Journal of Pediatric Surgery Case Reports最新文献

{"title":"Imperforate anus, multiple intestinal atresia and unilateral facial hypoplasia: A case series","authors":"Joy Ayemoba ,&nbsp;Carmelle Romain ,&nbsp;Kathryn J. Rowland","doi":"10.1016/j.epsc.2025.103076","DOIUrl":"10.1016/j.epsc.2025.103076","url":null,"abstract":"<div><h3>Introduction</h3><div>Imperforate anus and intestinal atresia are rare but well understood congenital disorders which affect the alimentary tract. Like intestinal atresia, facial hypoplasia is another congenital anomaly likely secondary to a vascular injury in utero.</div></div><div><h3>Case presentation</h3><div>Case 1 discusses a female born at 32 weeks with a prenatal diagnosis of duodenal atresia and discovery of imperforate anus and unilateral maxillary hypoplasia at birth. She was emergently taken to the operating room for bowel obstruction. During that operation, she underwent repair of multiple segments of atresia, a duodenoduodenostomy, and creation of an end ileostomy and mucus fistula. At two months of age, she returned to the operating room to restore continuity of the distal atretic bowel. At six months old she presented with a partial bowel obstruction secondary to a jejunal duplication cyst. Case 2 discusses a full-term male presenting with unilateral facial hypoplasia and imperforate anus at birth. Given failure to pass meconium and worsening abdominal distension he was taken to surgery, where multiple segments of intestinal atresia were identified. During this operation he was left in discontinuity following creation of a diverting loop ileostomy and colostomy. Two months later, he underwent repeat exploratory laparotomy during which multiple segments of atretic bowel were repaired. At four months of age, he underwent reversal of the diverting loop ileostomy followed by completion of posterior sagittal anorectoplasty at nine months old.</div></div><div><h3>Conclusion</h3><div>Intestinal atresias should be highly suspected in patients who present with anorectal malformations in conjunction with facial hypoplasia.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103076"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772302","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":"Type IVA choledochal cyst with gallbladder duplication: a case report","authors":"Saalim Nazki ,&nbsp;Saswati Behera ,&nbsp;Akshat Sudhanshu","doi":"10.1016/j.epsc.2025.103096","DOIUrl":"10.1016/j.epsc.2025.103096","url":null,"abstract":"<div><h3>Background</h3><div>Gallbladder duplication is a rare congenital anomaly, and its coexistence with choledochal cysts is exceptionally uncommon.</div></div><div><h3>Case</h3><div>A 7-year-old female presented with recurrent right upper quadrant abdominal pain over several months. Laboratory investigations revealed elevated serum AST (142 IU/L) (normal range 8–33 IU/L) and ALT (158 IU/L) (normal range 4–36 IU/L), with mildly raised alkaline phosphatase; bilirubin levels were within normal limits. Abdominal ultrasonography (USG) demonstrated common bile duct dilation, and Magnetic Resonance Cholangiopancreatography (MRCP) confirmed a Type IVA choledochal cyst. Laparoscopic excision of the cyst with hepaticoduodenostomy was planned. Intraoperatively, a V shaped duplicated intrahepatic bilobed gallbladder was discovered, with a single cystic artery and a single cystic duct (bifurcated high up distally to drain the duplicated lobes of gall bladder) draining into the common bile duct. Both gallbladders were excised, and a hepaticoduodenostomy was performed. Histopathology confirmed gallbladder duplication with chronic inflammatory changes and no dysplasia.</div></div><div><h3>Conclusion</h3><div>Gallbladder duplication is a rare congenital anomaly that may not be identified on preoperative imaging, particularly in the setting of complex biliary anomalies like choledochal cyst.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103096"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908702","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":"Pleural effusion after Nuss procedure: a case series","authors":"Hendrik van Braak ,&nbsp;Suzanne W.J. Terheggen-Lagro ,&nbsp;Joël Israels ,&nbsp;Joost van Schuppen ,&nbsp;Eline E. Deurloo ,&nbsp;Justin R. de Jong","doi":"10.1016/j.epsc.2025.103086","DOIUrl":"10.1016/j.epsc.2025.103086","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleural effusion is an underreported and poorly understood complication of the Nuss procedure.</div></div><div><h3>Cases presentation</h3><div><em>Case 1</em><em>:</em> A 16-year-old female presented five weeks postoperatively with dyspnea (CRP 258 mg/L), left-sided pleural and pericardial effusion. Drainage and treatment with amoxicillin/clavulanic acid, gentamicin, diuretics, ibuprofen, and prednisolone led to improvement. After steroid discontinuation, effusion recurred despite treatment with amoxicillin/clavulanic acid and gentamicin. Cultures remained negative. She required thoracic drainage and received oral clindamycin, later switched to ciprofloxacin, with eventual recovery.</div><div><em>Case 2</em><em>:</em> A 17-year-old male presented with right-sided chest pain and pleural effusion two weeks after a complicated Nuss procedure (due to extensive adhesiolysis for pneumonia-related lung adhesions. Despite antibiotics, symptoms progressed, and he was admitted (CRP 240 mg/L). Chest drainage yielded 1300 mL clear fluid; cultures were negative. Recurrent effusion eventually required video-assisted thoracoscopic surgery. He was treated with amoxicillin/clavulanic acid after surgery.</div><div><em>Case 3</em>: A 14-year-old female developed fever one week postoperatively (CRP 123 mg/L), with no abnormalities on imaging. Three weeks later, she developed right-sided effusion; 600 mL was drained, and she received ceftriaxone and clindamycin. Recurrence occurred within two weeks; oral prednisolone was added, resulting in rapid improvement. She was discharged on cotrimoxazole and tapered steroids. Two months later, imaging for persistent fatigue revealed Nuss bar dislocation and pneumothorax, requiring bar repositioning.</div></div><div><h3>Conclusion</h3><div>Pleural effusion after the Nuss procedure can be caused by a reactive inflammatory response, triggered by pleural or mechanical irritation. If an infection and bar displacement are ruled out, a course of corticosteroid therapy may be effective.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103086"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878424","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":"Lateral proximal esophagostomy and bouginage for the management of type-A esophageal atresia: a case series","authors":"Pastor Escárcega-Fujigaki ,&nbsp;Guillermo Hernández-Peredo-Rezk ,&nbsp;Haydee Vélez-Blanco ,&nbsp;Guadalupe-Gisela Caltzontzin-Basurto ,&nbsp;Carlos-Alberto Mesa-Aguirre ,&nbsp;Carlos Gutiérrez-Avalos","doi":"10.1016/j.epsc.2025.103070","DOIUrl":"10.1016/j.epsc.2025.103070","url":null,"abstract":"<div><h3>Introduction</h3><div>Type A esophageal atresia (EA) is a rare congenital anomaly. Multiple surgical approaches and techniques have been proposed for its treatment, highlighting the complexity of its correction.</div></div><div><h3>Case presentation</h3><div>Case 1 was of a female infant delivered at 35 weeks of gestation (weight, 2.7 kg; height, 47 cm; Apgar, 8–8), diagnosed with Type A EA and duodenal atresia. At 4 days of age, lateral proximal esophagostomy (LPE), duodenal membrane resection, and gastrostomy were performed. The patient was discharged after 36 days, with the parents instructed to perform bouginage. Owing to the pandemic, esophageal anastomosis was performed at 2 years of age. Subsequently, two esophageal dilatations were required; Nissen fundoplication with closure of gastrostomy and LPE were performed 4 months later. At approximately 5 years of age, the patient showed no difficulties in feeding. Case 2 was of a male infant delivered at 37 weeks of gestation (weight, 2.8 kg; height, 50 cm; Apgar, 8–9), diagnosed with Type A EA with VACTERL association. Gastrostomy and LPE were performed at 6 and 26 days of age, respectively; the patient was also discharged, with the parents instructed to perform bouginage. Due to malnutrition, esophagoplasty was performed at 1 year and 10 months. Subsequently, two esophageal dilations were performed, followed by closure of gastrostomy and LPE after 2 and 7 months, respectively. At the 3-year follow-up, the patient exhibited no feeding difficulties.</div></div><div><h3>Conclusion</h3><div>Lateral proximal esophagostomy and bouginage appear to be a feasible option for the management of type-A esophageal atresia.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103070"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739570","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":"Early-onset infantile hypertrophic pyloric stenosis: a case report","authors":"Eden Belay Tilahun ,&nbsp;Tihitena Nigussie mamo ,&nbsp;Werkneh Demissie Hailemariam ,&nbsp;Gobena Mormata Dima ,&nbsp;Nardos Mulu Admasu ,&nbsp;Abraham Sisay Abie","doi":"10.1016/j.epsc.2025.103090","DOIUrl":"10.1016/j.epsc.2025.103090","url":null,"abstract":"<div><h3>Introduction</h3><div>Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of non-bilious projectile vomiting in infants, typically presenting between 4 and 8 weeks of age. Early-onset cases, particularly those occurring within the first few days of life, are rare and often challenging to diagnose due to lack of standardized sonographic criteria for this age group.</div></div><div><h3>Case presentation</h3><div>A 12-day-old male neonate presented with persistent non-bilious projectile vomiting beginning on the first days of life. He was born at full term via spontaneous vaginal delivery to a 26-year-old primigravida mother after an uncomplicated pregnancy. Initial evaluation at a local health center led to conservative management for presumed gastroesophageal reflux. Persisting symptoms prompted referral after an initial ultrasound showed a pyloric muscle thickness of 3.6 mm and a length of 16 mm, suggestive of IHPS. However, due to the uncommon occurrence of IHPS at such an early age, a repeat ultrasound was done, which was interpreted as normal. An upper gastrointestinal contrast study was done to rule out intestinal malrotation and other sources of gastric outlet obstruction. Due to the persistence of symptoms, a third ultrasound was done on day of life 21, which showed a pyloric length of 16.6 mm and a thickness of 4.2 mm, conclusive for IHPS. The patient underwent an open Ramstedt pyloromyotomy without complications. The postoperative recovery was complicated by a hospital-acquired pneumonia, which was successfully treated. The patient was discharged on postoperative day 16 and remained asymptomatic at six months of follow-up, with normal growth and development.</div></div><div><h3>Conclusion</h3><div>Pyloric stenosis rarely occurs within the first few weeks of life but should be included in the differential diagnosis of newborns who develop persistent projectile non-bilious vomiting.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103090"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863573","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":"Familial intestinal malrotation and cleft lip and palate: A case report","authors":"Kamela Loo ,&nbsp;Krista Lai ,&nbsp;Vidhi Shah","doi":"10.1016/j.epsc.2025.103072","DOIUrl":"10.1016/j.epsc.2025.103072","url":null,"abstract":"<div><h3>Introduction</h3><div>The etiology of intestinal malrotation is unknown and it can occur in isolation or with other congenital anomalies. Although case reports have reported genetic etiologies of intestinal malrotation, association with cleft lip and palate is rare.</div></div><div><h3>Case presentation</h3><div>A 37 1/7-week male infant was born via C-section with a birth weight of 3270g and a prenatal diagnosis of cleft lip and palate. His Apgar scores at 1 and 5 minutes were 7 and 8, respectively, and he briefly required continuous positive airway pressure in the delivery room before weaning to room air. The infant was admitted to the neonatal intensive care unit for hypoglycemia and poor feeding. On day of life twelve, he developed bloody stools, metabolic acidosis, and abdominal distention, which progressed to respiratory failure, coagulopathy, and hypovolemic shock. Abdominal x-rays demonstrated a stomach bubble with paucity of distal gas. An abdominal ultrasound demonstrated inversion of the superior mesenteric vein and artery, which was highly suggestive of an intestinal malrotation with midgut volvulus. The patient underwent an emergent Ladd procedure without bowel resection. He had an uneventful postoperative recovery, with progression to full enteral feedings. The patient's older half sibling also had cleft lip and palate, experienced recurrent vomiting, and was diagnosed with malrotation requiring an elective Ladd procedure.</div></div><div><h3>Conclusion</h3><div>This case study suggests that the association of cleft lip and palate and intestinal malrotation may have a genetic background. Newborns who have cleft lip and palate who have siblings with this association should undergo imaging studies to rule out intestinal malrotation.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103072"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739569","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":"Anomalous congenital band causing duodenal and transverse colon obstruction in a 3-year-old girl: A case report","authors":"Amnah Fallatah ,&nbsp;Muhammad Afzal ,&nbsp;Sania Alblushi ,&nbsp;Zeinab Alsulaiman ,&nbsp;Huda Hussain Abugrain ,&nbsp;Ahmed Tabash","doi":"10.1016/j.epsc.2025.103081","DOIUrl":"10.1016/j.epsc.2025.103081","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal obstruction is commonly seen in children and may result from various acquired or congenital causes. Obstruction due to an anomalous congenital band (ACB) is exceptionally rare. These bands can develop anywhere along the gastrointestinal tract and often pose a diagnostic challenge preoperatively.</div></div><div><h3>Case presentation</h3><div>A 3-year-old girl presented with chronic constipation, abdominal pain, and bilious vomiting. She was initially diagnosed and treated for conditions such as simple constipation, cystitis, enteritis, and gastritis, but showed no improvement. The radiological evaluation included abdominal radiography, ultrasound, dual-contrast computed tomography (CT), and a single-contrast enhanced image of the upper gastrointestinal tract (GIT). Surgical intervention was undertaken based on CT and upper GIT contrast imaging findings indicating an obstruction in the second part of the duodenum. Operative findings revealed an ACB arising from the root of the small intestinal mesentery, obstructing both the duodenum and the transverse colon. The band was divided, and a portion of it was sent for histopathological examination. The postoperative period was uneventful, her symptoms fully resolved, and she was discharged on the 6th postoperative day. At the 2-month follow-up, she remained asymptomatic. To our knowledge, no such case has previously been documented in the literature.</div></div><div><h3>Conclusion</h3><div>Anomalous congenital bands should be considered in the differential diagnosis of children presenting with intestinal obstruction in the absence of previous abdominal operations, particularly when preoperative imaging findings are inconclusive.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103081"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841170","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":"Incarcerated umbilical cord hernia: a case report","authors":"Mohammed Alra'e ,&nbsp;Maaweya Jabareen ,&nbsp;Wasef Alhroub ,&nbsp;Radwan Abukarsh","doi":"10.1016/j.epsc.2025.103107","DOIUrl":"10.1016/j.epsc.2025.103107","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital hernia of the umbilical cord (CHUC) is a rare developmental anomaly that results from the incomplete return of the midgut into the abdominal cavity during fetal development. It is often misdiagnosed as a small omphalocele and may be associated with serious gastrointestinal complications, although such occurrences are infrequently reported in the literature.</div></div><div><h3>Case presentation</h3><div>A 4-day-old male neonate was brought due to bilious emesis, abdominal distension, and failure to pass meconium since birth. The perinatal history was unremarkable, but detailed ultrasonography had not been performed. Postnatally, the patient had poor sucking and intolerance to breastfeeding. Initial examination revealed an incarcerated umbilical cord hernia. The abdomen was markedly distended with full flanks, shiny erythematous skin, and tenderness with guarding, raising suspicion for a bowel perforation and peritonitis. Reduction of the hernia was not attempted. Radiographic imaging revealed pneumoperitoneum. The patient was taken for an emergency exploratory laparotomy, which was done through a transverse supraumbilical (infraumbilical, please see the figure) incision. We found a congenital hernia of the umbilical cord (CHUC), a segment of ileum incarcerated in the CHUC that had a Meckel's diverticulum, was necrotic and had two sites of perforation. We resected the necrotic segment which was 24 cm long, and did a primary end-to-end anastomosis. Enteral feedings with formula were initiated on postoperative day 5 and fully tolerated by the postoperative day 10. The patient was discharged in stable condition on the 16th day of life.</div></div><div><h3>Conclusion</h3><div>Umbilical cord hernias are generally benign malformations but can occasionally become incarcerated, causing intestinal obstruction and even intestinal necrosis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103107"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059944","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":"Three-dimensional modelling and printing for preoperative planning in the resection of an ischiorectal epithelioid sarcoma: a case report","authors":"Rachel J. Livergant ,&nbsp;Trevor D. Hamilton ,&nbsp;Daniel G. Rosenbaum ,&nbsp;Sima Zakani ,&nbsp;John Jacob ,&nbsp;Shahrzad Joharifard","doi":"10.1016/j.epsc.2025.103079","DOIUrl":"10.1016/j.epsc.2025.103079","url":null,"abstract":"<div><h3>Introduction</h3><div>Epithelioid sarcomas are rare malignant mesenchymal tumours, accounting for approximately 3–4 % of pediatric soft-tissue sarcomas, and present unique surgical challenges due to their infiltrative nature and proximity to critical anatomical structures. While three-dimensional modelling has emerged as a valuable adjunct in preoperative planning for complex tumours, its use in pediatric soft-tissue sarcomas is rare, with no described cases involving epithelioid sarcomas.</div></div><div><h3>Case presentation</h3><div>A 13-year-old girl presented with a year-long history of perineal pain and a palpable mass. Imaging revealed a tumour involving the rectum and external sphincter, abutting the posterior vaginal wall. Biopsy confirmed epithelioid sarcoma and staging showed indeterminate pulmonary nodules. She underwent neoadjuvant chemoradiotherapy. Two surgical options were considered: abdominoperineal resection with hysterectomy or vaginal preservation with increased risk of residual disease. A three-dimensional model with 2cm margins was created to aid decision-making. After multidisciplinary review and model consultation, the patient opted for vaginal preservation. She underwent abdominoperineal resection with VRAM flap reconstruction. Final pathology confirmed negative margins. Nearly three years later, she developed a pancreatic tail metastasis and progressive pulmonary lesions, which were treated with distal pancreatectomy, splenectomy, radiotherapy, and cryoablation. Additional metastases in the stomach, scalp, retroperitoneum, and flank are being managed with palliative radiotherapy.</div></div><div><h3>Conclusion</h3><div>Three-dimensional printed models can be helpful in the preoperative planning for the resection of tumours of the ischiorectal region.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103079"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772350","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 megacalycosis managed with observation only: A case report","authors":"Kristy Alexandra Smith,&nbsp;Mohamed Sameh Shalaby","doi":"10.1016/j.epsc.2025.103082","DOIUrl":"10.1016/j.epsc.2025.103082","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital megacalycosis (CM) is one of the rarest congenital renal anomalies. It typically presents with significant calyceal dilatation resembling severe pelvi-ureteric junction obstruction (PUJO) in a kidney with an intra-renal pelvis. Normal drainage on mercaptoacetyltriglycine (MAG3) renogram confirms the CM diagnosis.</div></div><div><h3>Case presentation</h3><div>A male infant presented antenatally with significant unilateral calyceal dilatation and presumed diagnosis of severe PUJO. Growth scans at 32, 36 and 39 weeks showed an increasingly dilated renal pelvis with normal liquor volume. He was delivered at 39 weeks by emergency caesarean due to fetal distress. Postnatal ultrasound (USS) was consistent with the antenatal scans with an anteroposterior diameter (APD) of 21mm but a MAG3 showed normal drainage and equal split function, confirming the diagnosis of megacalycosis rather than classic PUJO. The patient therefore avoided surgery and has been managed with active observation with 3 monthly USS. Repeat USS at 15 months shows improvement in dilatation (APD 13mm), and no deterioration of drainage or drop of function on repeat MAG3 at 12 months.</div></div><div><h3>Conclusion</h3><div>Congenital megacalycosis should be ruled out with MAG3 in children with suspected pelviureteric junction obstruction as the two conditions may have a similar USS appearance but have a significantly different management strategy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103082"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908765","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}