Journal of Pediatric Surgery Case Reports最新文献

{"title":"Hand-made silo for the management of gastroschisis in a limited-resource setting: a case series","authors":"Shweta Patil,&nbsp;Nahil Najeeb,&nbsp;Shreyas Dudhani,&nbsp;Amit Kumar Sinha,&nbsp;Rashi,&nbsp;Digamber Chaubey","doi":"10.1016/j.epsc.2025.103005","DOIUrl":"10.1016/j.epsc.2025.103005","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastroschisis is a rare congenital abdominal wall defect whose management in resource-limited settings poses significant challenges of hypothermia, severe fluid loss resulting in shock, infections, intestinal necrosis, and intestinal obstruction. Commercially available preformed silo bags are often unaffordable and/or inaccessible.</div></div><div><h3>Case presentations</h3><div>We used self-made silo bags in four patients with gastroschisis. Case 1 was a 39-week male with a 4-cm defect, who achieved complete reduction of the eviscerated bowel by day of life 6, followed by successful abdominal closure. The silo became dislodged once during the reduction process, but it was replaced easily. His growth continues to be appropriate at six months of follow-up. Case 2 was a 40-week male with a 4 cm defect, who achieved full reduction of the eviscerated bowel by day of life 7. He continues to grow well at 2 months of follow up. Case 3 was a 38-week female with a large (9 cm) defect and extensive herniation, who had suffered hypothermia and fluid loss before arrival. the hand-made silo was placed without difficulties. Before the herniated bowel could be completely reduced, the family left against medical advice and the patient was lost to follow up<strong>.</strong> Case 4 was a 40-week male with a 5 cm defect. Like the previous patient, before the herniated bowel could be completely reduced, the family left against medical advice, and he was lost to follow up.</div></div><div><h3>Conclusion</h3><div>In resource-limited environments, self-made silo bags offer a practical and cost-effective solution for managing gastroschisis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103005"},"PeriodicalIF":0.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800533","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}

{"title":"Embryonal biliary rhabdomyosarcoma in a 4-year-old female: a case report","authors":"Abdullah Nofal ,&nbsp;Somaya Al Kiswani ,&nbsp;Zaid Sawaftah ,&nbsp;Nader Sarhan ,&nbsp;Ali Bani Odah ,&nbsp;Humam Emad Rajha","doi":"10.1016/j.epsc.2025.103007","DOIUrl":"10.1016/j.epsc.2025.103007","url":null,"abstract":"<div><h3>Introduction</h3><div>Embryonal biliary rhabdomyosarcoma (EBRMS) is an exceptionally rare pediatric malignancy originating from the biliary tract. Due to its nonspecific presentation—jaundice, abdominal pain, and biliary obstruction—it often shares the clinical picture with more common hepatobiliary disorders such as hepatoblastoma or choledochal cysts, leading to diagnostic delays.</div></div><div><h3>Case presentation</h3><div>A previously healthy 4-year-old girl presented with progressive jaundice, pale stools, and dark urine, initially diagnosed as amebiasis. The persistence of symptoms led to further evaluation, revealing hepatomegaly and a porta hepatis mass. Laboratory findings indicated obstructive jaundice with markedly elevated bilirubin and liver enzyme levels. Imaging included contrast-enhanced CT, which revealed a hypodense, poorly enhancing mass occupying the porta hepatis, encasing key vessels such as the main portal veins, celiac trunk, and hepatic arteries, and leading to intrahepatic biliary dilation. Multiple enlarged lymph nodes were also observed. Porta hepatic core needle biopsy and histopathological analysis confirmed EBRMS, immunohistochemically positive for desmin and myogenin. Given the severity of biliary obstruction, percutaneous biliary drainage was performed before initiating chemotherapy. The patient received 11 cycles of a modified VAC regimen (vincristine, actinomycin D, and cyclophosphamide), with initial dose adjustments made due to her unstable clinical status, including omission of vincristine, a 25 % reduction in actinomycin D, and a 50 % reduction in cyclophosphamide. Full-dose chemotherapy was resumed after her condition stabilized. She also underwent intensity-modulated radiotherapy (41.4 Gy). She achieved complete tumor regression, normalization of liver function, and long-term remission. Follow-up CT after two years showed stable residual soft tissue thickening at the porta hepatis, with no signs of recurrent or progressive disease.</div></div><div><h3>Conclusion</h3><div>Despite its rarity, EBRMS and other biliary tree tumors should be considered in the differential diagnosis of children presenting with cholestasis. Early imaging studies, such as ultrasound, are critical to avoid diagnostic delays and ensure timely intervention.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103007"},"PeriodicalIF":0.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800126","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}

{"title":"Delayed presentation of iatrogenic esophageal perforation in children: A case series","authors":"Nangue Ngansob Loïs Landry ,&nbsp;Meera Luthra ,&nbsp;Aniruddh Setya","doi":"10.1016/j.epsc.2025.103006","DOIUrl":"10.1016/j.epsc.2025.103006","url":null,"abstract":"<div><h3>Introduction</h3><div>Esophageal perforation is a rare condition in children. It can be fatal and its mortality increases if the diagnosis is delayed.</div></div><div><h3>Cases presentation</h3><div>We report three pediatric cases of delayed presentation of esophageal perforation, all linked to an iatrogenic cause. Case 1 was a 3-year-old female child who had tachycardia, tachypnea and subcutaneous emphysema two days following a diagnostic endoscopy. She underwent an esophagram that showed a major leak in the mid esophagus. We placed a chest tube and did a surgical jejunostomy for enteral feedings. The perforation healed completely and spontaneously by day 23 of admission, as confirmed by a contrast study. Case 2 was an 11-year-old boy who had chest pain, dyspnea, fever, mild abdominal tenderness, and subcutaneous emphysema three days after undergoing an unsuccessful endoscopy to retrieve swallowed foreign bodies (2 coins). A barium swallow revealed a major leak in the lower third of the esophagus and plain chest fluoroscopy showed the coins in the pleural space. We did a thoracotomy, pleural wash-out, retrieval of the foreign bodies, and left a chest tube in place. The patient required an exploratory laparotomy and repair of a duodenal perforation of unknown etiology. At that time, we also did a gastrostomy and a jejunostomy. The perforation healed spontaneously, with a tiny leak remaining by day 50. Case 3 was a 4-year-old boy who developed a perforation of the lower third of the esophagus following an endoscopic balloon dilatation of an esophageal stricture. We placed a chest tube and did a gastrostomy and a feeding jejunostomy. The esophageal perforation had closed spontaneously by day 55. The three patients survived and still have their native esophagus.</div></div><div><h3>Conclusion</h3><div>Esophageal perforations that present beyond the first 24 hours may be managed with conservative measurements, without a surgical esophageal repair.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103006"},"PeriodicalIF":0.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800529","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}

{"title":"Gastric inflammatory myofibroblastic tumor in an infant with melena: A case report","authors":"Frederikke Bondo ,&nbsp;Sönke Detlefsen ,&nbsp;Niels Bjørn","doi":"10.1016/j.epsc.2025.103000","DOIUrl":"10.1016/j.epsc.2025.103000","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammatory myofibroblastic tumor (IMT) of the gastrointestinal tract is exceedingly rare in the pediatric population and typically clinically silent.</div></div><div><h3>Case presentation</h3><div>A previously healthy 12-month-old girl presented with melena and pallor, along with severe anemia (hemoglobin 2.7 g/dL). She was stabilized with transfusions. An initial abdominal ultrasound suggested a Meckel's diverticulum, but the exploratory laparotomy ruled this diagnosis out. Intraoperative gastroscopy revealed a gastric mass in the lesser curvature and biopsies were taken. Microscopy showed granulation tissue and nonspecific inflammation. A postoperative full-body CT-scan confirmed a 2.5- cm gastric mass. She underwent a second gastroscopy with additional biopsies, this time including deeper levels of the gastric mass. Histopathologic and immunohistochemical analysis provided the diagnosis of IMT. The infant underwent a second laparotomy and the tumor was removed through an anterior gastric incision. The tumor was resected. For technical reasons, the margins could not be assessed conclusively. She recovered well from the operation and was discharged on iron supplementation. Follow-up imaging and gastroscopy at three, six, and nine months showed no recurrence of the IMT.</div></div><div><h3>Conclusion</h3><div>IMT of the stomach is rare in infants but should be included in the differential diagnosis of gastrointestinal bleeding.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103000"},"PeriodicalIF":0.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800532","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}

{"title":"Pelvic inflammatory myofibroblastic tumor in a patient with Wilson's disease and KBG syndrome: A case report","authors":"Vincenzo Bagnara ,&nbsp;Gaetano Magro ,&nbsp;Agata Massimino ,&nbsp;Salvatore Arena ,&nbsp;Gabriela Vallejo Chamorro ,&nbsp;Fabiola Cassaro","doi":"10.1016/j.epsc.2025.103002","DOIUrl":"10.1016/j.epsc.2025.103002","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal ultrasound (US) is frequently used in patients with Wilson disease (WD) to identify possible renal and hepatic involvement. KBG syndrome (KBGs) is a rare condition characterized by skeletal abnormalities and intellectual disability, which usually has no abdominal manifestations.</div></div><div><h3>Case presentation</h3><div>A 12-year-old girl, affected by WD and KBGs, was referred to us due to a 51 × 34 mm cystic mass on the left ovary seen by abdominal US, initially interpreted as a left ovarian cyst. She underwent monthly follow-up US that showed a progressive increase in the size of the cyst. By the fourth month, the features had changed to a complex formation of the left ovary. Tumor markers, including CA125, AFP and BHCG, among others) were within normal limits. The patient was taken electively to the operating room for a laparoscopic resection of the suspected complex ovarian lesion. Intraoperatively we found a solid mass that connected on one side to the left parametrium and on the other side to a jejunal loop through what appeared to be a pseudo mesentery. The left ovary only had a simple cyst of approximately 3 cm in diameter. The right ovary and both Fallopian tubes were normal. We detached the mass from both connections using surgical staplers. She recovered well from the operation and was discharged home on the seventh postoperative day. The pathology analysis was consistent with an inflammatory myofibroblastic pseudotumor, and the margins were free of disease. At one year of follow-up with US and magnetic resonance imaging she has had no signs of recurrence.</div></div><div><h3>Conclusion</h3><div>The preoperative evaluation of adnexal and pelvic masses in syndromic females should include cross-sectional imaging, as ultrasound may not provide sufficient anatomical detail.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103002"},"PeriodicalIF":0.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785542","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}

{"title":"Refractory hypoglycemia as the presenting sign of Wilms tumor in a child: A case report","authors":"Shelley Warner ,&nbsp;Ruchi Amin","doi":"10.1016/j.epsc.2025.103003","DOIUrl":"10.1016/j.epsc.2025.103003","url":null,"abstract":"<div><h3>Introduction</h3><div>Wilms tumor, or nephroblastoma, most commonly presents in children as an asymptomatic abdominal mass and less commonly as hematuria or hypertension. Symptomatic hypoglycemia associated with Wilms tumor is rare and has only been reported in one previous case, even though insulin-like growth factor-2 (IGF-2) overexpression is the most common genetic alteration in this tumor.</div></div><div><h3>Case presentation</h3><div>A 4-year-old male was brought to the Emergency Department after multiple episodes of unresponsiveness and self-limited seizure activity. On arrival his blood glucose was 25 mg/dL. He was treated with glucagon, a dextrose 10 % (D10) bolus and placed on D10 maintenance fluid. Despite these measures his glucose continued to drop. During his hypoglycemia treatment, he underwent an abdominal ultrasound which showed a large right renal mass. A subsequent computerized tomography (CT) of the abdomen and pelvis showed a 13.9 x 10.4 × 13.0 cm multilobulated right renal mass. Due to the suspicion that the tumor could be the cause of the refractory hypoglycemia, he was taken to the operating room the following day and underwent an uneventful right radical nephrectomy with regional lymphadenectomy. Immediately after the operation his blood glucose increased to 232 mg/dL, and it remained between 90 and 117 mg/dL throughout his recovery. He did well post operatively and was discharged home on postoperative day 6. The pathology was consistent with a 1026-g Wilms tumor with gain of 1q, loss of 2q36 and 9q, but no abnormalities detected in chromosome 11. He subsequently underwent chemotherapy with vincristine, dactinomycin and doxorubicin for 24 weeks, along with 6 cycles of radiation for Stage III disease. He was lost to follow up before the last schedule chemotherapy dose. He returned to the hospital with abdominal pain a few months later. Multiple metastases were found in the spleen, liver and peritoneum. He is currently undergoing further chemotherapy, but his hypoglycemia remains resolved.</div></div><div><h3>Conclusion</h3><div>Children with unexplained persistent hypoglycemia should be screened for abdominal tumors. Although rarely reported, tumors that are related to over-secretion of IGF-2 can cause refractory hypoglycemia and must be promptly resected.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103003"},"PeriodicalIF":0.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790901","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}

{"title":"Anti-NMDA receptor encephalitis secondary to a mature cystic teratoma in a female teenager: A case report","authors":"John Spencer Laue ,&nbsp;Sarika Mullapudi ,&nbsp;Thomas J. Lee ,&nbsp;James Gilbert","doi":"10.1016/j.epsc.2025.103001","DOIUrl":"10.1016/j.epsc.2025.103001","url":null,"abstract":"<div><h3>Introduction</h3><div>Paraneoplastic encephalitis can occur due to a variety of tumors, the majority of which are rare in the pediatric population.</div></div><div><h3>Case presentation</h3><div>A 15-year-old female patient presented to the emergency department (ED) with altered mental status and four days of unresponsiveness after periods of agitation. Her symptoms of erratic behavior, anger, confusion, difficulty speaking, and visual hallucinations were initially thought to be due to a psychotic episode potentially from a contaminated cannabis vape product. Repeatedly altered neurological workups in the pediatric intensive care unit (PICU) alongside her worsening agitation and lack of resolution that would fit the time frame, cleared these concerns. Additionally, she had symptoms of dysautonomia with oscillating tachycardia and hypertension. These findings prompted an extensive work-up including the Mayo Pediatric Autoimmune Central Nervous System Disorders Panel from CSF (PCDEC). A computed tomography (CT) scan of the chest, abdomen, pelvis was ordered on the 3rd day of hospitalization due to concerns for a paraneoplastic encephalitis. The CT showed a 3.3cm × 3.7cm x 3.9cm left adnexal mass. She was promptly taken to the operating room for a resection of the mass. A laparoscopic total oophorectomy was done without any difficulties. The pathology report was consistent with a mature cystic teratoma. Laboratory results received 10 days later confirmed the diagnosis of anti-NMDA antibody encephalitis. In addition to the operation the patient received high-dose steroids, intravenous immunoglobulin (IVIG), and plasmapheresis. She was ultimately discharged home after 38 days of hospitalization.</div></div><div><h3>Conclusion</h3><div>Ovarian teratomas have the potential to trigger paraneoplastic encephalitis. In patients with suspected paraneoplastic encephalitis who are diagnosed with an ovarian tumor, prompt tumor resection should be performed.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103001"},"PeriodicalIF":0.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785541","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}

{"title":"Portal vein reconstruction using bovine pericardium graft after traumatic injury in a 6-year-old male: A case report","authors":"Ahsan Ali Ghauri,&nbsp;Zubair Shoukat,&nbsp;Faiz Rasool,&nbsp;Imran Hashim,&nbsp;Muhammad Saleem","doi":"10.1016/j.epsc.2025.102997","DOIUrl":"10.1016/j.epsc.2025.102997","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic portal vein injury (PVI) is a rare but life-threatening condition with a high mortality rate. Despite advancements in surgical techniques, the management of complex portal vein injuries remains challenging.</div></div><div><h3>Case presentation</h3><div>A 6-year-old male presented with abdominal trauma after being hit by a motor rickshaw. Despite inconclusive initial diagnostic imaging including a bedside abdominal ultrasound showing minimal ascites, the deterioration of all clinical parameters prompted an exploratory laparotomy. Intra-operative exploration revealed a transected portal vein with significant tissue loss and an avulsed common bile duct. Portal vein reconstruction was done using commercially available bovine pericardium, which was tubularized and grafted proximally and distally with polypropylene 6–0. Intra-operative Doppler ultrasound confirmed the successful restoration of portal venous flow. Additionally, we closed the common bile duct and did a cholecysto-duodenostomy to restore bile flow. Postoperative anticoagulation therapy included unfractionated heparin (10U/kg/hour) for 72 hours followed by aspirin (75mg daily) for six months, frequently monitoring the patency of the graft by Doppler ultrasound. He had a brief cardiac arrest 3 days after the operation due to ventilator-associated complications and suffered an ischemic brain injury that led to sensorimotor deficits. After an initial recovery in the intensive care unit, he was transferred to a rehabilitation unit and was discharged on postoperative day 19. At six-month of follow-up, Doppler ultrasound have confirmed graft patency. Liver function tests remain normal.</div></div><div><h3>Conclusion</h3><div>Bovine pericardium grafts appear to be a valuable option for the management of complex portal vein injuries.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102997"},"PeriodicalIF":0.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784061","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}

{"title":"Midgut volvulus in a child with left isomerism: A case report","authors":"Amir Abadi ,&nbsp;Abdoh Numan Abdallah ,&nbsp;Noura Khalil Abu-Baji ,&nbsp;Tawfeeq Ali Al-Shobaki ,&nbsp;Kamal Jamil Abed ,&nbsp;Marwan Joma","doi":"10.1016/j.epsc.2025.102999","DOIUrl":"10.1016/j.epsc.2025.102999","url":null,"abstract":"<div><h3>Introduction</h3><div>Left isomerism, also known as polysplenia syndrome, is a rare condition characterized by abnormal lateralization of organs during embryonic development. It is associated with multiple anatomical abnormalities, including mirror image arrangement of thoracic and abdominal organs, disrupted vascular patterns, and increased susceptibility to cardiac and extra-cardiac anomalies.</div></div><div><h3>Case presentation</h3><div>An 8-year-old previously healthy girl presented to the emergency department with recurrent vomiting and general fatigue. Two days prior, she fell while playing and sustained a direct abdominal impact upon hitting the ground. Following the injury, she developed diffuse abdominal pain and frequent episodes of non-bloody, non-bilious vomiting. Over the next 48 hours, her vomiting became progressively projectile and green. She visited a pediatric clinic twice, where she received intravenous fluids and antiemetics, with only minimal symptomatic improvement. On arrival at the ED, she appeared dehydrated, with borderline blood pressure and persistent diffuse abdominal pain. There were no known chronic medical conditions and no family history of gastrointestinal disorders, On physical exam, patient was ill-appearing, fatigued, and mildly lethargic, with dry mucous membranes, and delayed capillary refill. On abdominal examination, there was diffuse tenderness, predominantly in the epigastric and periumbilical regions along with mild abdominal distension with guarding but no rebound tenderness and decreased bowel sounds. An ultrasound was done and was inadequate. A CT abdomen with contrast revealed a left isomerism along with midgut volvulus. Finally, an urgent exploratory laparotomy was done with an uneventful recovery.</div></div><div><h3>Conclusion</h3><div>Although rare, midgut volvulus should be ruled out in patients with left isomerism who develop abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102999"},"PeriodicalIF":0.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826320","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 repositioning of a malpositioned peritoneal dialysis catheter using an abdominal wall anchoring technique: A case report","authors":"Naoki Hashizume ,&nbsp;Hiroki Yoshida ,&nbsp;Shiori Tsuruhisa ,&nbsp;Naruki Higashidate ,&nbsp;Seiji Tanaka ,&nbsp;Tatsuru Kaji","doi":"10.1016/j.epsc.2025.102998","DOIUrl":"10.1016/j.epsc.2025.102998","url":null,"abstract":"<div><h3>Introduction</h3><div>Peritoneal dialysis (PD) catheters can sometimes change their position spontaneously and become dysfunctional, typically requiring a complete replacement.</div></div><div><h3>Case presentation</h3><div>A 6-year-old boy with Wolf–Hirschhorn syndrome and chronic kidney disease had a PD catheter placed laparoscopically via a left pararectal incision, with the catheter tip positioned in the pouch of Douglas. On the 20th postoperative day, the PD catheter became dysfunctional. Evaluation by a plain abdominal film showed that the PD catheter had migrated spontaneously to the upper abdomen. Instead of replacing it, we decided to reposition the PD catheter and anchor it to the abdominal wall to prevent further migration. To do that, we placed two percutaneous stitches of non-reabsorbable material under laparoscopic guidance. To manipulate the catheter and place the stitches around it, we did a trans-umbilical laparoscopic approach with two ports through an ad-hoc device placed in the umbilicus. The percutaneous stitches went in and out the abdomen through the abdominal and anchored the PD catheter in such a way that the end was in the pouch of Douglas, unable to become dislodged again. The two stitches were spaced 10 mm apart from each other. The postoperative course was uneventful, and the PD catheter remained functional and in the correct position for 6 months until it was removed because it was no longer needed.</div></div><div><h3>Conclusion</h3><div>Malpositioned PD catheters may be repositioned and secured by anchoring them to the abdominal wall with transparietal stitches.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102998"},"PeriodicalIF":0.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747907","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}