Papers by Akram Elbatarny
African Population Studies, Feb 19, 2018
Background Intussusception represents one of the most common urgent surgical admissions during ea... more Background Intussusception represents one of the most common urgent surgical admissions during early infancy and childhood period. It's a form of intestinal obstruction which is manifested by colicky abdominal pain, red current jelly stool and abdominal mass. Abdominal Ultrasound is the method of choice for diagnosis. Treatment of intussusception ranged from simple non operative reduction either by pneumatic or hydrostatic enema to surgical exploration. There multiple variables that may affect the result of of non operative management. Aim We tried to study them to know whom patient would pass without surgery. Patients and methods Two hundred patients diagnosed with intussusceptions included in this study. All of them received ultra sound guided hydrostatic reduction using warm saline. The maximum number of attempts of reduction was three times. We used intrvenous sedation in irritable infants. Results 2 hundred cases with intussusception were treated in this study. One hundred forty were reduced (group A) and 60 cases (group B) required surgical exploration. The mean body weight in group A was 7.3 Kg while in group B 9.3Kg. seventy five cases from both groups were operated. Conclusion Several factors affect the result of hydrostatic reduction as total leukocytic count, CRP and duration of symptoms. In addition the size of the mass and the presence or absence of free peritoneal fluid affects the non operative management.
Frontiers in Pediatrics, Sep 30, 2021
Background: Gastroschisis management remains a controversy. Most surgeons prefer reduction and fa... more Background: Gastroschisis management remains a controversy. Most surgeons prefer reduction and fascial closure. Others advise staged reduction to avoid a sudden rise in intra-abdominal pressure (IAP). This study aims to evaluate the feasibility of using the umbilical cord as a flap (without skin on the top) for tension-free repair of gastroschisis. Methods: In a prospective study of neonates with gastroschisis repaired between January 2018 to October 2020 in Tanta University Hospital, we used the umbilical cord as a flap after the evacuation of all its blood vessels and suturing the edges of the cord with the skin edges of the defect. They were guided by monitoring abdominal perfusion pressure (APP), peak inspiratory pressure (PIP), central venous pressure (CVP), and urine output during 24 and 48 h postoperatively. The umbilical cord flap is used for tension-free closure of gastroschisis if PIP > 24 mmHg, IAP > 20 cmH 2 O (15 mmHg), APP < 50 mmHg, and CVP > 15cmH 2 O. Results: In 20 cases that had gastroschisis with a median age of 24 h, we applied the umbilical cord flap in all cases and then purse string (Prolene Zero) with daily tightening till complete closure in seven cases, secondary suturing after 10 days in four cases, and leaving skin creeping until complete closure in nine cases. During the trials of closure, the range of APP was 49-52 mmHg. The range of IAP (IVP) was 15-20 cmH 2 O (11-15 mmHg), the range of PIP was 22-25 cmH 2 O, the range of CVP was 13-15 cmH 2 O, and the range of urine output was 1-1.5 ml/kg/h. Conclusion: The umbilical cord flap is an easy, feasible, and cheap method for tension-free closure of gastroschisis with limiting the PIP ≤ 24 mmHg, IAP ≤ 20 cmH 2 O (15 mmHg), APP > 50 mmHg, and CVP ≤ 15cmH 2 O.
The Egyptian Journal of Hospital Medicine, Oct 1, 2019
Background: Trauma is considered the leading cause of children death worldwide. The most common c... more Background: Trauma is considered the leading cause of children death worldwide. The most common cause of death in pediatric trauma is abdominal trauma. Aim of the study: This study aimed to evaluate incidence of solid organ injury after blunt abdominal trauma (BAT) in pediatric patients. Patients and Methods: The study was conducted on pediatric patients admitted to Emergency Department, Tanta University Hospital with suspected solid organ injury after isolated blunt abdominal trauma. Results: In this study, we had 119 patients with blunt abdominal trauma presented to emergency department. FAST (Focused Assessment with Sonography for Trauma) showed that intra-peritoneal free fluid (IPFF) only with no solid organ injury was found in 39.5%. Splenic injury was found in about 38.7% of patients while hepatic injury was present in about 18.5%. Renal injury was found in about 1.7%. Both renal and splenic injury were present in about 0.8%. Conclusion: Splenic injury was the most common solid organ to be injured in blunt abdominal trauma in pediatrics.
Journal of Laparoendoscopic & Advanced Surgical Techniques, Aug 1, 2020
Background/Purpose: Many techniques have been described for the treatment of pediatric inguinal h... more Background/Purpose: Many techniques have been described for the treatment of pediatric inguinal hernia (PIH). Some authors emphasized the importance of disconnecting the sac, to create a scar, and to close the peritoneum mimicking the open approach. Others stated that peritoneal disconnection alone is enough for treatment of PIH regardless of the size of the internal ring. In this study, we compare the short-term results of laparoscopic disconnection of PIH sac versus disconnection and peritoneal closure. Patients and Methods: The study was carried from March 2016 to March 2017, on 34 patients with 40 PIH. Patients were randomly divided into two groups: group A, subjected to laparoscopic hernia sac disconnection and group B, subjected to laparoscopic hernia sac disconnection with peritoneal closure. Both groups were compared regarding the operative details, including complications and conversion, postoperative complications and recurrence. Results: Group A included 20 hernias in 15 patients, whereas group B included 20 hernias in 19 patients. The age ranged from 1 to 23 months. In group A, the mean operative time (OT) was 34.6 and 39.4 minutes, for unilateral and bilateral cases, respectively, whereas in group B, it was 45.1 minutes for unilateral cases and 65 minutes for 1 bilateral case. The OT was significantly shorter in group A for unilateral cases. There was no conversion and no intraoperative complications. Three recurrences occurred in group A (15% of hernias/20% of cases) with no recurrences in group B; difference was statistically insignificant. All 3 recurrences occurred in hernias with an internal ring diameter (IRD) >10 mm. Hospital stay was statistically shorter in group B. Conclusion: Both laparoscopic sac disconnection with internal ring closure and sac disconnection only are safe and effective treatments of PIH. However, the latter technique is not recommended for cases with IRD >10 mm because of the unacceptable high recurrence with rings >10 mm.
Journal of Indian Association of Pediatric Surgeons, 2016
Laparoscopic splenectomy (LS) is considered the standard approach for the treatment of children w... more Laparoscopic splenectomy (LS) is considered the standard approach for the treatment of children with nonmalignant hematological diseases due to the advances in the minimal invasive surgery over the conventional splenectomy (CS). Different techniques are involved in the operation to secure the hilum. The use of (Ligasure™) is a safe, effective, less time consuming and with less complications rate. Sixty children (33 with thalassemia, 20 with immune thrombocytopenic purpura [ITP] and seven with spherocytosis) were operated during the period from June 2007 to December 2014. These children had undergone LS using (Ligasure™). Three ports were used in small-sized spleens while four ports were used in large spleens. There were 60 children (37 girls and 23 boys) with a mean age of 10.2 years had LS using Ligasure™ with mean operative time of 85 min for cases of ITP and 120 min for other cases. There was no mortality. Two cases were converted to CS. Use of Ligasure™ alone was safe, less time consuming with less complications rates.
Journal of advances in medicine and medical research, May 4, 2023
Introduction: Vaginal atresia is a component of Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), ... more Introduction: Vaginal atresia is a component of Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), which includes variable Mullerian duct abnormalities with normal secondary sexual characteristics. Associated renal anomalies are present in about 30% of cases(1) Objective: To present a rare variant of MRKHS in a14-y old female with a right ovary in a right inguinal hernia and renal anomalies managed bysigmoid vaginoplasty. Case Description: A 14-year-old girl presented with primary amenorrhea and cyclic abdominal painone year before, pelviabdominal swelling, right inguinal hernia, and well-developed secondary sexual characteristics with a single introital opening. Investigations revealed a left ectopic pelvic Original Research Article
Annals of Pediatric Surgery, Jul 1, 2017
Background Intussusception represents one of the most common urgent surgical admissions during ea... more Background Intussusception represents one of the most common urgent surgical admissions during early infancy and childhood period. It's a form of intestinal obstruction which is manifested by colicky abdominal pain, red current jelly stool and abdominal mass. Abdominal Ultrasound is the method of choice for diagnosis. Treatment of intussusception ranged from simple non operative reduction either by pneumatic or hydrostatic enema to surgical exploration. There multiple variables that may affect the result of of non operative management. Aim We tried to study them to know whom patient would pass without surgery. Patients and methods Two hundred patients diagnosed with intussusceptions included in this study. All of them received ultra sound guided hydrostatic reduction using warm saline. The maximum number of attempts of reduction was three times. We used intrvenous sedation in irritable infants. Results 2 hundred cases with intussusception were treated in this study. One hundred forty were reduced (group A) and 60 cases (group B) required surgical exploration. The mean body weight in group A was 7.3 Kg while in group B 9.3Kg. seventy five cases from both groups were operated. Conclusion Several factors affect the result of hydrostatic reduction as total leukocytic count, CRP and duration of symptoms. In addition the size of the mass and the presence or absence of free peritoneal fluid affects the non operative management.
Annals of Pediatric Surgery, Oct 1, 2014
Background/purpose Trapped penis refers to a phallus that has become entrapped by a dense cicatri... more Background/purpose Trapped penis refers to a phallus that has become entrapped by a dense cicatricial scar usually following circumcision. It is associated with cosmetic, psychosocial, voiding, and hygienic complications and concerns. Prompt treatment is usually required to alleviate concerns and prevent complications. The treatment is essentially surgical. This prospective study was carried out to report the surgical management of cases of trapped penis, the necessary steps/procedures needed, and the outcome of surgical repair, and parent satisfaction. Patients and methods Patients with postcircumcision trapped penis indicated for surgical treatment were evaluated and managed. Evaluation included the age of patients, duration from circumcision, presenting complaints, predisposing conditions, surgical techniques, skin adequacy, and complications. The techniques used included scar excision, degloving, dermopexy, corporopexy, and skin coverage. Skin coverage was achieved by simple closure, split thickness skin graft (STSG), or scrotal flaps. One or more of the above-mentioned techniques were used depending on the individual characteristics of every case. The cases were evaluated for early complications, parent/patient satisfaction (evaluated subjectively), and recurrence. Results A total of 21 children were surgically managed during a 5-year period. The mean age at the time of correction was 28 months (range: 3-133 months). The most common presenting complaints were anxiety and hidden penis. The mean time between circumcision and presentation was 13.9 months (range: 1-117 months). The techniques used for repair included simple scar excision and skin closure in 17 patients, scrotal flap in one patient, and STSG in three patients. Dermopexy was added in seven patients, and corporopexy was added in four patients. Of the patients, six had buried penis, and one patient had megameatus intact prepuce. Parent/patient satisfaction was excellent to good in 95% of patients. Conclusion Postcircumcision trapped penis should be treated promptly to alleviate complications and anxiety, and improve body image. The treatment is mainly surgical; conservative treatment can be tried in early and mild cases. Circumcision in the buried penis converts a minor procedure to a complicated one. Skin coverage after the release of the trapped penis is a challenge and multiple plans should be available. STSG is a good option for penile coverage. Associated conditions and predisposing factors can be addressed in the same operation. The knowledge and practice of circumcision need to be improved. Ann
Annals of Pediatric Surgery, Apr 1, 2018
Infantile hypertrophic pyloric stenosis (IHPS) is a common condition in the neonates, with an inc... more Infantile hypertrophic pyloric stenosis (IHPS) is a common condition in the neonates, with an incidence of 1-4 per 1000 live births with a male : female ratio of 4 : 1 [1]. Recently, myringotomy knife was introduced as an alternative device in performing pyloromyotomy in cases of IHPS, since the manufacturing of retractable and arthrotomy knives has been stopped [4]. The aim of this study was to evaluate LP using myringotomy knife (SM69) with regard to its efficacy, feasibility, safety, operative time, rate of conversion, complications, and short-term results.
Annals of Pediatric Surgery, Jul 1, 2014
Background/aim Sacrococcygeal teratomas are the most common tumor during the neonatal period. The... more Background/aim Sacrococcygeal teratomas are the most common tumor during the neonatal period. They are either benign (mature) or malignant (immature, composed of embryonic elements). This retrospective study aims at reviewing our experience in management and outcome of this pathology during the period from January 2008 to November 2013. Patients and methods Charts were designed to collect the following data: the age at presentation, sex, clinical presentation, associated anomalies, Altman's classification, investigations, management modality, tumor histology with respect to type and resection margins, outcome of treatment, and bowel or urinary complications. Results A total of 20 patients were included in this study. There were six male patients and 14 female patients. Ten patients were Altman type I, seven were type II, one was type III, and two were type IV. Surgical intervention was carried out using a posterior sacral approach in 17 patients (all type I and II patients) or combined abdominal and posterior sacral approaches in the remaining three patients (types III and IV). Recurrence occurred in two patients; these were types III and IV. We had one mortality. Two patients reported involuntary bowel movements, two reported frequent soiling, and five reported constipation. Conclusion Awareness about this pathology among practitioners is essential and would have avoided complications in this series. Early diagnosis and complete excision with removal of the coccyx is associated with good prognosis. Recurrence is related to tumor spillage during excision. Long-term lower gastrointestinal problems (constipation, fecal soiling) correlate with Altman's classification of the tumor.
Journal of Pediatric Urology, Dec 1, 2014
To evaluate the correction of different degrees of penile torsion following a ladder step so that... more To evaluate the correction of different degrees of penile torsion following a ladder step so that simpler steps are used whenever possible. This can avoid the morbidity and complications of complex procedures. Patients and methods: Cases of congenital and acquired penile torsion were repaired on a ladder step basis irrespective of the degree of torsion, starting with degloving and skin realignment, then a dorsal dartos flap and finally corporopexy. The torsion is checked with artificial erection after each step, and if corrected completely then the next step(s) is omitted. Results: Twenty-five cases of penile torsion (30e180) were repaired over a 4-year period. Three cases were corrected by degloving only, 12 by degloving and skin realignment, five by a dartos flap and four required a corporopexy. Postoperative complications included five cases of penile edema, one case of hematoma and one case of dorsal skin gangrene. Residual torsion of <15 occurred in three cases. No cases required redo surgery. Conclusion: A ladder step approach is a good option for penile torsion repair, starting with simpler techniques until complete correction is achieved. There is no need to plan a complex procedure in advance.
Annals of Pediatric Surgery, Apr 20, 2023
Background Splenectomy is an established therapeutic intervention for benign haematological disor... more Background Splenectomy is an established therapeutic intervention for benign haematological disorders (BHD) in children. Laparoscopic splenectomy (LS) has become accepted as the preferred alternative to the open procedure. The aim of this study was to evaluate the Hem-o-lok clips in controlling the splenic hilum during laparoscopic splenectomy in children as regards feasibility, safety, operative time, cost, and perioperative complications. Methods This study included 27 cases with BHD, from April 2020 to December 2021, who underwent LS. In all patients, the Hem-o-lok clips were used to control the splenic pedicle. Operative time, intraoperative complications, need for conversion, and splenic extraction were reported. Postoperative course, complications, and hospital stay were also recorded. Patients were followed up for 3 months for development of complications and for evaluation of cosmetic appearance. Results The mean operative time, excluding splenic extraction, was 67.04 min. There were 3 intraoperative minor bleeding incidents, all not related to Hem-o-lok application, and they were successfully controlled, with no need for conversion. The mean hospital stay was 1.3 days. We used one cartridge for each case (cost; 686 LE, US $28). Conclusions The Hem-o-lok clips are feasible, safe, and cost effective in controlling the splenic hilum during LS in children with benign haematological diseases.
Annals of Pediatric Surgery, Apr 1, 2011
Purpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact pr... more Purpose: To evaluate the diagnosis and treatment methods of hypospadias with megameatus intact prepuce (MIP). Materials and Methods: A retrospective analysis was performed in 27 MIP children, 13 of whom underwent tubularized incised plate urethroplasty (TIP procedure), 7 underwent the Duplay procedure, 5 underwent the Mathieu procedure, 1 underwent meatal advancement and glanuloplasty (MAGPI procedure), and 1 underwent the glans approximation procedure (GAP). The patients were followed for 6-36 months to evaluate the surgical outcomes by the Pediatric Penile Perception Score (PPPS). Results: A total of 27 patients with a mean age of 8.12 ± 3.0 years were enrolled in this study, and 25 cases (25/27, 92.6%) were accidentally discovered during the first visit for phimosis. The patients had a formed urethra of 0.5 to 1.5 cm. Complications occurred in 4 of the 27 patients (14.81%): 2 patients with urethral fistula and 2 patients with meatal stenosis. One patient had a case of self-healed urethral fistula, and the remaining 3 patients underwent reoperation. The post-operative effect was satisfactory in all patients, and the urinary flow and stream during urination were normal. The overall average PPPS score of non-operative surgeons and parents was satisfactory. There were no significant differences in meatus appearance, glans appearance, skin appearance, and general appearance PPPS score among the Mathieu, TIP, and Duplay surgical procedures. Conclusions: MIP clinical manifestations are concealed and usually noted when circumcision is attempted. The suitable procedure for each patient should be tailored according to the anatomic features, and several techniques can be used with good functional and cosmetic results.
The Egyptian Journal of Hospital Medicine, Jul 1, 2019
Background: Several techniques have been described for treatment of intra-abdominal testis includ... more Background: Several techniques have been described for treatment of intra-abdominal testis including microsurgical autotransplantation, primary laparoscopic orchiopexy (VILO), one-and two-stage laparoscopic Fowler-Stephens procedures, and staged laparoscopic traction orchiopexy (Shehata technique). Aim of the work: To evaluate the role of laparoscopy in the treatment of non-palpable undescended testis. Patients and methods: This study was carried out in the Pediatric Surgery Unit, Tanta University Hospitals, during the period from April 2017 to October 2018, on 37 cryptorchid boys with 40 non-palpable testes. The mean age of the patients was 3.46 ± SD 3.1 years. Laparoscopic exploration was done for all cases, and if testes were found intraabdominally, with rough measurement of the length oftesticular vessels (TV), decision was taken either to do VILO or Shehata technique. Results: Out of 40 testes, 17 testes (42.5%) were vanishing, 3 intra-abdominal testes (7.5%) with long TV enough to undergo VILO, and 20 intra-abdominal testes (50%) with short testicular vessels underwent Shehata technique. Follow up for 3-12 months postoperatively showed that all 3 testes underwent VILO were normal in size and vascularity. While the 20 testes underwentShehata technique, 19/20 (95%) testes were normal in size, while small testis was detected in 1/20 testis (5%). Conclusion: VILO has excellent results in management ofintra-abdominal testes with sufficient TV length while Shehata technique has excellent results in management ofintra-abdominal testis with short TV.
Tanta Medical Journal, 2014
Purpose The aim of the study was to compare the short-term results of stented versus nonstented o... more Purpose The aim of the study was to compare the short-term results of stented versus nonstented open Anderson-Hynes dismembered pyeloplasty regarding operative time, hospital stay, functional outcome, and complications. Patients and methods Twenty-seven pediatric open Anderson-Hynes dismembered pyeloplasties were performed for primary pelviureteric junction obstruction (PUJO) by a single team at a single institution from November 2009 to October 2012. Preoperative investigations included renal function tests, urine microscopy, culture, and sensitivity, renal ultrasonography, and diethylenetriamine pentaacetic acid (DTPA). Patients were simply randomized into two groups: group I, the stented group (either nephrostent or JJ stent), and group II, the nonstented group. Outcome was analyzed with respect to operative time, hospital stay, postoperative complications, postoperative effect on hydronephrosis, and postoperative differential renal function (DRF). Minimal follow-up was 6 months. Results This study included 27 pediatric patients with primary PUJO, 14 patients in group I and 13 patients in group II. The mean age was 5.72.6 years. Twelve (44.4%) cases were right sided and 15 (45.6%) were left sided; no bilateral cases were present. The mean DRF preoperatively was good in both groups (37.5% for group I vs. 35.6% in group II). There was no significant difference in operative time between both groups. The hospital stay was significantly shorter in the stented group, but this was mainly related to postoperative care policy in both groups. There was no significant difference between both groups regarding the complication rate. Postoperative DRF as well as hydronephrosis were significantly improved in both groups, but there was no statistically significant difference between both groups. Conclusion The use of stents in pyeloplasty is not justified as a routine. The overall success and complication rates are independent of whether or not to drain or of the method of drainage. Therefore, it seems that the choice depends on local circumstances and surgeon preference. A larger number of patients is needed to validate these results.
African Journal of Paediatric Surgery, 2015
Background: Palpable Undescended Testis (PUT) represents a common paediatric problem in many prem... more Background: Palpable Undescended Testis (PUT) represents a common paediatric problem in many premature and some mature infants. There are several surgical techniques to correct PUT either through combined inguinal and scrotal incision or single transverse scrotal incision. This study assessed single high transverse scrotal incision for the management of PUT as regards to feasibility, postoperative success and final cosmetic results. Materials and Methods: One hundred twenty patients were managed at the Paediatric Surgery Department of Tanta University Hospital with PUT during the period from March 2010 to March 2014. They were all operated at the age of 6-12 months. We excluded recurrent cases, and cases older than 12 months. Through high transverse scrotal incision, the layers were divided, and the canal entered through the external ring, dissecting the PUT and bringing it through the incision. Hernia sac, if present, was ligated at the neck. Creation of the dartos pouch was then made through the same incision. All infants were followedup at 1 month, 2 months and 6 months to detect any re-ascended cases, testicular atrophy and the final cosmetic appearance. Results: A total of 140 PUTs were operated upon in 120 patients. PUT was bilateral in 20 patients, right-sided in 65 cases and left-sided in 35 cases. Thirty testes were located at the external ring; the others were located within the inguinal canal. No cases needed a redo operation, and there was no case of postoperative testicular atrophy. Conclusion: Single high transverse incision was sufficient to deal with PUT especially, in young infants (age 6 months) with no need for conversion in most cases to the traditional two incisions technique, and good long term follow-up and a better cosmetic results.
Journal of Laparoendoscopic & Advanced Surgical Techniques, Aug 1, 2015
We present a procedure of suturing the transversus abdominis muscular arch to the ileopubic tract... more We present a procedure of suturing the transversus abdominis muscular arch to the ileopubic tract laparoscopically in order to repair recurrent unilateral pediatric inguinal hernia (PIH). Twenty-five children with recurrent unilateral PIH were treated during a 5-year period in a tertiary academic center. All cases were subjected to laparoscopic hernia repair and discharged the next morning. Sutures were placed from the muscular arch to the ileopubic tract, avoiding the spermatic vessels and duct, in an interrupted manner using 2/0-3/0 polypropylene (Prolene(®); Ethicon, Somerville, NJ) or polyglactin 910 (Vicryl(®); Ethicon) sutures. In 4 cases, a rectangular purse-string-like suture was added to narrow the internal ring defect. Operative findings and postoperative results and complications were assessed. The patients were followed up for a period that ranged between 6 and 60 months. There were 23 boys and 2 girls. Operative age ranged between 18 months and 15 years. Three or four sutures were placed in each case. In 4 cases, an additional rectangular purse-string-like suture was added. Operative time ranged between 35 and 70 minutes, and there was no conversion. Mild scrotal edema was reported in 4 cases and port-site infection in 2 cases; all cases were treated conservatively. One case of recurrence among boys was reported, but there was no case of testicular atrophy. Cosmetic outcomes were excellent. Laparoscopic interrupted muscular arch repair is a feasible and safe technique in the reconstruction of the inguinal canal in recurrent unilateral PIH. Larger studies and long-term follow-up are needed to support our encouraging results.
Journal of the Pakistan Medical Association
Objective: To evaluate Hem-o-Lok polymer clips’ feasibility, safety and cost-effectiveness in con... more Objective: To evaluate Hem-o-Lok polymer clips’ feasibility, safety and cost-effectiveness in controlling the splenic pedicle during paediatric laparoscopic splenectomy.Method: The prospective study was conducted from May 2019 to December 2021 at Kafrelsheikh University Hospital, Egypt, and comprised children of either gender aged <18 years who had benign haematological diseases and were indicated for laparoscopic splenectomy. During the procedure, Hem-o-Lok clips were used for controlling the splenic pedicle. Patients were encouraged to ambulate the same day, and the drain was removed 24hours postoperatively. The cases were followed up for three months postoperatively.Results: Of the 23 subjects, 11(47.8%) were boys and 12(52.2%) were girls. The overall mean age was 8.74±3.44 years (range: 4-15 years). There were 6(26%) cases of spherocytosis, 1(4.3%) immune thrombocytopenic purpura and 16(69.6%) with thalassemia major. The mean operative time was 93.43±29.87 minutes (range: 65-...
Annals of Pediatric Surgery, Apr 20, 2023
Journal of Advances in Medicine and Medical Research
Introduction: Vaginal atresia is a component of Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), ... more Introduction: Vaginal atresia is a component of Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), which includes variable Mullerian duct abnormalities with normal secondary sexual characteristics. Associated renal anomalies are present in about 30% of cases(1) Objective: To present a rare variant of MRKHS in a14-y old female with a right ovary in a right inguinal hernia and renal anomalies managed bysigmoid vaginoplasty. Case Description: A 14-year-old girl presented with primary amenorrhea and cyclic abdominal painone year before, pelviabdominal swelling, right inguinal hernia, and well-developed secondary sexual characteristics with a single introital opening. Investigations revealed a left ectopic pelvic single kidney, hematometra with left hematosalpinx and right-sided inguinal hernia containing the right ovary with a left ovarian cyst. The first procedure included diagnostic laparoscopy and cystoscopy with the combined repair of the right-sided inguinal hernia and laparoscopic d...
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Papers by Akram Elbatarny