Purpose: The establishment of enteral feeding is the end point of any intestinal anastomosis. This study examined the effects of early feeding (EF) as compared to delayed feeding (DF) on postoperative outcomes after intestinal anastomosis in children. Methods: This was a randomized controlled pilot study to assess the effect of EF vs. DF in terms of time to reach full feed, along with wound infection and anastomotic leak. Results: Twenty-eight patients were enrolled in both study groups. The median time to first feed in EF was 60 hours and 96 hours in DF. The median time to first bowel sound was 42 hours in EF and 48 hours in DF (p=0.208). The median time to first bowel movement was 72 hours in EF and 72 in DF (p=0.820). The median time of postoperative hospital stay was 5.5 days in EF and 6.0 days in DF (p=0.01). There was no significant difference in complications of wound infection, wound dehiscence, relook surgery, or anastomotic leak in both groups. Conclusion EF after intestinal anastomosis is safe and feasible in children after intestinal anastomosis.

Hirschsprung disease (HSCR) is a genetic disorder with an incidence of 1:5000, seen in the pediatric age group. The association between HSCR and neuroblastoma (NBL), ends of the neurocristopathy spectrum is rare. Less than 10 cases of this association are reported in the literature and the association between the Phox gene and Sox10 gene in the pathophysiology of these is being studied. We report a one-year-old baby, who presented to us, with chronic constipation on regular enemas and laxative usage. There was a history of delayed passage of meconium. At the time of Duhamel’s pull through a well-defined, bilobed hard presacral mass, was encountered. Excision and coccygectomy were done and the pull was completed. The histopathology showed a well-differentiated NBL. Fludeoxyglucose positron emission tomography scan and the N-Myc amplification were negative and the patient was managed with expectant treatment. She is doing well over a 3-year follow-up with no recurrence and good resolution of bowel functions.

Mucoepidermoid carcinoma (MEC) is most common malignancy of minor salivary glands in adults. Pulmonary MEC is extremely uncommon comprising of only 0.1%–0.2% of the primary lung malignancies and <1% of primary bronchial tumors. It is even rarer in children and literature limited to few case reports only. Here we present a case report of a 9-year-old boy diagnosed with primary MEC of trachea along with review of the literature. A 9-year-old male child presented with complaint of dry cough for two years which was later associated with shortness of breath after one year. Bronchoscopic examination revealed a growth arising from right lateral wall of carina occluding 50% of the lumen and detailed histopathological examination revealed it to be a MEC of the trachea. Patient underwent local excision of the tumor with primary anastomosis. In view of positive margins adjuvant radiotherapy of 60 Gy in 30 fractions were given to the tumor bed. Patient tolerated the treatment well and is disease free at 6 months follow-up. Experience with MEC of the trachea in children is limited and optimal treatment protocols have not been defined, with current treatment mainly extrapolated from MEC of the salivary glands.