Journal of Pediatric Surgery Case Reports最新文献

{"title":"Intussusception secondary to a double Meckel's diverticulum in a 2-month-old infant: a case report","authors":"Natalia Guzmán Alfonso ,&nbsp;Jorge Ricardo Beltrán Chitiva ,&nbsp;Juan J. Valero ,&nbsp;Esteban Felipe Patiño Calderón ,&nbsp;Álvaro Andrés Trujillo Ceballos ,&nbsp;Carlos Andrés Cadavid Restrepo","doi":"10.1016/j.epsc.2025.103052","DOIUrl":"10.1016/j.epsc.2025.103052","url":null,"abstract":"<div><h3>Introduction</h3><div>Double Meckel's diverticulum is extremely rare. Only five cases have been reported in the pediatric population, none of which were associated with intestinal intussusception.</div></div><div><h3>Case presentation</h3><div>A 2-month-old, full-term infant born at 37 weeks of gestation was admitted with a one-day history of vomiting and blood-streaked stool. Laboratory tests were within normal limits. Abdominal x-ray showed distended bowel loops. Abdominal ultrasound showed findings suggestive of an Ileocolic intussusception. Due to the duration of symptoms, an enema reduction was not attempted. He was taken to the operating room for an exploratory laparoscopy. We used a single-port technique through a small incision at the umbilicus. We found an ileo-ileal intussusception and exteriorized the involved segment through the umbilical incision. The intussusception was manually reduced, and we found two Meckel's diverticula on the antimesenteric border of the affected segment, one measuring 1.5 cm by 2 cm, and the other one 1 cm by 1 cm. The larger one served as the leading point for the intussusception. We resected the affected segment that included the two diverticula and did a primary anastomosis. Because the bowel was somewhat compromised, we planned to do a second look. The patient remained the intermediate care unit, extubated. We took him back to the operating room 72 hours later and confirmed that the anastomosis was intact. He resumed enteral feedings three days after the last operation and was discharged home two days later. The pathological examination confirmed two true Meckel's diverticula with no evidence of heterotopic gastric mucosa.</div></div><div><h3>Conclusion</h3><div>Patients who are found to have a Meckel's diverticulum should have their entire small bowel inspected to rule out a second Meckel's diverticulum, which although rare, has been reported.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103052"},"PeriodicalIF":0.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694935","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":"Transverse and left colon volvulus in a child with cerebral palsy: a case report","authors":"Younis Al-Mufargi ,&nbsp;Shiyam Al-Shaibani ,&nbsp;Balqees Al-Mujaini ,&nbsp;Mohsin Alriyami ,&nbsp;Mostafa Mahmoud Hamad ,&nbsp;Abdulmalik Al-Atar","doi":"10.1016/j.epsc.2025.103065","DOIUrl":"10.1016/j.epsc.2025.103065","url":null,"abstract":"<div><h3>Introduction</h3><div>Colonic volvulus is an uncommon cause of intestinal obstruction in children, with sigmoid volvulus being the most frequently reported type. Transverse and left colonic volvulus is exceedingly rare, particularly in patients with underlying neuromuscular disorders such as spastic cerebral palsy (CP).</div></div><div><h3>Case presentation</h3><div>A 10-year-old male child with a known history of spastic cerebral palsy (CP) presented to the emergency department with progressive abdominal distension for five days and urinary retention for two days. He had a history of chronic constipation and was on oral baclofen for the management of his spasticity. He was febrile (38 °C), tachycardic, and had a severely distended and tense abdomen. Abdominal imaging, including x-ray and computed tomography (CT) revealed grossly distended large bowel loops with no clear transition point, suggestive of large bowel obstruction. He was taken emergently to the operating room for an exploratory laparotomy. We found that the transverse and left colon had volvulized and had patchy ischemia. The right and sigmoid colon were healthy. We did a resection of the volvulized colon, followed by a primary colo-colic anastomosis. The patient's postoperative recovery was uneventful. He resumed enteral feedings on postoperative day 3 and was discharged home shortly afterwards. At the 6-week follow up he continued to do well and had regular bowel function.</div></div><div><h3>Conclusion</h3><div>Volvulus of the transverse and left colon should be considered in children who develop a bowel obstruction, particularly in those with a history of chronic constipation and/or cerebral palsy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103065"},"PeriodicalIF":0.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665862","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":"Choledocholithiasis causing cystic duct perforation in an infant: A case report","authors":"Spencer C. Buted ,&nbsp;Jenny L. Stevens ,&nbsp;Kristine S. Corkum","doi":"10.1016/j.epsc.2025.103063","DOIUrl":"10.1016/j.epsc.2025.103063","url":null,"abstract":"<div><h3>Introduction</h3><div>Infant choledocholithiasis causing a distal obstruction resulting in a cystic duct perforation is a rare finding especially in infants with no underlying risk factors.</div></div><div><h3>Case presentation</h3><div>A 5-month-old, previously healthy male with poor weight gain presented with worsening irritability and abdominal pain. Laboratory studies on presentation to the emergency department were notable for a leukocytosis to 15.14 × 10³ mcL and total bilirubin of 1.7 mg/dL. Imaging (ultrasound, x-ray, computed tomography) showed moderate intra-abdominal free fluid, no identifiable gallstones, and non-obstructive gaseous bowel distension. We decided to perform a diagnostic laparoscopy which revealed bilious ascites. An exploratory laparotomy was performed; a distal common bile duct stone and perforation of the cystic duct was noted with intraoperative cholangiogram. An open, trans-cystic common bile duct exploration was performed to clear the distal obstruction and cholecystectomy and ligation of the cystic duct proximal to the perforation was performed. Patency of biliary tract was confirmed with repeat intraoperative cholangiogram. The patient had an uncomplicated post-operative course with resumption of oral liquids on post-operative day 4. He was discharged on post-operative day 11; his outpatient follow-up is significant for weight gain and no symptom recurrence.</div></div><div><h3>Conclusion</h3><div>Cystic duct perforation is a potential complication of choledocholithiasis in infants.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103063"},"PeriodicalIF":0.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670358","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":"Torsion of a herniated ovary in an infant: a case report","authors":"Ismail Benomar ,&nbsp;Hidaya Zitan ,&nbsp;Loubna Aqqaoui ,&nbsp;Ali Lahrech ,&nbsp;Houda Oubejja ,&nbsp;Fouad Ettayebi","doi":"10.1016/j.epsc.2025.103066","DOIUrl":"10.1016/j.epsc.2025.103066","url":null,"abstract":"<div><h3>Introduction</h3><div>Inguinal hernias are relatively common in newborns; however, herniation of the ovary through the canal of Nuck is a rare condition that can lead to ovarian torsion and infarction if not promptly managed.</div></div><div><h3>Case presentation</h3><div>We report the case of a 3-month-old female infant, born at term following an uneventful pregnancy and neonatal period, with normal growth parameters and psychomotor development. She presented with a non-reducible, tender right inguinal mass associated with local signs of inflammation. Symptoms had been evolving over five days. Doppler ultrasonography revealed an enlarged, heterogeneous ovarian structure with absent vascular flow, indicative of adnexal torsion. Surgical exploration confirmed torsion of the right fallopian tube and a necrotic ovary within an inflamed hernia sac. A right salpingo-oophorectomy was performed. The patient was discharged 24 hours postoperatively. Histopathological examination revealed ovarian gangrene without evidence of neoplastic or dysplastic changes. Postoperative recovery was uneventful, and no complications were observed at the 3-month follow-up.</div></div><div><h3>Conclusion</h3><div>Ovaries herniated into the inguinal canal require prompt reduction and hernia repair to avoid potential complications such as torsion and infarction, as observed in our patient.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103066"},"PeriodicalIF":0.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653693","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":"Suprapubic dermoid sinus in a 9-month-old infant: A case report","authors":"Eiman Yassir Musa Hussain ,&nbsp;Tarek Abdelazeem Sabra ,&nbsp;Sarah Magdy Abdelmohsen","doi":"10.1016/j.epsc.2025.103058","DOIUrl":"10.1016/j.epsc.2025.103058","url":null,"abstract":"<div><h3>Introduction</h3><div>Suprapubic dermoid sinuses are rare congenital anomalies resulting from incomplete ectodermal separation during embryogenesis.</div></div><div><h3>Case presentation</h3><div>A 9-month-old male infant presented with a midline suprapubic dimple noted since birth and no other medical history. Ultrasound revealed a superficial sinus tract, and Magnetic Resonance Imaging (MRI) confirmed a well-defined, blind-ending tract without any deeper communication. A complete excision was done in the operating room under general anesthesia. We guided the dissection of the sinus with methylene blue injected in it. The histopathology confirmed the diagnosis of a dermoid sinus lined with keratinized squamous epithelium containing dermal appendages. The postoperative recovery was uneventful. No recurrence was observed at the 1-month, 3-month, and 6-month follow-up visits.</div></div><div><h3>Conclusion</h3><div>Dermoid sinuses, although rare, should be included in the differential diagnosis of midline congenital dimples in infants.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103058"},"PeriodicalIF":0.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679394","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":"Congenital H-type recto-vaginal fistula with normal anus: a case report","authors":"Samuel Kefiyalew Kelbessa,&nbsp;Berhanu Nigusse Bikila,&nbsp;Amanuel Mesfin Oljira","doi":"10.1016/j.epsc.2025.103054","DOIUrl":"10.1016/j.epsc.2025.103054","url":null,"abstract":"","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103054"},"PeriodicalIF":0.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633583","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":"Surgical evaluation and management of infected tailgut cysts in pediatrics: A case series","authors":"Matthew T. Parrish ,&nbsp;Ryan Watkins ,&nbsp;D. Dean Potter Jr.","doi":"10.1016/j.epsc.2025.103062","DOIUrl":"10.1016/j.epsc.2025.103062","url":null,"abstract":"<div><h3>Introduction</h3><div>Tailgut cysts are lesions occurring in the presacral space that most commonly present in early adulthood but can be identified in the pediatric population. Superimposed infection is even more rare which can lead to diagnostic and treatment uncertainty when encountered.</div></div><div><h3>Case presentations</h3><div>Patient 1 was an 8-year-old male who originally presented with lower abdominal pain and fevers. A computed tomography (CT) scan was performed identifying a 2.8 cm presacral fluid collection. Definitive management via posterior midline approach with coccygectomy was performed. He subsequently developed a small fluid collection that resolved with antibiotics. Patient 2 was a 15-year-old male who presented from an outside institution after CT revealed a presacral abscess. Attempts at transgluteal drain were unsuccessful. Subsequently, he was taken to the operating room, were an anterior, laparoscopic approach was used to partially excise the presacral cyst. After recurrence, a posterior approach with coccygectomy was performed with resolution of the cyst. Patient 3 was a 10-year-old female who was found to have a 4.3 cm presacral abscess that recurred after surgical drainage at an outside institution. The patient was taken to the operating room, where a posterior midline approach with coccygectomy was performed with resolution of the cyst.</div></div><div><h3>Conclusion</h3><div>Complete surgical excision appears to be the most definitive treatment modality for infected tailgut cysts with our preferred approach through the posterior sagittal midline. While rare, tailgut cysts should remain in the differential for any recurrent or new complex presacral infection resistant to standard medical and surgical treatment.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103062"},"PeriodicalIF":0.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633543","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":"Use of intraoperative ex VIVO fluorescence confocal microscopy to identify ganglionic bowel in Hirschsprung’s DISEASE: A case series","authors":"Donatella Di Fabrizio ,&nbsp;Irene Tavolario ,&nbsp;Francesca Mastroberti ,&nbsp;Edoardo Bindi ,&nbsp;Alessandra Filosa ,&nbsp;Gaia Goteri ,&nbsp;Giovanni Cobellis","doi":"10.1016/j.epsc.2025.103064","DOIUrl":"10.1016/j.epsc.2025.103064","url":null,"abstract":"<div><h3>Introduction</h3><div>Hirschsprung's disease requires precise intraoperative identification of ganglionic bowel to ensure successful pull-through. Ex vivo fluorescence confocal microscopy (FCM) may offer a rapid, real-time diagnostic adjunct.</div></div><div><h3>Case Presentations</h3><div>Case 1: A 2-month-old male presented with delayed meconium passage, abdominal distension, and bilious vomiting. Contrast enema revealed a rectosigmoid transition zone, and rectal suction biopsy confirmed aganglionosis. He underwent laparoscopic Soave-Georgeson pull-through. Intraoperatively, seromuscular biopsies were stained with acridine orange and fast green and examined using FCM. Digital images were analyzed remotely by a pathologist, who confirmed the presence of ganglion cells within 5 minutes. The pull-through was completed based on this assessment. Postoperative recovery was uneventful, and at 18-month follow-up, the child had normal bowel function and growth. Case 2: A 3-month-old female presented with chronic constipation, vomiting, and failure to thrive. Imaging and rectal biopsy confirmed Hirschsprung's disease. She underwent laparoscopic pull-through guided by FCM, following the same protocol as in Case 1. Real-time identification of ganglion cells allowed for prompt selection of the pull-through segment. The postoperative course was uncomplicated. At 12-month follow-up, the child had normal stooling patterns and appropriate weight gain.</div></div><div><h3>Conclusion</h3><div>Intraoperative ex vivo fluorescence confocal microscopy seems to be a fast and reliable method for the identification of ganglionic bowel during the pull-through procedure for the management of Hirschsprung disease.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103064"},"PeriodicalIF":0.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614183","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":"Brunner's gland hyperplasia causing gastric outlet obstruction in a child: a case report","authors":"Saswati Behera ,&nbsp;Ram Samujh ,&nbsp;Gursewak Singh ,&nbsp;Gulshan Kumar Saini ,&nbsp;Ankita Soni ,&nbsp;Navdeep Singh Dhoat","doi":"10.1016/j.epsc.2025.103061","DOIUrl":"10.1016/j.epsc.2025.103061","url":null,"abstract":"<div><h3>Introduction</h3><div>Brunner's gland hyperplasia (BGH) is a rare, benign proliferation of the mucus-secreting glands located predominantly in the proximal duodenum. It is most often identified incidentally during endoscopic or radiologic evaluations.</div></div><div><h3>Case presentation</h3><div>A 12-year-old boy presented with several weeks of intermittent postprandial abdominal pain, non-projectile vomiting, and gradually increasing upper abdominal distension. His symptoms acutely worsened, progressing to bilious vomiting and marked abdominal bloating. On physical examination, visible gastric peristalsis and hyperactive bowel sounds were observed. Abdominal radiography showed a distended stomach, and contrast-enhanced computed tomography (CT) revealed an intraluminal mass in the third part of the duodenum. Upper gastrointestinal endoscopy identified a large, pedunculated polypoid lesion obstructing more than 50 % of the duodenal lumen. Endoscopic biopsies revealed chronic inflammation without evidence of malignancy. Due to the risk of perforation and technical limitations of endoscopic resection, the patient underwent exploratory laparotomy. Intraoperatively, hypertrophic mucosal folds were identified near the duodenojejunal junction. A mucosectomy was performed via enterotomy. Histopathological examination confirmed Brunner's gland hyperplasia without any evidence of dysplasia. The postoperative course was uneventful, and the patient remains asymptomatic at 8 months of follow-up.</div></div><div><h3>Conclusion</h3><div>Brunner's gland hyperplasia should be included in the differential diagnosis of children who develop duodenal or gastric outlet obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103061"},"PeriodicalIF":0.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614013","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":"Appendiceal stricture following Mini-ACE® enema button placement: a case report","authors":"Signe Olsbø ,&nbsp;Kjetil Næss Ertresvåg ,&nbsp;Kristin Bjørnland","doi":"10.1016/j.epsc.2025.103060","DOIUrl":"10.1016/j.epsc.2025.103060","url":null,"abstract":"<div><h3>Introduction</h3><div>Few studies have looked at complications related to antegrade continence enema (ACE) devices. This report discusses a complication of the Mini-ACE® button and how it was managed.</div></div><div><h3>Case presentation</h3><div>The patient was a 7-year-old boy with a history of constipation and fecal incontinence. He first experienced constipation at the age of 1 year. Hirschsprung disease was ruled out by a rectal biopsy. After a multidisciplinary evaluation, he underwent an appendicostomy procedure with a Mini-ACE® for antegrade enemas. The Mini-ACE® functioned well for 1 year. However, after a routine replacement, increased resistance was noted during water installation. When attempting to replace the device, not even a guidewire could be passed through the appendix. Contrast fluoroscopy identified a 2-cm long appendiceal stricture, located about 3 cm from the cecum. Since a new Mini-ACE® could not be inserted, conservative treatment with oral laxatives was initiated. The patient refused rectal enemas. The patient's constipation and fecal incontinence recurred. Three months later he was taken to the operating room to revise the appendicostomy. Through a laparoscopic approach, the stricture was resected, and the two ends of the appendix were anastomosed. At one year of follow-up, the patient has good symptom control, and the use of the Mini-ACE remains uncomplicated. The stricture was likely caused by the inflation of the Mini-ACE® balloon within the appendix.</div></div><div><h3>Conclusion</h3><div>ACE appendicostomies can develop fibrosis if the button balloon is inflated within the appendix. If the fibrotic segment is not too long, resection and appendiceal anastomosis may be a viable option to preserve the appendicostomy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103060"},"PeriodicalIF":0.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614011","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}