Journal of Pediatric Surgery Case Reports最新文献

{"title":"Bilateral intralobar bronchopulmonary sequestration presenting as spontaneous hemopneumothorax: Case report","authors":"Mariel Magdits ,&nbsp;Kirk Jones ,&nbsp;Lan Vu","doi":"10.1016/j.epsc.2025.103057","DOIUrl":"10.1016/j.epsc.2025.103057","url":null,"abstract":"<div><h3>Introduction</h3><div>Bilateral intralobar bronchopulmonary sequestration (BPS) is an exceptionally rare congenital anomaly. While BPS can present with recurrent infections or chronic respiratory symptoms, hemothorax as an initial manifestation is uncommon and potentially life-threatening.</div></div><div><h3>Case presentation</h3><div>A 17-year-old male presented with acute left-sided chest pain and tachypnea. The initial chest X-ray revealed a left-sided pneumothorax. After transferring to a children's hospital for management, a follow-up radiograph was obtained, showing a new fluid collection in addition to the pneumothorax. A chest tube was placed, yielding 500 mL of bright red blood, confirming hemothorax. A chest CT angiogram identified active arterial bleeding from the left lung apex. Video-assisted thoracoscopic surgery (VATS) was performed, revealing 1.5 L of hemothorax and ongoing bleeding from a chest wall artery and a severed arterial stump at the lung apex, adjacent to apical blebs. The bleeding was controlled with cauterization and clipping, and a wedge resection of the left lung apex was performed. The chest CT scan demonstrated additional cysts in the apex of the right lung. A month later, elective right-sided VATS, apical wedge resection, and pleurodesis were performed. Intraoperative findings included a systemic feeding artery along with associated cysts at the right lung apex, similar to the left side. The procedures were well-tolerated, and the patient recovered without complications. Final pathology made the diagnosis of bilateral intralobar BPS with complete resection of the lesions.</div></div><div><h3>Conclusion</h3><div>When spontaneous pneumothorax is complicated by hemothorax, underlying congenital anomalies such as intralobar BPS should be considered.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103057"},"PeriodicalIF":0.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633544","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":"Thoracic heteropagus conjoined twins with associated omphalocele: a case report","authors":"Mahamoud Omid Ali Ada ,&nbsp;Mansour Issoufou Hama Sidi ,&nbsp;Hellé Moustapha ,&nbsp;Issoufou Yaro ,&nbsp;Oumarou Habou ,&nbsp;Habibou Abarchi","doi":"10.1016/j.epsc.2025.103055","DOIUrl":"10.1016/j.epsc.2025.103055","url":null,"abstract":"<div><h3>Introduction</h3><div>Heteropagus conjoined twins represent an exceptionally rare congenital malformation. A thoracic attachment is even more uncommon. The concurrent presence of omphalocele further complicates management, particularly in resource-limited settings.</div></div><div><h3>Case presentation</h3><div>A 7-day-old female neonate was admitted following a full-term pregnancy and normal vaginal delivery due to a mass in the lower thoracic region, attached to the sternum, with two pelvic limbs and one thoracic limb joined by a pelvis, resembling a parasitic twin. The parasitic twin presented a perineum with female-type external genitalia but no anal orifice. Additionally, a type 2 omphalocele (Aitken classification) with a maximum diameter of 9 cm was observed in the patient's abdomen. Thoraco-abdomino-pelvic computed tomography (CT) imaging revealed osseous segments of limbs within the anterior thoracic mass, alongside herniation of part of the liver through the abdominal wall defect. Echocardiography revealed multiple ventricular septal defects. The diagnosis of a thoracopagus parasitic twin was established. Surgical excision of the parasitic twin was performed at the age of 20 days. A circular incision above the pedunculated base exposed the parasitic pelvis, which contained a rudimentary kidney, dilated ureter, and distended bladder. We did a complete excision included the pelvis, lower limbs, rudimentary upper limb, and osseous components, and finished with a tension-free skin closure. The postoperative recovery was complicated by a minor superficial wound infection, which resolved with antibiotics. We decided to treat the omphalocele conservatively with daily dressing changes to promote skin coverage. We plan to close the omphalocele at the age of 18 months.</div></div><div><h3>Conclusion</h3><div>The management of heteropagus twins requires comprehensive imaging evaluation. In resource-limited settings, patients with a combination of malformations may benefit from a staged treatment strategy to optimize outcomes.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103055"},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605839","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":"Midgut volvulus without intestinal malrotation in a teenager: a case report","authors":"Yasmine Houas,&nbsp;Alma Baccouche,&nbsp;Nader Bennour Ghaddab,&nbsp;Sirine Fkaier,&nbsp;Riadh Jouini","doi":"10.1016/j.epsc.2025.103056","DOIUrl":"10.1016/j.epsc.2025.103056","url":null,"abstract":"<div><h3>Introduction</h3><div>Midgut volvulus is a life-threatening surgical emergency typically associated with intestinal malrotation in neonates and infants. However, midgut volvulus without malrotation is rare and often underrecognized, particularly in older children, leading to delays in diagnosis and management.</div></div><div><h3>Case presentation</h3><div>We present the case of a previously healthy 13-year-old male with a one-week history of intermittent, crampy abdominal pain and bilious vomiting. He was initially diagnosed with viral gastroenteritis and treated symptomatically, but symptoms persisted and worsened. On admission, he was afebrile but had a distended, tender abdomen without signs of peritonitis. Abdominal X-rays were inconclusive, showing nonspecific bowel gas patterns. An abdominal ultrasound showed no definitive abnormalities. Due to ongoing symptoms, a contrast-enhanced abdominal computed tomography (CT) scan was performed, revealing a classic “whirlpool sign” of the superior mesenteric vessels and proximal bowel dilation. The patient underwent emergency exploratory laparotomy. Intraoperatively, a 360° midgut volvulus was found, caused by congenital mesenteric adhesions. The bowel appeared viable. Detorsion and complete adhesiolysis were performed without the need for resection. The postoperative course was uneventful: oral feeding was reinitiated on postoperative day 2, and the patient was discharged on postoperative day 6. At three-month follow-up, he remained asymptomatic with no signs of recurrence.</div></div><div><h3>Conclusion</h3><div>Midgut volvulus must be included in the differential diagnosis of teenagers who develop abdominal pain and/or bilious emesis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103056"},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605838","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":"Umbilical heterotopic pancreas in an infant: a case report","authors":"Abdulkarim Hasan ,&nbsp;Basheer Abdullahi Jabo ,&nbsp;Zakaria Elaskary ,&nbsp;Khaldon Abdulrahman Alaghbari ,&nbsp;Mohamed Abbas Ibrahim ,&nbsp;Khalid Nafie","doi":"10.1016/j.epsc.2025.103053","DOIUrl":"10.1016/j.epsc.2025.103053","url":null,"abstract":"<div><h3>Introduction</h3><div>Heterotopic pancreas is a rare congenital anomaly in which pancreatic tissue is located outside its normal anatomical position without any ductal or vascular connection to the main pancreas. Umbilical heterotopic pancreas is extremely uncommon.</div></div><div><h3>Case presentation</h3><div>A 5-month-old male was brought to our clinic due to persistent clear umbilical discharge since birth. He was born at term following an uneventful pregnancy and delivery, with no antenatal or perinatal complications. Physical examination revealed a mildly erythematous umbilicus with serous discharge but no signs of infection or systemic illness. The initial diagnosis was umbilical granuloma. Due to persistent symptoms, we took the patient to the operating room for a surgical excision. Intraoperatively, a small firm nodule was identified beneath the umbilical skin. The lesion was well-circumscribed but inseparable from the overlying umbilical tissue. There was no communication with intra-abdominal viscera. Complete excision of the umbilicus and the subcutaneous lesion was performed, followed by umbilicoplasty. Histopathological analysis revealed ectopic pancreatic tissue composed of acini, ducts, and islets of Langerhans, confirming the diagnosis of umbilical heterotopic pancreas. The patient recovered uneventfully and was discharged home on the second postoperative day. At four-weeks of follow-up, the surgical site was well healed, with no recurrence or discharge.</div></div><div><h3>Conclusion</h3><div>Although rare, umbilical heterotopic pancreas should be included in the differential diagnosis of infants who present umbilical discharge.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103053"},"PeriodicalIF":0.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614012","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":"Gastroduodenal intussusception due to hypertrophic pyloric stenosis in a newborn: a case report","authors":"Bonny-Obro Rebecca,&nbsp;Aké Yapi Landry,&nbsp;Midekor-Gonebo Kokoé,&nbsp;Kouassi-Dria Amenan Kan,&nbsp;Ouattara Jean Jaures,&nbsp;Moh Ello Nicolas","doi":"10.1016/j.epsc.2025.103051","DOIUrl":"10.1016/j.epsc.2025.103051","url":null,"abstract":"<div><h3>Introduction</h3><div>Intussusception is the most common cause of intestinal obstruction in infants but is an extremely rare condition in neonates. Intussusception may occur at any site in the gastrointestinal tract. Gastroduodenal intussusception is an unusual type of intussusception.</div></div><div><h3>Case report</h3><div>An 18-day-old male neonate was referred to us due to postprandial non-bilious vomiting that began on day of life 5. He had no history of diarrhea, constipation, or fever. He was in poor general condition and had signs of dehydration. The abdomen was soft, non-tender, had no guarding and no palpable masses. Meconium-like stool was present in the diaper. Laboratory tests revealed moderate anemia and abnormal coagulation. The abdominal x-ray showed a lack of air in the gastrointestinal tract. We did an abdominal computerized tomography (CT) scan that showed a gastroduodenal intussusception. We took the patient to the operating room for an exploratory laparotomy. We found a gastroduodenal intussusception with a hypertrophic pylorus, a jejuno-jejunal intussusception, and an ileo-ileal intussusceptions. We reduced all the intussusceptions manually and did an extramucosal pyloromyotomy. The postoperative recovery was uneventful, and the patient was discharged on postoperative day 10. He is thriving well at five months of follow up.</div></div><div><h3>Conclusion</h3><div>Gastroduodenal intussusception should be included in the differential diagnosis of newborns and young infants with gastric outlet obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103051"},"PeriodicalIF":0.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535892","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":"Pentaphalia: a case report","authors":"Eden Belay Tilahun ,&nbsp;Wondimagegn Gizaw woldesenbet ,&nbsp;Kibrom Legesse Abrha ,&nbsp;Abraham Sisay Abie","doi":"10.1016/j.epsc.2025.103050","DOIUrl":"10.1016/j.epsc.2025.103050","url":null,"abstract":"<div><h3>Introduction</h3><div>Supernumerary penis is an exceedingly rare congenital malformation, with an incidence of approximately 1 in 5–6 million births. It is usually associated with other congenital anomalies.</div></div><div><h3>Case presentation</h3><div>A male infant was noted to have abnormal genital at birth, in the for of five penises. Physical examination revealed five distinct penile-like structures of varying sizes. Three of them exhibited a normal glans penis, while the other two were underdeveloped. All structures were covered by preputial skin. Only one of them had a normally located and functional urethra, while the others had blind ending pits at their ends. There was additionally a soft tissue mass in the perineum next to the scrotum, and right testis was undescended and palpable in the inguinal are. Ultrasound and computerized tomography scan (CT) studies showed a cystic abdominal mass, which eventually was confirmed to be a colonic duplication, right renal agenesis, and a lumbosacral spina bifida occulta. The patient was taken to the operating room at the age of 8 months for a perineal reconstruction. All the non-functioning penises were excised, and a urethral catheter was left in the urethra of the functioning penis. Additionally, he underwent resection of the colonic duplication and a right orchiopexy. He was discharged on the third postoperative day. The urethral catheter was removed seven days after the operation. At nine months of follow up he has not had urinary infections or signs of a urethral stricture. All wounds have healed well.</div></div><div><h3>Conclusion</h3><div>Patients with supernumerary penises should be thoroughly evaluated for additional congenital anomalies. Ideally, a complete evaluation of the urinary system should be done prior to attempting a definitive reconstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103050"},"PeriodicalIF":0.2,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523825","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":"Bowel obstruction following pediatric blunt abdominal trauma: A case series","authors":"Alya Barq,&nbsp;Whitman Wiggins,&nbsp;Heather Liebe,&nbsp;Janice A. Taylor,&nbsp;Shawn D. Larson,&nbsp;Steven L. Raymond","doi":"10.1016/j.epsc.2025.103048","DOIUrl":"10.1016/j.epsc.2025.103048","url":null,"abstract":"<div><h3>Introduction</h3><div>Blunt abdominal trauma is a rare cause of intestinal obstruction. Only case reports and small case series have been described in the literature.</div></div><div><h3>Case presentations</h3><div><strong>Case 1:</strong> a 10-year-old female was admitted after a high-speed motor vehicle collision (MVC). She had a seatbelt sign and a grade I splenic laceration. She was discharged one day after the admission. She returned with abdominal pain and nausea twelve days post-trauma and was diagnosed with a small bowel obstruction. She improved spontaneously and was discharged two days later. Two days after the second discharge she presented again with abdominal pain and was taken to the operating room for an exploratory laparoscopy. We found two areas of jejunal narrowing secondary to omental bands. The involved bowel was resected, followed by a primary anastomosis. She recovered uneventfully.</div><div><strong>Case 2:</strong> a 7-year-old male presented after a high-speed MVC. He had a seatbelt sign. A computerized tomography (CT) scan showed mesenteric stranding with small volume pelvic fluid. He was discharged after a four-day hospital stay. He returned forty-two days later with abdominal pain and emesis. A CT scan of the abdomen showed a transition point at the mid-descending colon. He underwent colonic resection of his mid-descending colon due to a stricture. He recovered well post-operatively.</div><div><strong>Case 3:</strong> a 9-year-old male presented to an outside institution following a rear-end high-speed collision. He was discharged shortly after the admission. He returned ten days post-trauma with signs of intestinal obstruction. Abdominal CT showed pelvic fluid and some distended loops of bowel. He was taken to the operating room. We found a stricture in the jejunum. We resected the affected bowel and did an end-to-end anastomosis. He had an uneventful recovery and was discharged on post-operative day three.</div></div><div><h3>Conclusion</h3><div>Blunt abdominal trauma in children can result in intestinal strictures or adhesive bands leading to delayed bowel obstruction. This diagnosis should be considered in children with a recent history of abdominal trauma who develop acute abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103048"},"PeriodicalIF":0.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523880","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":"Intraperitoneal metastases from cutaneous melanoma in a 2-year-old girl: A case report","authors":"García-Ledezma Arnold ,&nbsp;Tirado-Camarena Salvador ,&nbsp;Izabal-Tinajero Neivy Marely ,&nbsp;Román-Matus Alexis ,&nbsp;García-Calderón Cesar Iván ,&nbsp;Torres-Salazar Quitzia Libertad","doi":"10.1016/j.epsc.2025.103049","DOIUrl":"10.1016/j.epsc.2025.103049","url":null,"abstract":"<div><h3>Introduction</h3><div>Cutaneous melanoma represents less than 1 % of all pediatric malignancies, with an incidence of 4.9 cases per million in children aged 0–4 years. Intraperitoneal metastasis is exceptionally rare in this population.</div></div><div><h3>Case presentation</h3><div>A 2-year-old female with a history of congenital hydrocephalus and a large congenital melanocytic nevus (CMN) over the lower back and buttocks developed oral intolerance, abdominal distension, and acute abdominal pain. The initial workup raised suspicion of ventriculoperitoneal (VP) shunt malfunction. Abdominal ultrasound and abdominal computerized tomography (CT) revealed free peritoneal fluid; no adnexal mass was identified preoperatively. She underwent an exploratory laparotomy during which we found an 8 × 7 × 7-cm right adnexal mass involving the right ovary, right fallopian tube, the omentum, and additionally there were multiple peritoneal nodules. Right salpingo-oophorectomy, omentectomy, and biopsy of peritoneal implants were performed. Histopathology confirmed a malignant small blue cell tumor positive for S100, HMB-45, and Melan-A, consistent with melanoma. No extracutaneous primary lesion was found. The final diagnosis was CMN-associated melanoma with intraperitoneal metastasis, stage IV. The patient recovered uneventfully, initiated systemic treatment, and remains under multidisciplinary follow-up.</div></div><div><h3>Conclusion</h3><div>Intraperitoneal metastasis must be ruled out in patients with congenital melanocytic nevus who develop abdominal pain, distension, or feeding intolerance.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103049"},"PeriodicalIF":0.2,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517229","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":"Conservative management of sharp metallic foreign body ingestion in a toddler in a low-resource setting: a case report","authors":"Hassan Elmi Moumin ,&nbsp;Abdirashid Hasan Kahin ,&nbsp;Roukia Mahamad Nour ,&nbsp;Mohamoud Hashi Abdi ,&nbsp;Abdirahman Omer Ali","doi":"10.1016/j.epsc.2025.103047","DOIUrl":"10.1016/j.epsc.2025.103047","url":null,"abstract":"<div><h3>Introduction</h3><div>Foreign body ingestion is common in children. Swallowing sharp metallic objects such as screws poses a high risk of intestinal perforation. Standard management requires urgent endoscopic removal, which may not be readily available everywhere.</div></div><div><h3>Case presentation</h3><div>A 1-year-old male presented 2 h after ingesting a metallic screw, experiencing vomiting but hemodynamically stable. Initial abdominal radiograph located the screw in the proximal small bowel. Due to the unavailability of pediatric endoscopy, the child was admitted for conservative management. He was given intravenous fluids and clear liquids by mouth. Additionally, he received oral lactulose. He underwent frequent serial abdominal exams and serial abdominal radiographs. The foreign body progressed daily, and two days after the admission it was seen in the ileocecal region by x-ray. On the third hospital day, the screw passed spontaneously in the stool without complications. He remained asymptomatic and tolerated his enteral feedings throughout the admission.</div></div><div><h3>Conclusion</h3><div>A trial of conservative management under strict clinical monitoring can be attempted in children who swallowed sharp foreign bodies and are asymptomatic, particularly in resource-limited settings where standard interventional options are inaccessible.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103047"},"PeriodicalIF":0.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472461","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":"Wandering spleen and intestinal malrotation in a 14-year-old female: a case report","authors":"Moustafi Amine ,&nbsp;Mrani Alaoui Nidal ,&nbsp;Zaoui Younes ,&nbsp;Cherkaoui Malki Mohamed ,&nbsp;Chat Latifa","doi":"10.1016/j.epsc.2025.103046","DOIUrl":"10.1016/j.epsc.2025.103046","url":null,"abstract":"<div><h3>Introduction</h3><div>Wandering spleen is an uncommon condition. It is often associated with congenital anomalies affecting the splenic ligaments and can result in complications such as splenic torsion and infarction.</div></div><div><h3>Case presentation</h3><div>A 14-year-old female presented with moderate epigastric pain accompanied by fever, non-bilious vomiting, abdominal distension, and absence of bowel movements for 48 hours. She was tachycardic, febrile, and exhibited diffuse abdominal tenderness with guarding. Laboratory investigations revealed leukocytosis and elevated inflammatory markers. Abdominal ultrasound showed a spleen located in the lower abdomen, with absent blood flow. Contrast-enhanced computerized tomography (CT) confirmed a torsed, infarcted spleen in an ectopic position, along with features suggestive of intestinal malrotation: abnormally positioned duodenojejunal junction and a narrow mesenteric root. The patient underwent emergency exploratory laparotomy. We found a twisted spleen with infarction, and intestinal malrotation without volvulus. We did a splenectomy and a Ladd procedure, including a prophylactic appendectomy. Her postoperative course was uneventful, and she was discharged in stable condition. Follow-up visits 6 and 12 months later revealed normal growth, absence of gastrointestinal symptoms, and no complications related to asplenia. One year later, however, she developed type 1 diabetes for unknown reasons.</div></div><div><h3>Conclusion</h3><div>Wandering spleen with splenic torsion should be consider in the differential diagnosis of children who present with acute abdominal pain. Intestinal malrotation should be ruled out in patients with wandering spleen, as both conditions can coexist.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103046"},"PeriodicalIF":0.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472462","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}