Journal of Pediatric Surgery Case Reports最新文献

{"title":"Appendiceal foreign bodies: a case series","authors":"Sevgi Ulusoy Tangul,&nbsp;Atilla Senayli","doi":"10.1016/j.epsc.2025.103037","DOIUrl":"10.1016/j.epsc.2025.103037","url":null,"abstract":"<div><h3>Introduction</h3><div>Ingested foreign bodies in children generally pass through the gastrointestinal tract without complications but may occasionally lodge within the appendix.</div></div><div><h3>Case presentation</h3><div>Case 1 was a 7-year-old boy who presented with a two-day history of abdominal pain, vomiting, diffuse tenderness, and rebound tenderness. He had a white blood cell count of 23.4 × 10³/μL. On direct abdominal radiography, a radiopaque object was noted on the right side of the sacrum. Abdominal computed tomography revealed a 9-mm hyperdense focus on the pelvic inlet, suggestive of an appendicolith or a calcified lymph node. The appendix was not clearly visualized. The patient was hospitalized and started on intravenous ampicillin-sulbactam. Due to persistent symptoms for 24 hours, we took him to the operating room for an exploratory laparoscopy with a preliminary diagnosis of acute appendicitis. We identified an inflamed appendix containing a wire-like structure extending from inside the appendix through the appendiceal wall. We did an appendectomy, and he had an uneventful recovery. Case 2 was a 3-year-old girl referred to us after the incidental detection of a metal pin in the right lower quadrant on an abdominal X-ray done following a minor fall. As the pin remained stationary for one week, she underwent a colonoscopy, but the foreign body was visualized within the colon. She was sent home with the expectation that the foreign body would pass spontaneously. However, at three months of follow up, the foreign body had not moved at all, so we took her to the operating room for a diagnostic laparoscopy. We did not find the foreign body in the small bowel, but we found an edematous, hyperemic appendix, so we did an appendectomy suspecting that the foreign body could be there. Effectively, the pin was found within the appendix. Her recovery was uneventful.</div></div><div><h3>Conclusion</h3><div>Swallowed foreign bodies can occasionally lodge in the appendix. Foreign bodies lodged in the appendix may remain silent or, rarely, cause appendicitis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103037"},"PeriodicalIF":0.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral bronchogenic cysts in a pediatric patient removed via single-sided thoracoscopy: a case report","authors":"A. Lackinger ,&nbsp;W. Krois ,&nbsp;A. Szelenyi ,&nbsp;M. Metzelder","doi":"10.1016/j.epsc.2025.103032","DOIUrl":"10.1016/j.epsc.2025.103032","url":null,"abstract":"<div><h3>Introduction</h3><div>Bronchogenic cysts are rare congenital anomalies from abnormal bronchial development. They usually present as solitary lesions; multiple cysts are extremely rare. Diagnosis and management can be challenging due to their location and symptoms.</div></div><div><h3>Case presentation</h3><div>A 9-year-old boy presented with fever, cough, and malaise. A sputum test confirmed Mycoplasma pneumonia, and initial chest radiographs showed pneumonia and two circumscribed masses on both sides of the trachea. MRI scan suggested bilateral bronchogenic cysts: one near the right main bronchus and another more caudally on the left side, with a suspected connection between them. Two months after the resolution of the pneumonia, the patient was taken to the operating room. He was placed in left lateral prone position. We used three working ports: a 5-mm port for the camera, and two 3-mm ports for surgical instruments. We did not require single-lung ventilation during the procedure. Both cysts were excised through the right-sided thoracoscopy. The right cyst was first dissected and ligated at the base with a Roeder loop. The left cyst, found cranial to the first one and without connection to the first one, was subsequently dissected free of all attachments. Both cysts were removed from the chest into a retrieval bag. A chest tube was left in place and removed on postoperative day 3, and the patient was discharged home on postoperative day 5. Histopathology confirmed bronchogenic cysts.</div></div><div><h3>Conclusion</h3><div>Single-sided thoracoscopy appears to be a safe and effective approach for managing selected cases of bilateral bronchogenic cysts. The left lateral prone positioning provided optimal vision, allowing access to both cysts from one side.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103032"},"PeriodicalIF":0.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspiration of a needle and retrieval via bronchotomy in a 2-year-old child: a case report","authors":"Harsali F. Lampus,&nbsp;Candy Tjoe,&nbsp;Christha Z. Tamburian,&nbsp;Truelly J. Chananta","doi":"10.1016/j.epsc.2025.103035","DOIUrl":"10.1016/j.epsc.2025.103035","url":null,"abstract":"<div><h3>Introduction</h3><div>Foreign body aspiration in children is uncommon, with an incidence of 1 case per 10,000 children per year. Most cases occur in children younger than three years. The retrieval of aspirated foreign bodies can be challenging.</div></div><div><h3>Case presentation</h3><div>A 2-year-old boy was referred to our pediatric surgery department because of a suspected needle ingestion or aspiration two months before. He had a recent history of intermittent vomiting, fever, and cough. His physical exam was within normal limits. A chest X-ray revealed a metallic object resembling a 2.9-cm needle in the left paravertebral region at the level of the 6th to 8th thoracic vertebrae. With the initial thought that the needle could be in the esophagus, he underwent initially an endoscopy, but no foreign body was found in the esophagus. Bronchoscopy was not available at the time of the endoscopy. We then proceeded with a thoracic computerized tomography (CT) scan, which confirmed that the needle was lodged in the left lower bronchus. He was taken to the operating room for an attempted bronchoscopic retrieval, but it was not successful. We decided to remove the foreign body surgically through a left thoracotomy. The needle was identified by palpation. A transverse incision was made on the left lower bronchus, and the needle was successfully retrieved. The bronchus was closed with interrupted stitches of 5.0 monofilament sutures. A chest tube was left in place. His recovery was uneventful. The chest tube was removed three days after the operation, and he was discharged home seven days after the operation.</div></div><div><h3>Conclusions</h3><div>Patients with suspected ingestion foreign body and inconclusive plain films must undergo advanced imaging studies to rule out a location outside the gastrointestinal tract before undergoing any endoscopic or surgical interventions. Surgery continues to play a role in the management of aspirated foreign bodies in selected cases.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103035"},"PeriodicalIF":0.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal lactobezoar (milk curd syndrome): a case report","authors":"Saswati Behera ,&nbsp;Gulshan Kumar Saini ,&nbsp;Ram Samujh ,&nbsp;Navdeep Singh Dhoat ,&nbsp;Manish Swami","doi":"10.1016/j.epsc.2025.103034","DOIUrl":"10.1016/j.epsc.2025.103034","url":null,"abstract":"<div><h3>Introduction</h3><div>Lactobezoar or milk curd syndrome (MCS) is a rare cause of neonatal small bowel obstruction (SBO). Its incidence has decreased with the reduced use of formula rich in calcium and fat, but sporadic cases continued to be reported.</div></div><div><h3>Case presentation</h3><div>A full-term newborn with a birth weight of 3500 g was brought to the emergency room on day 26 of life due to respiratory distress and a two-day history of feeding intolerance, progressive abdominal distension and multiple episodes of bilious vomiting. The baby had primarily been fed cow's milk, along with intermittent formula. Following initial resuscitation in the intensive care unit, an abdominal x-ray was obtained, which showed dilated bowel loops, multiple air fluid levels, and ground glass appearance in right iliac fossa. He underwent an ultrasound (US) study of the abdomen which ruled out a midgut volvulus. The patient was taken to the operating room for an emergency laparotomy. We found clear ascites, a normal jejunum, and a severely dilated ileum and colon. The lumen of the ileum and colon was full of curd-like contents, or lactobezoars. The bowel wall also had pneumatosis intestinalis. The intraluminal contents were evacuated through gentle manual forward milking. No bowel resection was needed. The baby was started on broad-spectrum antibiotics covering both gram-negative and anaerobic organisms. The baby was kept NPO for 3 days, and enteral feedings with breast milk were started on day 4 and advanced as tolerated. The recovery was uneventful, and the baby was discharged home on day 5. He continues to do well on follow-up.</div></div><div><h3>Conclusion</h3><div>Even though its incidence has decreased significantly with formula modifications, lactobezoars (or milk curd syndrome) should be included in the differential diagnosis of newborns who develop acute intestinal obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103034"},"PeriodicalIF":0.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic fundus-first cholecystectomy in children with prior abdominal surgeries: a case series","authors":"Carlos García-Hernández,&nbsp;Lourdes Carvajal-Figueroa,&nbsp;Sergio Landa-Juárez,&nbsp;Ariadna Anette Alvelais-Arzamendi,&nbsp;Carlos Aguilar-Gutierrez","doi":"10.1016/j.epsc.2025.103033","DOIUrl":"10.1016/j.epsc.2025.103033","url":null,"abstract":"<div><h3>Introduction</h3><div>Gallbladder disease is increasingly diagnosed in children. In some cases, adhesions from prior abdominal surgeries may make the standard infundibulum-first dissection very difficult. The fundus-first (top-down) cholecystectomy technique offers an alternative in those cases.</div></div><div><h3>Case series</h3><div>We present five pediatric cases of calculous cholecystitis in patients with complex surgical histories. Case 1 was a 12-year-old female with a history of intussusception and multiple intestinal surgeries. She presented with 2 years of colicky pain and vomiting. She underwent a fundus-first cholecystectomy that took 75 min. Oral intake was started 18 hours after the operation and she was discharged after 4 days. She has had no complications at 2 years of follow-up. Case 2 was a 6-year-old female with a history of necrotizing enterocolitis (NEC) and bowel resection. She presented with a six-month history of abdominal pain and vomiting. The Fundus-first cholecystectomy took 65 minutes. Oral intake resumed 12 hours after the operation and she was discharged after 3 days. No complications at 3 years of follow up. Case 3 was a 16-year-old female with a history of enterocolitis and bowel surgeries. She presented with a four-year history of intermittent abdominal pain. The operation lasted 45 minutes and she was discharged after 3 days. No complications have been observed at 1 year of follow up. Case 4 was 13-year-old female with a history of Hirschsprung's disease. She presented with a three-year history of abdominal pain. The fundus-first cholecystectomy took 65 minutes. She was discharged after 4 days and has had no complications at 6 months o follow up. Case 5 was a 9-year-old male with a history of pyloric stenosis and mucosal perforation. He presented with a one-year history of abdominal pain. The fundus first cholecystectomy took 75 minutes, he was discharged after 3 days, and has had no complications at 2 years of follow up.</div></div><div><h3>Conclusion</h3><div>Fundus-first laparoscopic cholecystectomy is a safe and effective alternative to a standard cholecystectomy in pediatric patients with complex surgical histories and limited infundibular access.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103033"},"PeriodicalIF":0.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-operative indocyanine green (ICG) administration for surgical guidance in laparoscopic subtotal pancreatectomy for congenital hyperinsulinism: A case series","authors":"Kok On Ho,&nbsp;Rambha Rai,&nbsp;Yong Chen,&nbsp;York Tien Lee,&nbsp;Amos Hong Pheng Loh,&nbsp;Yee Low","doi":"10.1016/j.epsc.2025.103031","DOIUrl":"10.1016/j.epsc.2025.103031","url":null,"abstract":"<div><h3>Introduction</h3><div>Indocyanine green (ICG)-guided surgery is gaining traction in pediatric surgery with its utilization reported in pancreatectomy for congenital hyperinsulinism (CHI). ICG can also be an adjunctive strategy to help surgeons new to complex laparoscopic surgeries.</div></div><div><h3>Case presentation</h3><div>Both infants were Diazoxide-resistant diffuse CHI with ABCC8 mutations. Their surgeries were performed at 3 months of age.</div><div>Patient 1: A laparoscopic subtotal pancreatectomy (85 % resection) was initially performed due to parental preference to preserve some pancreatic function. However, the patient experienced persistent hypoglycemia refractory to maximal medical management, necessitating a revision pancreatectomy. Serial low-dose intra-operative administration of ICG was used to identify vascular and biliary landmarks. However, the intra-pancreatic segment of the common bile duct (CBD) was not visualized despite multiple boluses of ICG, and thus pancreatic transection was performed at the level right of the superior mesenteric vein (SMV), accounting for a subtotal pancreatectomy (90 % resection).</div><div>Patient 2: Serial low-dose intra-operative administration of ICG was used in identification and preservation of the splenic vessels during dissection and the identification of key vascular landmarks including SMV and portal vein (PV). A near-total pancreatectomy was initially attempted with serial ICG administrations to determine the level of pancreatic transection and to avoid an intra-pancreatic CBD injury. However, we were unable to identify the intra-pancreatic CBD which was buried deep within the bulky pancreatic head tissue. A subtotal pancreatectomy with pancreatic transection at the level right of the SMV (90 % resection) was performed.</div><div>All surgeries were performed laparoscopically with no intra-operative complications.</div></div><div><h3>Conclusion</h3><div>ICG-guidance can aid in real-time visualization of key vascular and extra-pancreatic biliary structures, potentially avoiding intra-operative injuries during laparoscopic subtotal pancreatectomy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103031"},"PeriodicalIF":0.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatopulmonary fusion associated with congenital diaphragmatic hernia: A case series","authors":"Nicole Chicoine ,&nbsp;Carrie Foster ,&nbsp;Mihai Puia-Dumitrescu ,&nbsp;Jimiane Ashe ,&nbsp;Rebecca Stark ,&nbsp;Samuel E. Rice-Townsend","doi":"10.1016/j.epsc.2025.103015","DOIUrl":"10.1016/j.epsc.2025.103015","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatopulmonary Fusion (HPF) is an exceedingly rare anomaly associated with right sided congenital diaphragmatic hernia (CDH) and has a high mortality rate.</div></div><div><h3>Case presentations</h3><div>Three neonates were cared for at our pediatric medical center for management of their CDH and coinciding HPF. Case 1 was a former term female who had a prenatal diagnosis of partial anomalous pulmonary venous return (PAPVR). She developed respiratory distress shortly after birth, which prompted further imaging. She underwent a computed tomography angiography (CTA) that showed a right CDH and abnormal perfusion of the superior aspect of the right hepatic lobe, suggestive of anomalous pulmonary venous return to the right portal system. HPF was suspected based on that finding. At 2 months old she underwent a successful separation of the fusion and a mesh repair of the CDH. The patient survived to the hospital discharge. Case 2 was a late preterm female with a prenatal diagnosis of a right CDH and images on prenatal echocardiogram suggestive of atypical venous return to the liver. HPF was diagnosed incidentally during the repair of the CDH. The fusion was separated with electrocautery and a stapler. The CDH defect was repaired with a mesh. The patient survived to the hospital discharge. Case 3 was a former term female who underwent repair of her right CDH on day of life 5. Her HPF was identified at the time of the CDH repair and was separated using electrocautery and a stapler. Her course was notable for refractory pulmonary hypertension with infectious complications, which eventually resulted in her demise during the index hospitalization.</div></div><div><h3>Conclusion</h3><div>While HPF is typically encountered incidentally in the operating room during the repair of a right CDH, it should be suspected in patient who have vascular anomalies of the right hepatopulmonary region.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103015"},"PeriodicalIF":0.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient gallbladder wall thickening in pediatric acute hepatitis: A case series","authors":"Abdulaziz Hussein","doi":"10.1016/j.epsc.2025.103030","DOIUrl":"10.1016/j.epsc.2025.103030","url":null,"abstract":"<div><h3>Introduction</h3><div>Transient gallbladder wall thickening is an uncommon sonographic finding in pediatric patients diagnosed with acute hepatitis. It may mimic primary gallbladder pathology such as cholecystitis, potentially leading to unnecessary surgical procedures.</div></div><div><h3>Clinical presentation</h3><div>Four pediatric patients between the ages of 4 and 8 years presented with acute viral hepatitis and symptoms of abdominal pain, jaundice, and fatigue. The first patient was a 5-year-old girl whose initial ultrasound showed gallbladder wall thickening of 5.6 mm. Follow-up ultrasound 7 weeks later revealed a reduction of the thickness to 1.8 mm. The second patient was a 4-year-old girl who had epigastric pain and dark urine. Ultrasound revealed gallbladder wall thickening of 5.1 mm, which decreased to 0.9 mm on the follow-up ultrasound done after 7 weeks. The third patient was an 8-year-old boy who presented with jaundice and abdominal discomfort. His gallbladder wall measured 5.7 mm initially and decreased to 2.2 mm after 7 weeks. The fourth patient was an 8-year-old boy who had gallbladder wall thickening of 7.0 mm, which on follow-up imaging 4 weeks later had decreased to 3.0 mm. All patients were managed conservatively, without any surgical intervention.</div></div><div><h3>Conclusion</h3><div>Children with acute viral hepatitis can develop transient gallbladder wall thickening, which typically self-resolves within a few weeks and does not require any specific intervention.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103030"},"PeriodicalIF":0.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric volvulus in a neonate with congenital diaphragmatic hernia: A case report","authors":"Nicole Chicoine ,&nbsp;Carrie Foster ,&nbsp;Mihai Puia-Dumitrescu ,&nbsp;Ashley H. Ebanks ,&nbsp;Samuel E. Rice-Townsend ,&nbsp;Rebecca Stark ,&nbsp;for the CDH Study Group","doi":"10.1016/j.epsc.2025.103023","DOIUrl":"10.1016/j.epsc.2025.103023","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastric volvulus in neonates with congenital diaphragmatic hernia (CDH) is rare and typically presents beyond the neonatal period. Early neonatal presentation poses diagnostic and management challenges.</div></div><div><h3>Case presentation</h3><div>A term (41-week) male neonate (3.6 kg) with an unremarkable prenatal course and normal prenatal ultrasound was born via vacuum-assisted vaginal delivery. Apgar scores were 0, 3, and 5 at 1, 5, and 10 minutes. He developed respiratory distress and worsening metabolic acidosis, requiring intubation. Chest radiograph showed a left-sided CDH with a large gastric bubble despite Replogle placement, raising concern for gastric volvulus. Due to progressive instability, he was transferred to our quaternary center and taken urgently to the operating room. Intraoperatively, a large left-sided diaphragmatic defect (2.5 × 3 cm) was identified with herniation and volvulus of the stomach, along with herniation of the small intestine, colon, and spleen. The stomach was detorsed, and the defect was repaired with a patch. His postoperative course was uneventful; feeds were initiated on postoperative day (POD) 5, and he was discharged home on full feeds on POD 33. At his 6-week follow-up, he remained asymptomatic with no recurrence.</div></div><div><h3>Conclusion</h3><div>While gastric volvulus in patients with CDH is rare and typically presents beyond the neonatal period, it can also occur in neonates. Awareness of this early presentation can prompt timely surgical intervention and favorable outcomes.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103023"},"PeriodicalIF":0.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral intralobar and extralobar pulmonary sequestration: A case report","authors":"Afef Toumi ,&nbsp;Marwa Messaoud ,&nbsp;Amine Ksia ,&nbsp;Mabrouk Abdelaaly ,&nbsp;Amina Ben Salem ,&nbsp;Lassaad Sahnoun","doi":"10.1016/j.epsc.2025.103027","DOIUrl":"10.1016/j.epsc.2025.103027","url":null,"abstract":"<div><h3>Background</h3><div>Bilateral pulmonary sequestration is a rare condition, with the coexistence of intralobar (ILS) and extralobar sequestration (ELS) being particularly uncommon. Antenatal diagnosis of such bilateral presentations remains exceedingly rare.</div></div><div><h3>Case presentation</h3><div>A 26-week of gestational age fetus was diagnosed by prenatal ultrasound with an echogenic lesion in the right hemithorax and an echogenic lesion in the left hemithorax. Fetal MRI at 36 weeks confirmed bilateral pulmonary lesions. A male infant was delivered at 39 weeks with no respiratory symptoms. Postnatal angiothoracic computed tomography (CT) with 3D vascular reconstruction confirmed left extralobar and right intralobar sequestrations. Although the child remained asymptomatic, elective surgery was scheduled at 9 months to prevent potential complications while allowing for continued growth and lung development. The ELS was successfully excised via a thoracoscopic approach, with an uneventful postoperative course. At 12 months, a right lower lobectomy was performed, through thoracotomy, to remove the ILS. The postoperative period was marked by a transient pulmonary infection, which resolved with antibiotic therapy. Histopathological examination confirmed the diagnosis of pulmonary sequestration. At 18 months of follow-up, the child exhibited normal growth and development without any complications.</div></div><div><h3>Conclusion</h3><div>In cases of bilateral, intrapulmonary and extrapulmonary sequestrations, a sequential resection before the age of 1 year seems to be a safe and effective management option.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103027"},"PeriodicalIF":0.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}