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Superior mesenteric artery (SMA) syndrome is a rare condition in which the third portion of the duodenum is compressed between the SMA anteriorly and the aorta posteriorly. The resulting duodenal obstruction is often due to rapid weight loss and commonly resolves with distal tube feeds. Occasionally, patients fail this medical management, and require a surgical bypass. We present the case of a male adolescent who presented with SMA syndrome and underwent laparoscopic duodenojejunostomy using a retroperitoneal technique that avoids crossing of the transverse colon and does not create a duodenal diverticulum proximal to the mesenteric root.

Since the first reported case in 1959, ventricular cholecystic (VC) shunts have been used as an alternative treatment for hydrocephalus, most often used in the event of ventriculoperitoneal shunt failure. To date, all surgical placements of VC shunts have been performed using an open operative technique. This case report describes the laparoscopic placement of a VC shunt in a 20-month-old male child. A three-year follow-up appointment after surgery demonstrated no reported complications. We describe the first documented laparoscopic technique for this procedure and discuss a decision algorithm for VC shunts as well as some of the benefits of this minimally invasive approach. Keywords: Ventricular cholecystic shunt, Ventricular gallbladder shunt, Ventriculobiliary shunt

Fetus in Fetu (FIF) is a rare congenital anomaly in which a malformed parasitic twin is found within the body of a living child or adult. In this case report, an 18 month-old male child presented with a large abdominal mass and failure to thrive. Imaging studies confirmed the presence of a large retroperitoneal fetus in fetu with significant mass effect of the adjacent structures. A surgical resection was performed and pathology confirmed the diagnosis. These rare cases have become more frequently reported and a review of the literature for the past 15 years will describe the demographics, updated genetic findings, pathology and outcomes of this unusual tumor. Recent findings will also discuss an infrequent association with teratomas that may warrant a longer follow-up for surveillance of malignancy.

A 12 year-old boy presented with right lower abdominal and groin pain. Intraoperatively, he was found to have acute appendicitis associated with a strangulated Meckel's diverticulum, or Littre's hernia. Both the appendix and Meckel's diverticulum were resected laparoscopically while the inguinal hernia was repaired four months later. We present an uncommon finding of a strangulated Littre's hernia discovered concurrently with acute appendicitis. The presentation, management and review of the literature of this condition are discussed.