualitative data were analyzed using the Modified Colaizzi method to extract themes, and NVivo-12 software was employed for systematic data organization and management.</p><p><strong>Results: </strong>The analysis generated four main themes from 22 subthemes, namely \"Confound to comprehension,\" \"Inconsistent support system,\" \"Complexities of child care needs,\" and \"Parental challenges and accommodation,\" which comprehensively elucidated the parental experiences of caring for a child with surgically managed hydrocephalus.</p><p><strong>Conclusion: </strong>Counseling service should be provided to the parents of children with surgically managed hydrocephalus by the physician and nurse about the disease, management, domiciliary care and follow-up. Emphasis must be placed on empowering them with coping strategies for common issues therein. Need specific, detailed education it be imparted to the parents while in the hospital and at discharge.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"710-717"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xanthogranulomatous Orchitis Masquerading as Chronic Epididymo-orchitis in a Paediatric Patient.","authors":"Yogesh Kumar Sarin, Meghna Kinjalk, Kiran Agarwal, Neha Jamwal","doi":"10.4103/jiaps.jiaps_438_25","DOIUrl":"10.4103/jiaps.jiaps_438_25","url":null,"abstract":"<p><p>Xanthogranulomatous orchitis (XGO) represents an extremely uncommon form of destructive granulomatous inflammation of the testis, very sparingly documented in pediatric age groups. The clinical picture often mimics chronic epididymo-orchitis, ischemic testicular injury, or even malignant neoplasms, which makes timely diagnosis challenging and frequently delays definitive intervention. We present the case of a 12-year-old boy with nearly 1 year of recurrent urinary tract infections and persistent scrotal symptoms, repeatedly misinterpreted as inflammatory orchitis on ultrasonography. A radionuclide perfusion scan revealed complete absence of blood flow within the affected testis, confirming nonviability and warranting orchiectomy. Histopathology showed a classical xanthogranulomatous reaction composed of abundant foamy macrophages, multinucleated giant cells, inflammatory infiltrate, and areas of necrosis. The child underwent successful orchidectomy with delayed prosthetic testicular implant and remains asymptomatic during follow-up. This case reinforces the need to consider XGO as a differential diagnosis in children with chronic, nonresolving testicular inflammatory disorders and supports the role of perfusion scanning in guiding operative decision-making.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"854-857"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cecal Fistula Masquerading as Umbilical Sinus Following Laparoscopic Appendectomy in a Child: A Diagnostic Pitfall.","authors":"Komal Aggarwal, Anju Verma, Nishant Agarwal, Vijai Datta Upadhyaya","doi":"10.4103/jiaps.jiaps_84_26","DOIUrl":"10.4103/jiaps.jiaps_84_26","url":null,"abstract":"","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"873-874"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Management of Children with Pancreatic Fluid Collections: A Retrospective Observational Study.","authors":"Yerrabathina Gururavitheja, Raghunath Bangalore Vasudeva, Veerabhadra Radhakrishna, Raghu Sampalli Ramareddy","doi":"10.4103/jiaps.jiaps_467_25","DOIUrl":"10.4103/jiaps.jiaps_467_25","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic fluid collections (PFCs) are the most common local complications of pediatric pancreatitis. Evidence in children is limited, with most evidence extrapolated from adult studies.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted at a tertiary pediatric surgical center between 2013 and 2024. Children with acute pancreatitis (AP), acute recurrent pancreatitis, or acute-on-chronic pancreatitis (ACP) who developed PFCs were included. PFCs were classified according to the revised Atlanta classification.</p><p><strong>Results: </strong>Fluid collections were noted in 92 (40%) children. Acute peripancreatic fluid collection (APFC) was the most common type (70%). Acute necrotic collections (ANCs) occurred more frequently in older children (<i>P</i> = 0.013) and presented earlier than APFCs (3.5 ± 2.7 vs. 6.2 ± 5.1 days, <i>P</i> = 0.04). APFCs were more commonly associated with ACP, whereas ANCs predominated in AP (<i>P</i> = 0.004). Fifty-three percent of APFCs progressed to pancreatic pseudocysts (PPCs), and 54% of ANCs progressed to walled-off necrosis (WON). APFC diameter >6 cm and pancreatitis phenotype independently predicted progression to PPC, while PPC diameter >6 cm, ascites, and increasing age predicted the need for intervention. Most children were managed conservatively; symptomatic PPCs and WONs required drainage, predominantly via a percutaneous approach.</p><p><strong>Conclusion: </strong>PFCs occurred in approximately 40% of children with pancreatitis, most commonly as APFCs. Collections >6 cm in diameter were more likely to progress and require intervention. Percutaneous drainage was a safe and effective modality for symptomatic collections in this cohort.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"750-761"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Struma Ovarii Presenting as an Abdominal Mass in a 15-year-old Girl.","authors":"Clare Cheng, Ho Kok On, Narasimhan Kannan Laksmi","doi":"10.4103/jiaps.jiaps_93_26","DOIUrl":"10.4103/jiaps.jiaps_93_26","url":null,"abstract":"<p><p>Struma ovarii is an uncommon monodermal ovarian teratoma. Symptoms are often nonspecific, which may lead to misdiagnosis. We report a rare case of a 15-year-old girl who presented with a painless left abdominal mass. Imaging revealed a sizable ovarian lesion, which was then resected via a lower midline laparotomy. This case highlights the diagnostic challenge of distinguishing struma ovarii from other ovarian neoplasms in adolescents. We also describe our surgical approach and management considerations.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"864-866"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Multimodal Large Language Models for Grading Pediatric Vesicoureteral Reflux on MCUG: A Preliminary Study.","authors":"Shubham Saini, Anmol Bhatia, Akshay Kumar Saxena, Ravi Prakash Kanojia, Kushaljit Singh Sodhi","doi":"10.4103/jiaps.jiaps_90_26","DOIUrl":"10.4103/jiaps.jiaps_90_26","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the diagnostic accuracy of ChatGPT-5 and Gemini 2.5 Pro compared with a pediatric radiologist reference standard in grading vesicoureteral reflux (VUR) on pediatric micturating cystourethrogram (MCUG) studies.</p><p><strong>Materials and methods: </strong>This retrospective study included 125 pediatric MCUG cases, comprising 25 cases per VUR Grade (I-V) as determined by radiologists. A balanced distribution of VUR grades was employed to facilitate a comprehensive assessment of model performance across the severity spectrum. For each case, the most representative image was anonymized, and the stored Joint Photographic Experts Group images were randomly uploaded to ChatGPT-5 and Gemini 2.5 Pro with a standardized prompt requesting VUR grading. Grades assigned by the models were compared with the radiologist's consensus standard.</p><p><strong>Results: </strong>VUR was present in 182/250 (72.8%) renal units, more frequently on the left side (80%) than the right side (65.6%). Both models demonstrated the highest accuracy in identifying the absence of reflux (ChatGPT-5 = 92.6% and Gemini 2.5 Pro = 88.2%). Overall diagnostic accuracy was 52% (131/250) for ChatGPT-5 and 46% (115/250) for Gemini 2.5 Pro. ChatGPT-5 performed best for grades III-IV (51% and 49%, respectively), whereas Gemini 2.5 Pro performed best for Grade V (54%). Agreement with radiologists was fair (ChatGPT-5 κ = 0.40; Gemini 2.5 Pro κ = 0.33).</p><p><strong>Conclusion: </strong>ChatGPT-5 and Gemini 2.5 Pro demonstrated fair but suboptimal accuracy in grading VUR. Model performance appears to be influenced by the prompting strategy used. Multimodal large language models show potential as adjunctive tools; however, further optimization of prompting approaches and multimodal integration is required before clinical application.</p>","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"723-731"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antegrade Stent Placement during Infant Laparoscopic Pyeloplasty: Our Technique and Surgical Video.","authors":"Shandip Kumar Sinha, Praney Gupta, Rahul Dey","doi":"10.4103/jiaps.jiaps_182_26","DOIUrl":"10.4103/jiaps.jiaps_182_26","url":null,"abstract":"","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"31 5","pages":"849-850"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}