Newborn presenting with ruptured omphalocele is an emergency which threatens the life of baby. We are reporting a case of a male newborn baby, born in hospital and had ruptured omphalocele sac during vaginal delivery. After reduction of herniated bowel excess omphalocele sac was excised and remaining sac was closed using absorbable suture material. Patient was kept NBM for 4 days and gradually started on feeds. On further evaluation patient was found to have Beck with –Widemann syndrome. Patient’s karyotype was normal. Patient kept on regular follow-up with serial USG-KUB after discharge. To our knowledge, there are only few reported cases of bed-side repair of ruptured omphalocele sac. This case is presented for its simple and effective bedside management.

We report a rare variant of exstrophy-epispadias complex, a duplicate bladder communicating with exstrophy bladder via a fistula. On presentation appeared to be a case of classical bladder exstrophy with diastasis of the pubis and rectus muscles, a low lying umbilicus and a form of epispadias. On careful examination phallus appeared normal with normal external urethral meatus.The micturating cysto-urethrogram was done which elicited a rare anomaly; duplicate bladder exstrophy.

Gastric perforation in neonates is an uncommon entity. Definite causes are found in few patients. Iatrogenic perforation secondary to introduction of a hard nasogastric tube has been reported in literature. Majority of cases have no obvious reasons.

We present two cases of gastric perforation in preterm babies probably caused by nasogastric tube. One baby had pneumoperitoneum while other one did not show gas under diaphragm. Etiopathogenesis of gastric perforation in preterm babies is discussed along with a comment on Spontaneous Intestinal Perforation (SIP).

Ascariasis is the most common helminthic infestation in the tropical countries and hepatobiliary complications are less common in children. We report a young girl who presented with acute abdomen due to hepato biliary ascariasis with pancreatitis managed by endotherapy using forward view gastroscope.

Background: Non-traumatic acute intestinal perforation secondary to Enterocolitis is a severe event that requires immediate treatment. Exploratory laparotomy has been the gold standard in the past decades. Recently, several reports described that minimal invasive surgery has been successfully applied to colonic perforation in emergent settings for both adult and children. The aim of this study is to evaluate the efficacy of laparoscopy on non-traumatic intestinal perforation in children.

Method: Between June 2009 and September 2013, patients under 18 year-old who underwent laparoscopic surgery for non-traumatic acute intestinal perforation were enrolled. The demographics of the patients, operative details, postoperative complications and the time resuming oral intake were retrospectively collected by chart review.

Result: There were consecutive 7 patients, including 5 boys and 2 girls. The mean age was 8.3 ± 4.2years (range: 2-15 years). A diversity of operative procedures was undertaken, encompassing tube cecostomy in 1 case, primary repair with tube cecostomy in 1 case, primary repair in 4 cases, and appendectomy in 1 case. Conversion to laparotomy was not necessary. The time resuming oral feeding was between postoperative day (POD) 6.3 ± 1.4th (range: 5-8 days). For two cases receiving tube cecostomy, constant stool leaking beside the tube predisposed to chronic wound infection and granolomas which required further surgeries. Otherwise, there was no complication recorded, such as surgical site infection, intestinal obstruction.

Conclusion: Laparoscopic surgery for non-traumatic acute intestinal perforation in children is technically feasible and providing benefits of low complication rate and satisfactory cosmetic outcomes. Minimally invasive surgery could be considered as first-line approach for non-traumatic acute abdomen. For cases of solitary perforation, primary repair can be safely performed through laparoscopy.