Kidney transplantation is the treatment of choice for the majority of patients with Kidney Failure in an ideal world and is preferred over dialysis on the basis of evidence that demonstrate improvement in health-related quality of life and prolongation of life expectancy. However, shortage of suitable organs remains a limiting factor for program expansion. In Brunei Darussalam, despite having conducted over 16 cases of successful living related donor-recipient kidney transplantation over a period of 8 years, the program is still considered at its infancy state. This review article discusses the evolution of our program and the problems associated with setting up such a nationwide kidney transplantation program and elaborate our plans to increase the scope of services in the future, towards ‘Wawasan 2035’.

Spleno-gonadal fusion is a rare malformation consisting of an abnormal connection between the spleen and the gonad. Spleno-gonadal fusion has been classified into two types: continuous and discontinuous. The majority of the cases present as a scrotal mass, scrotal tenderness and for suspicion of testicular pathology. Some are incidental findings at the time of herniotomy or orchiodopexy. About 25% of the reported cases of continuous spleno-gonadal fusion have associated anomalies. None of these anomalies has been reported in the discontinuous spleno-gonadal fusion. An incidental case of discontinuous spleno-gonadal fusion in a three year old boy after a patent processus vaginalis ligation procedure is reported.

Congenital hypertrophy of infantile pyloric stenosis (CHIPS) is an acquired condition where the thickened pyloric sphincter causes high grade gastric outlet obstruction. The incidence is higher in the West compared to the East. Over a 15 years period, there has only been a single case of pyloric stenosis in a patient of Caucasian descent in our local setting. A rare and interesting set of six weeks old male twins with CHIPS is reported. Both patients responded well to pyloromyotomy.