Journal of Pediatric Surgery Case Reports最新文献_第10页

Rectosigmoid intussusception presenting as rectal prolapse in a premature baby: A case report 早产儿直肠乙状结肠肠套叠表现为直肠脱垂：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-24 DOI: 10.1016/j.epsc.2024.102890

Cesar Kattini , Meagan E. Wiebe , Marc-Olivier Deguise , Brigitte Lemyre , Ahmed Nasr

{"title":"Rectosigmoid intussusception presenting as rectal prolapse in a premature baby: A case report","authors":"Cesar Kattini , Meagan E. Wiebe , Marc-Olivier Deguise , Brigitte Lemyre , Ahmed Nasr","doi":"10.1016/j.epsc.2024.102890","DOIUrl":"10.1016/j.epsc.2024.102890","url":null,"abstract":"<div><h3>Introduction</h3><div>Rectosigmoid intussusception in premature infants is a rare condition. We present a case of rectosigmoid intussusception initially presenting as rectal prolapse.</div></div><div><h3>Case presentation</h3><div>A premature male baby born at 24 weeks gestation was transferred to our center at two months of age due to recurrent rectal prolapse with minimal straining, despite repeated reductions. The etiology of the prolapse was unclear. An abdominal X-ray showed bowel dilation with air-fluid levels. The gas pattern in the abdomen indicated a mid to distal bowel obstruction. An abdominal ultrasound revealed an intussusception behind the bladder, measuring 3.8 cm in cranio-caudal dimension, appearing to be in the rectum or distal sigmoid colon. The patient underwent a diagnostic laparoscopy. We found a rectosigmoid intussusception, which we reduced laparoscopically. After the laparoscopy we did a flexible sigmoidoscopy and saw that the bowel wall appeared edematous and bruised but was not compromised. There were no polyps or any other intraluminal lesions. We concluded that the recurrent prolapse was the intussusception protruding through the anus (likely originating from mesenteric lymph nodes) rather than a rectal prolapse. There were no perioperative or postoperative complications, the patient tolerated the procedure well and had an uneventful recovery.</div></div><div><h3>Conclusion</h3><div>Rectosigmoid intussusception can resemble rectal prolapse and should be ruled out if prolapse recurs immediately after reduction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102890"},"PeriodicalIF":0.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Late presentation of type-I jejunal atresia in an infant: A case report 婴儿I型空肠闭锁的晚期表现：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-24 DOI: 10.1016/j.epsc.2024.102891

Sunnie Wong , Rachel Landisch , Rachel Ruiz , Sumit Datta , Julie Fuchs

{"title":"Late presentation of type-I jejunal atresia in an infant: A case report","authors":"Sunnie Wong , Rachel Landisch , Rachel Ruiz , Sumit Datta , Julie Fuchs","doi":"10.1016/j.epsc.2024.102891","DOIUrl":"10.1016/j.epsc.2024.102891","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal atresia is an uncommon cause of intestinal obstruction. In the vast majority of the cases, signs and symptoms develop early in the neonatal period. Presentations beyond the neonatal period are rare.</div></div><div><h3>Case presentation</h3><div>A former premature female infant who was otherwise healthy developed recurrent, non-bilious vomiting associated with feedings at the age of 8 months. Up until that time her weight gain had been appropriate, and she had regular bowel movements. Over the course of the following weeks, the vomiting became more frequent. A few days after her 9-month well-child visit during which she still appeared to be in good health, her vomiting turned bilious and was not related to feedings. Her parents brought her to the emergency room. She was admitted to the hospital and underwent imaging studies to investigate the source of what seemed to be an intestinal obstruction. The upper gastrointestinal series (UGI) showed delayed passage of contrast, and a caliber change in the proximal small bowel. The computerized tomography (CT) confirmed the findings, which were suggestive of a partial proximal intestinal obstruction. She underwent a laparotomy. We identified an area of caliber change 15 cm distal to the ligament of Treitz. We opened the proximal side and identified a jejunal membrane that had a pinhole opening in the center. We resected a 4-cm segment of jejunum that included the caliber transition and the membrane and did an end-to-end anastomosis. She tolerated the operation well and was discharged home 12 days later. At the age of 1 year, she is thriving well.</div></div><div><h3>Conclusion</h3><div>Although type-I jejunal atresia typically presents in the neonatal period, it should be included in the differential diagnosis of infants with recurrent vomiting and signs of a partial bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102891"},"PeriodicalIF":0.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preoperative percutaneous catheter drainage for symptomatic macrocystic congenital pulmonary airway malformation: A case report 症状性大囊状先天性肺气道畸形的术前经皮导管引流术：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-23 DOI: 10.1016/j.epsc.2024.102889

Ilaria Acquaviva , Edoardo Bindi , Giovanni Cobellis

{"title":"Preoperative percutaneous catheter drainage for symptomatic macrocystic congenital pulmonary airway malformation: A case report","authors":"Ilaria Acquaviva , Edoardo Bindi , Giovanni Cobellis","doi":"10.1016/j.epsc.2024.102889","DOIUrl":"10.1016/j.epsc.2024.102889","url":null,"abstract":"<div><h3>Introduction</h3><div>Infants with congenital pulmonary airway malformation (CPAM) are generally asymptomatic and the surgical treatment can be planned using a thoracoscopic technique. We report the case of a newborn with a large type 1 CPAM who presented with severe respiratory distress and was treated with percutaneous transthoracic drainage before open surgery.</div></div><div><h3>Case report</h3><div>A full-term male patient was born via vaginal delivery. Antenatal imaging had raised suspicion of type 1 CPAM in the right lung. At birth, he was admitted to the neonatal intensive care unit (NICU) due to ventilatory insufficiency and oxygen dependence. A chest X-ray confirmed the antenatal diagnosis of a large type 1 CPAM. On the first days of life (DOL), we inserted a percutaneous transthoracic chest tube to drain the large cyst and initiated high-frequency oscillatory ventilation (HFOV). Although the patient initially showed clinical improvement, his condition subsequently deteriorated. Suspecting tube dislocation, on the seventh DOL a second drainage was placed in the cyst. On the tenth DOL, given the persistent clinical severity, a right upper lobectomy was performed. Postoperatively, the patient was supported by conventional ventilation with a reduced oxygen requirement. On the thirteenth DOL, the infant was successfully extubated. Histological analysis confirmed the diagnosis of type 1 CPAM. After nearly a month, the infant was transferred to the pediatric surgery ward and later discharged. During multidisciplinary follow-up, the patient maintained good general health with no signs of recurrence.</div></div><div><h3>Conclusion</h3><div>In newborns with large, symptomatic type-1 CPAMs a percutaneous catheter drainage can be used as a temporizing measure before the definitive surgical resection.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102889"},"PeriodicalIF":0.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unusual variant of esophageal atresia and tracheo-esophageal fistula: A case report 食管闭锁和气管食管瘘的异常变异：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-17 DOI: 10.1016/j.epsc.2024.102886

Rachael Stottlemyre , David M. Notrica , Mark McOmber , Erin Garvey

{"title":"Unusual variant of esophageal atresia and tracheo-esophageal fistula: A case report","authors":"Rachael Stottlemyre , David M. Notrica , Mark McOmber , Erin Garvey","doi":"10.1016/j.epsc.2024.102886","DOIUrl":"10.1016/j.epsc.2024.102886","url":null,"abstract":"<div><h3>Introduction</h3><div>Esophageal atresia (EA) is the most common congenital anomaly affecting the esophagus. We describe an unusual variant of EA, which shares similarities with Type A but features a mid-esophageal segment attached to the trachea.</div></div><div><h3>Case presentation</h3><div>A 38-week gestational age baby girl had prenatal diagnoses of EA and congenital cardiac anomalies. Postnatal attempts to advance an orogastric tube were unsuccessful, and EA was confirmed by chest X-ray showing the tube at the T2/T3 level without distal bowel air. Further workup included bronchoscopy, which identified a posterior tracheal outpouching without an apparent connection to the esophagus, and Cardiac CT, which revealed a mid-esophageal segment with a tracheo-esophageal fistula. Workup was consistent with complex esophageal anatomy with distinct proximal and distal pouches and a mid-esophageal segment attached to the trachea. A gastrostomy tube was placed for decompression and enteral feeds. Surgical intervention included closure and excision of the mid-esophageal fistula. The gap between the proximal and distal pouches was impressive, requiring cervical esophageal mobilization and two esophageal myotomies to add length, and concluded in a primary esophago-esophagostomy. Postoperative complications included a contained leak at the anastomosis, which was managed conservatively with placement of a feeding tube past the anastomotic site and resolved after 4 weeks. The patient required multiple esophageal dilations during the first two years of life and achieved successful closure of the gastrostomy at 25 months of age without further complications.</div></div><div><h3>Conclusion</h3><div>Awareness of rare subtypes of EA enables surgeons to anticipate and address unique challenges that may arise during surgical intervention.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102886"},"PeriodicalIF":0.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001143/pdfft?md5=435e0b03042a138668ddc69bbb9b1924&pid=1-s2.0-S2213576624001143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Totally implantable venous access device (TIVAD) migration into the pleural space: A case report 全植入式静脉通路装置 (TIVAD) 移入胸膜腔：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-16 DOI: 10.1016/j.epsc.2024.102887

Fatemeh Shahrahmani , Reza Shojaeian

{"title":"Totally implantable venous access device (TIVAD) migration into the pleural space: A case report","authors":"Fatemeh Shahrahmani , Reza Shojaeian","doi":"10.1016/j.epsc.2024.102887","DOIUrl":"10.1016/j.epsc.2024.102887","url":null,"abstract":"<div><h3>Introduction</h3><p>Totally implantable venous access devices (TIVADs) offer significant advantages for long-term intravenous therapy, but their use is not without potential complications. Catheter migration is one of them.</p></div><div><h3>Case presentation</h3><p>An 11-year-old boy with a primitive neuro-ectodermal tumor (PNET) undergoing chemotherapy was a candidate for a TIVAD placement. A TIVAD was implanted through the right internal jugular vein and secured to the pectoralis major in a right thoracic subcutaneous pouch without complications. Approximately six months later, port malfunction was noticed. Physical examination revealed that the port was no longer palpable, and a chest X-ray confirmed that the port was displaced. Subsequent chest X-rays showed different locations of the port and the catheter. With the hypothesis that the port had entered the pleural space and was moving freely, we did an exploratory thoracoscopy. We confirmed the intrapleural position of the port and catheter and removed both without complications. The patient was discharged four days later.</p></div><div><h3>Conclusion</h3><p>Although rare, TIVADs can migrate from the chest wall into the pleural cavity. Frequent evaluation of their function and position is critical for the early detection of complications.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102887"},"PeriodicalIF":0.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001155/pdfft?md5=b35c2212113fd61ef60e660b6d980bd9&pid=1-s2.0-S2213576624001155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Massive thymic hyperplasia in a toddler masquerading as a loculated pleural effusion: A case report 伪装成定位性胸腔积液的幼儿大面积胸腺增生：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-16 DOI: 10.1016/j.epsc.2024.102885

Emily J. Zolfaghari , Matthew Shaughnessy , Hao Wu , Michael Caty , Emily Christison-Lagay , Matthew A. Hornick

{"title":"Massive thymic hyperplasia in a toddler masquerading as a loculated pleural effusion: A case report","authors":"Emily J. Zolfaghari , Matthew Shaughnessy , Hao Wu , Michael Caty , Emily Christison-Lagay , Matthew A. Hornick","doi":"10.1016/j.epsc.2024.102885","DOIUrl":"10.1016/j.epsc.2024.102885","url":null,"abstract":"<div><h3>Introduction</h3><p>Pediatric massive thymic hyperplasia is a rare condition that can masquerade as a respiratory illness, making diagnosis challenging.</p></div><div><h3>Case presentation</h3><p>An 18-month-old female with a 3-month history of multiple admissions for suspected pneumonia warranting antibiotics presented with recurrent respiratory distress, fevers, and fatigue. Work-up for possible parapneumonic effusion, including six chest x-rays and an ultrasound, eventually led to a computed tomography (CT) of the chest, which revealed a large homogeneous mass occupying much of the right-hemithorax. Percutaneous core biopsy showed thymocytes suggestive of either a massive thymic hyperplasia or a thymoma. Consensus was to proceed with upfront surgical resection of the mass, which was performed via right thoracotomy. Pathology was consistent with true thymic hyperplasia. The post-operative course was uncomplicated, and no issues were identified at 3-month follow-up. We plan to follow the patient at 6 months, 1 year, and then annually with surveillance chest x-rays to monitor for recurrence case-report.</p></div><div><h3>Conclusion</h3><p>Thymic hyperplasia should be included in the differential diagnosis of pediatric patients with persistent respiratory symptoms and abnormal findings on chest x-ray.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102885"},"PeriodicalIF":0.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001131/pdfft?md5=45ed11365993c746183d75987cd2ea86&pid=1-s2.0-S2213576624001131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Capillary hemangioma of the external oblique muscle: A case report 外斜肌毛细血管瘤：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-13 DOI: 10.1016/j.epsc.2024.102881

K.K. Athish , Venkat Hariharan Marimuthu , Vamsi Krishna Reddy Kurri , Suggula Vamsi Krishna , Anwadevi Arun , Dinesh Kumar Sathanantham

{"title":"Capillary hemangioma of the external oblique muscle: A case report","authors":"K.K. Athish , Venkat Hariharan Marimuthu , Vamsi Krishna Reddy Kurri , Suggula Vamsi Krishna , Anwadevi Arun , Dinesh Kumar Sathanantham","doi":"10.1016/j.epsc.2024.102881","DOIUrl":"10.1016/j.epsc.2024.102881","url":null,"abstract":"<div><h3>Introduction</h3><p>Intramuscular hemangiomas (IMH) are rare benign vascular tumors. They can occur anywhere in the body but are more common in the head and neck. Their location in the muscles of the abdominal wall is uncommon.</p></div><div><h3>Case presentation</h3><p>A 14-year-old girl presented with 5 months of progressive swelling on the right side of her abdomen followed by intermittent pain. On examination, a solitary mass with ill-defined borders was noted fixed to the subcutaneous tissue in the right lumbar quadrant. After elevating the right leg, the swelling became more prominent. Doppler ultrasonography revealed a mixed echogenic mass in the subcutaneous plane of the anterior abdominal wall of the right lumbar region. Magnetic resonance imaging of abdomen was suggestive of hemangioma, and the patient underwent surgical excision. Histopathological examination confirmed the diagnosis of capillary hemangioma. During follow-up at 3 and 6 months, the patient did not present with recurrence and was healthy.</p></div><div><h3>Conclusion</h3><p>Although IMH is a rare soft-tissue tumor, it should be considered when diagnosing symptomatic intramuscular swelling.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102881"},"PeriodicalIF":0.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221357662400109X/pdfft?md5=9ec8de4d6c3107a0df91527188b423de&pid=1-s2.0-S221357662400109X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laparoscopic-guided sclerotherapy of an abdominal lymphatic malformation: A case report 腹腔镜引导下的腹腔淋巴畸形硬化疗法：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-12 DOI: 10.1016/j.epsc.2024.102883

Paul McClure , Kate McNevin , Giri Shivaram , Caitlin Smith

{"title":"Laparoscopic-guided sclerotherapy of an abdominal lymphatic malformation: A case report","authors":"Paul McClure , Kate McNevin , Giri Shivaram , Caitlin Smith","doi":"10.1016/j.epsc.2024.102883","DOIUrl":"10.1016/j.epsc.2024.102883","url":null,"abstract":"<div><h3>Introduction</h3><p>While most lymphatic malformations (LMs) are treated by percutaneous sclerotherapy, intra-abdominal LMs may be difficult to access percutaneously due to their anatomic location.</p></div><div><h3>Case presentation</h3><p>An 11-year-old otherwise healthy boy presented with abdominal pain and cross-sectional imaging (including CT scan and MRI) identified an intra-abdominal LM located in the lesser sac, bordered by the stomach, spleen, and pancreas. An attempt to access the lesion percutaneously was made, however this was unsuccessful due to overlying viscera. Given the morbidity associated with an open surgical approach, the patient underwent laparoscopic-guided doxycycline sclerosant injection. After the LM was exposed laparoscopically, a pigtail catheter was placed into the lesion using the Seldinger technique. Doxycycline sclerosant was instilled three times over the course of three days and the pigtail catheter was removed after the third instillation. The LM completed resolved in addition to the abdominal pain the patient was experiencing. After more than one year of follow up, the LM has not recurred.</p></div><div><h3>Conclusion</h3><p>Abdominal LMs may be safely treated with a laparoscopic-guided doxycycline sclerosant injection when surgical excision would be exceedingly morbid and there is no safe percutaneous entry site.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102883"},"PeriodicalIF":0.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001118/pdfft?md5=41430dd8736a686d574082953ab93bd7&pid=1-s2.0-S2213576624001118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rapunzel syndrome leading to multiple bowel perforations: A case report 长发公主综合征导致多发性肠穿孔：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-12 DOI: 10.1016/j.epsc.2024.102884

Zachary Ballinger , Erin Scott , Alanna Hickey , Jonathan Green , Jeremy Aidlen , Muriel Cleary

{"title":"Rapunzel syndrome leading to multiple bowel perforations: A case report","authors":"Zachary Ballinger , Erin Scott , Alanna Hickey , Jonathan Green , Jeremy Aidlen , Muriel Cleary","doi":"10.1016/j.epsc.2024.102884","DOIUrl":"10.1016/j.epsc.2024.102884","url":null,"abstract":"<div><h3>Introduction</h3><p>Although patients with Rapunzel syndrome are often asymptomatic, rare complications such as isolated gastric or duodenal perforation, pancreaticobiliary or intestinal obstruction, and intussusception have been described.</p></div><div><h3>Case presentation</h3><p>A 5-year-old female with no known medical history presented after nearly two weeks of worsening constipation, abdominal distension, and abdominal pain. A CT scan demonstrated a large gastric bezoar, pneumoperitoneum, and large volume complex free fluid. The patient was taken to the operating room for an abdominal exploration. We found a large gastric trichobezoar with hair extending into the small bowel, consistent with Rapunzel syndrome. The gastric trichobezoar was connected to a mid-ileal trichobezoar through interdigitating hair fibers. At multiple locations along the small bowel, garroted linear perforations had occurred due to tension created by the intestinal peristalsis along the interconnecting hair fibers, creating mucosal ulcerations and transmural pressure necrosis that required an extensive small bowel resection. Ultimately, we did one end-end small bowel anastomosis and placed a gastrostomy tube. Gastrostomy tube feeds were started on postoperative day 6 after confirming with a contrast study that there were no intestinal leaks. She developed a superficial wound infection that was managed with antibiotics and negative pressure wound therapy. She was discharged tolerating regular diet on post-operative day 23, and is undergoing psychiatric therapy.</p></div><div><h3>Conclusion</h3><p>Although rare, Rapunzel syndrome can lead to severe complications. When two trichobezoars are present, interconnecting hair fibers can cause small bowel perforations.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102884"},"PeriodicalIF":0.2,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221357662400112X/pdfft?md5=e70dd972dbf25f5b0036274726829134&pid=1-s2.0-S221357662400112X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Jejunal perforation secondary to dog bite: A case report 继发于狗咬伤的空肠穿孔：病例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2024-09-11 DOI: 10.1016/j.epsc.2024.102880

Abel Girma Demessie , Suleiman Ayalew , Michael A. Negussie , Leaynadis Kassa , Asratu Getnet Amare , Mesfin Tesera Wassie

{"title":"Jejunal perforation secondary to dog bite: A case report","authors":"Abel Girma Demessie , Suleiman Ayalew , Michael A. Negussie , Leaynadis Kassa , Asratu Getnet Amare , Mesfin Tesera Wassie","doi":"10.1016/j.epsc.2024.102880","DOIUrl":"10.1016/j.epsc.2024.102880","url":null,"abstract":"<div><h3>Introduction</h3><p>Dog bites commonly result in soft tissue injuries and infections, but rarely cause intestinal perforation.</p></div><div><h3>Case presentation</h3><p>A 9-year-old male presented with abdominal distension and vomiting three days after being bitten in the abdomen by a stray dog. He was not evaluated immediately after the injury. One day later he developed abdominal distension, difficulty passing stool and gas, non-projectile vomiting, and intermittent high-grade fever. Two days after these symptoms began, he visited a local health center where he was started on antibiotics and was referred to our hospital for further care. On arrival, he was febrile, tachycardic, tachypneic, irritable, had a normal oxygen saturation and a Glasgow Coma Scale of 15. Abdominal examination revealed distension, diffuse tenderness, absent bowel sounds, and visible bite marks in the left lumbar and iliac regions. Blood tests were normal. A plain abdominal X-ray showed pneumoperitoneum. Suspecting a bowel perforation, the patient was taken to the operating room for an exploratory laparotomy. Approximately 200 ml of pus were found in the peritoneal cavity, along with a pinpoint jejunal perforation 30 cm from the ligament of Treitz, and a serosal tear 3 cm distal to it. The involved jejunal segment was resected, followed by a primary end-to-end jejunal anastomosis. Oral feedings were initiated on postoperative day four. The recovery was uneventful and at the two-week follow-up, he was in good health.</p></div><div><h3>Conclusion</h3><p>Intestinal perforation following a dog bite, although rare, should be considered in patients presenting with abdominal symptoms after such injuries.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102880"},"PeriodicalIF":0.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001088/pdfft?md5=f0620379358ac48d00a37432db7dda78&pid=1-s2.0-S2213576624001088-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142230774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0