Journal of Pediatric Surgery Case Reports最新文献

{"title":"Laparoscopic repair of transurethral extrusion of a ventriculoperitoneal shunt: A case report","authors":"Hannah Baker ,&nbsp;Ryan Jafrani ,&nbsp;Cristine S. Velazco ,&nbsp;Hubert Swana","doi":"10.1016/j.epsc.2024.102907","DOIUrl":"10.1016/j.epsc.2024.102907","url":null,"abstract":"<div><h3>Introduction</h3><div>Transurethral protrusion of ventriculoperitoneal shunt is a rare finding with few reported cases in the literature. As most presentations are treated with an open surgical approach, our case details successful management with laparoscopic intervention. Here we describe the presentation, diagnosis, and management of a pediatric patient with erosion and extrusion of a ventriculoperitoneal shunt through the urethra.</div></div><div><h3>Case presentation</h3><div>A 3-year-old girl with a history of congenital hydrocephalus treated with ventriculoperitoneal shunt presented to the Emergency Department after an incidental finding of the peritoneal end of the shunt protruding from the urethra draining cerebrospinal fluid (CSF). The patient was asymptomatic with vitals and laboratory values within normal limits. Urine and CSF cultures were negative. Preoperative x-ray showed distal midline protrusion of the shunt. Due to exposed hardware with risk of infection, a combined surgical effort between pediatric urology, neurosurgery, and general surgery was implemented. Laparoscopy was utilized to transect the shunt tubing with subsequent removal through the urethra, revealing a posterior cystotomy. The bladder defect was closed entirely with absorbable suture. The shunt hardware was removed in its entirety and an extraventricular drain (EVD) was placed. The patient subsequently underwent an endoscopic third ventriculostomy (ETV) and did not require shunt replacement. The postoperative course was uneventful with benign follow up imaging.</div></div><div><h3>Conclusion</h3><div>Minimally invasive surgical intervention can be utilized as a safe and effective alternative to open surgery for treatment of ventriculoperitoneal shunt migration. As cases may present asymptomatically, a high index of suspicion with detailed physical exam should be applied.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102907"},"PeriodicalIF":0.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534068","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":"Acquired colovesical fistula in a neonate: A case report","authors":"Mohamad El mahmoud ,&nbsp;Noura Almutairi ,&nbsp;Abdullah Alotaibi ,&nbsp;Mohammed Alonazi ,&nbsp;Abdullah Abduldaem ,&nbsp;Essa Alkhodair","doi":"10.1016/j.epsc.2024.102902","DOIUrl":"10.1016/j.epsc.2024.102902","url":null,"abstract":"<div><h3>Introduction</h3><div>Colovesical fistula (CVF) is an abnormal communication between the colon and the urinary bladder, allowing fecal matter to enter the bladder. Acquired CVF are extremely rare in newborns.</div></div><div><h3>Case presentation</h3><div>A 4-week-old male with trisomy 21 presented with septic shock and suspected necrotizing enterocolitis. Feedings were stopped and he initiated a course of intravenous antibiotics. A Foley catheter was inserted upon admission by the urology team due to difficulty with straight catheterization. It drained clear urine for approximately 20 days, after which it was removed without complications. Ten days after the removal of the Foley catheter he developed watery diarrhea and bile-stained urine, suspicious of a CVF. An abdominal X-ray revealed that the Foley catheter had entered the peritoneal cavity beyond the urinary bladder limits and showed air in the bladder. A cystourethrogram confirmed the diagnosis of a CVF. He was taken to the operating room for a cystoscopy, which confirmed a wide opening at the posterior dome of the bladder, followed by an exploratory laparotomy during which a bladder-to-sigmoid colon was identified and divided. The involved segment of the sigmoid colon was also resected. A double-barrel ileostomy was created to protect the sigmoid anastomosis. The bladder defect was closed in two layers with absorbable sutures. A Foley catheter was left in place. The patient recovered well. A cystourethrogram 10 days after the operation confirmed no leak, and the Foley catheter was removed. The ileostomy was closed 1 months after the CVF repair.</div></div><div><h3>Conclusion</h3><div>Neonatal acquired CVF is very rare but should be suspected in patients who develop bile-stained urine and watery stool.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102902"},"PeriodicalIF":0.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534122","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":"Necrotizing enterocolitis and optimal surgical timing: Case series","authors":"Mariel Magdits ,&nbsp;Gabriella Grisotti ,&nbsp;Lan Vu","doi":"10.1016/j.epsc.2024.102906","DOIUrl":"10.1016/j.epsc.2024.102906","url":null,"abstract":"<div><h3>Introduction</h3><div>The pathophysiology and management of necrotizing enterocolitis (NEC) with identification of the subset of NEC totalis and the timing of surgical intervention, remains an area of active research and clinical uncertainty. A third of deaths from NEC are attributed to NEC totalis. This case series presents three distinct cases of total or near-total NEC.</div></div><div><h3>Case series</h3><div>Case 1: A female preterm infant born at 27 weeks of gestation developed sepsis at six days of life, diagnosed with NEC evidenced by portal venous gas and diffuse pneumatosis intestinalis. Surgical exploration 8 weeks later revealed extensive involvement of the entire small bowel, culminating in a fatal outcome. Case 2: A male preterm infant delivered at 24 weeks and 4 days gestation presented with respiratory distress syndrome shortly after birth and developed abdominal distension and ongoing metabolic acidosis and thrombocytopenia. On day 12 post-NEC diagnosis, surgical exploration revealed extensive bowel necrosis involving most of the small bowel and right colon. The patient did not survive the operation due to intraoperative hemorrhage secondary to the degree of acute inflammation. Case 3: A preterm female infant delivered at 25 weeks and 5 days gestation exhibited respiratory failure and a tense abdomen within the first week of life. Upon transfer to a higher level of care, imaging revealed massive pneumoperitoneum and exploration demonstrated extensive bowel necrosis from the mid jejunum to the distal transverse colon. Prompt surgical intervention within 24 hours post-diagnosis resulted in bowel resection and jejunostomy creation, leading to improved clinical condition and ongoing survival.</div></div><div><h3>Conclusion</h3><div>The presented case series suggests that timing in surgical intervention for NEC may play a role in outcomes.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102906"},"PeriodicalIF":0.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445025","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":"Congenital Treves’ field transmesenteric hernia in 7-month-old infant: A case report","authors":"Abdelrahman S. Elnour ,&nbsp;Omer Abuagla ,&nbsp;Faisal Nugud ,&nbsp;Osman Taha","doi":"10.1016/j.epsc.2024.102905","DOIUrl":"10.1016/j.epsc.2024.102905","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital Treves’ field hernia is the herniation of a visceral segment through a defect in the terminal ileal mesentery, poses a high risk of strangulation and bowel gangrene. Its preoperative diagnosis is challenging due to its rarity, nonspecific presentation, and often inconclusive imaging.</div></div><div><h3>Case presentation</h3><div>A previously healthy 7-month-old female infant presented with an 18-h history of intense diffuse abdominal pain, nausea, and bilious vomiting. On examination, she appeared ill and dehydrated, with tachycardia and tachypnea. Her abdomen was grossly distended, tense, and tender, with no visible scars or hernias. Blood tests, including a complete blood count, urea, and electrolytes, were normal except for an elevated white blood cell count. Abdominal X-rays and ultrasound revealed features consistent with distal small bowel obstruction, with no evidence of intussusception. Following resuscitation, an emergency laparotomy was performed for suspected acute abdomen due to distal small bowel obstruction. Intraoperatively, the jejunum and proximal ileum were dilated, and a portion of the ilium was found herniated through a 6 × 4 cm mesenteric defect. After reduction, approximately 25 cm of necrotic small bowel was resected, followed by an end-to-end anastomosis. The postoperative recovery was smooth, and she was discharged on day seven with no signs of short bowel syndrome on follow-up.</div></div><div><h3>Conclusion</h3><div>Congenital Treves’ field transmesenteric hernia is a rare cause of intestinal obstruction in children that should be considered in cases of mechanical small bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102905"},"PeriodicalIF":0.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533014","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":"Chronically retained esophageal foreign body, a case report","authors":"Nardos Mulu Admasu,&nbsp;Fisseha Temesgen Gebru,&nbsp;Tihitena Negussie Mamo,&nbsp;Eden Belay Tilahun,&nbsp;Etsub Abebaw","doi":"10.1016/j.epsc.2024.102904","DOIUrl":"10.1016/j.epsc.2024.102904","url":null,"abstract":"<div><h3>Introduction</h3><div>Foreign body ingestion is one of the most common pediatric emergencies among infants and young children. Between 80 % and 90 % of ingested foreign bodies pass spontaneously, 10 %–20 % require endoscopic removal, and about 1 % necessitates an open approach for removal.</div></div><div><h3>Case presentation</h3><div>A 13-year-old female developed progressive dysphagia over the course of 11 years. The parents reported a history of a foreign body ingestion (a plastic candlepin holder) 11 years before. They were informed that the foreign body would pass spontaneously but they did not recall ever having recovered it. Over the years she was repeatedly taken to various healthcare facilities where chest X-rays were performed and reported as normal, and she was sent home without interventions. When she presented to our clinic, she could swallow chewed solid food only with liquids. A neck examination revealed a bulge on the right anterolateral side. The remainder of the physical examination was unremarkable. An esophagogram revealed an upper esophageal stricture with a diverticulum. Upper GI endoscopy demonstrated a proximal esophageal stricture, while a neck CT scan showed narrowing of the proximal esophagus and a foreign body with a central hole. The impacted foreign body was successfully removed by endoscopy. She was able to swallow solid food for about a year, after which she developed dysphagia again. Endoscopy revealed narrowing at the proximal esophagus. An attempt at esophageal dilation was unsuccessful. She subsequently underwent a cervical exploration, which showed a short proximal esophageal stricture and a diverticulum proximal to the stricture. A diverticulectomy and resection with end-to-end anastomosis were done. Six months after the operation she continues to eat solid foods with some difficulty, but is gaining weight, and remains under close surveillance.</div></div><div><h3>Conclusion</h3><div>Diagnosing non-radiopaque esophageal foreign bodies is challenging in centers with limited resources. Chronically impacted foreign bodies and their complications are difficult to treat due to the lack of a standardized approach.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102904"},"PeriodicalIF":0.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433999","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":"Congenital rib absence with liver herniation: A case report","authors":"Yirgalem Teklebirhan Gebreziher ,&nbsp;Feven Mekonen Tadesse ,&nbsp;Hadush Tesfay Negash ,&nbsp;Berihu Tadish Gebre","doi":"10.1016/j.epsc.2024.102903","DOIUrl":"10.1016/j.epsc.2024.102903","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital rib absence with liver herniation is an extremely rare condition. Only a few cases have been reported, and most of them have been associated with Poland syndrome.</div></div><div><h3>Case presentation</h3><div>A full-term female newborn, born at 38 weeks of gestation with a birth weight of 3100 g, delivered vaginally following a normal pregnancy was brought to our clinic at 11 days of life for a right lower thoracic bulge. There was no relevant family history. The physical exam was completely normal except for a 4 × 5 cm round protrusion in the right lower anterolateral chest. The ribs in the area were clearly absent. The skin, the subcutaneous tissue and the muscles appeared normal. He had normal vital signs and breath sounds. The abdominal exam was normal. A plain chest X-ray showed normal lung fields, absence of the right lower ribs, a right diaphragmatic eventration, and a soft tissue herniation. A three-dimensional computed tomography (3D-CT) reconstruction confirmed the diagnosis of congenital hypoplastic 6th and 7th right ribs, absent 8th and 9th right ribs, and a foramen in the right 10th rib. It also showed that the visible bulge was the liver protruding through the weakened chest wall. The only other anatomical anomaly was 6th to 9th thoracic butterfly vertebrae. The patient is being managed conservatively and is doing well.</div></div><div><h3>Conclusion</h3><div>Congenital intercostal liver herniation with absent ribs is an extremely rare condition and can be managed conservatively in asymptomatic cases. We recommend 3D-CT reconstruction as an effective way to confirm the diagnosis and rule out associated malformations.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102903"},"PeriodicalIF":0.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533015","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":"Esophageal placement of a biliary stent to manage a iatrogenic esophageal perforation: A case report","authors":"Saurin Dipak Dani,&nbsp;Dravina Shetty,&nbsp;Abhaya R. Gupta,&nbsp;Paras R. Kothari","doi":"10.1016/j.epsc.2024.102898","DOIUrl":"10.1016/j.epsc.2024.102898","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-operative anastomotic stricture can occur after a gastric tube esophagoplasty in children with esophageal atresia, resulting in difficulty swallowing. Endoscopic dilatation is commonly used to treat these strictures. The dilatations carry a risk of esophageal perforation.</div></div><div><h3>Case presentation</h3><div>A two-year-old male was admitted to the intensive care unit for an esophageal perforation that resulted from an esophageal dilatation. He had a history of long-gap type-C esophageal atresia/tracheo-esophageal, which had been managed with a cervical esophagostomy and a gastrostomy at birth, followed by an esophageal replacement by reverse gastric tube at the age of 17 months. At the age of 20 months, he developed dysphagia. An esophageal stricture was diagnosed by endoscopy. He underwent several balloon dilatations, followed by dilatations with solid dilators. The last dilatation was complicated by the esophageal perforation that prompted his hospital admission. At the time of the admission, we placed a chest tube, started antibiotics, and kept him NPO. We resumed enteral feedings 12 days after the perforation but immediately noticed that the formula was draining out of the chest tube. A surgical repair of the persistent fistula was deemed unsafe. We decided to place a biliary stent to cover the perforation endoscopically. Nasogastric feeds were reinitiated. The stent was kept in place for six weeks, while the patient was fed by a nasogastric tube. After 6 weeks, a contrast study confirmed that the perforation had sealed. Oral feedings were started at that time and the chest tube was removed. He has had no recurrence of the perforation or the stricture since then.</div></div><div><h3>Conclusion</h3><div>Biliary stents could be an option for the management of iatrogenic esophageal perforations in children.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102898"},"PeriodicalIF":0.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417726","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":"Chest wall reconstruction with biological mesh, rib stabilization, and latissimus dorsi rotation: A case report","authors":"Lucía Fein ,&nbsp;Bruno Cuturi ,&nbsp;Ruver Berazategui ,&nbsp;Sylvia Duarte","doi":"10.1016/j.epsc.2024.102899","DOIUrl":"10.1016/j.epsc.2024.102899","url":null,"abstract":"<div><h3>Introduction</h3><div>Children with chest wall tumors may require extensive chest wall resections. The reconstruction of large chest wall defects can be surgically challenging. We present a new chest wall reconstruction method.</div></div><div><h3>Case presentation</h3><div>A 2.5-year-old male who developed respiratory symptoms and chest pain was diagnosed with an Askin's tumor of the left chest wall. The tumor originated in the posterior segments of the seventh and eighth ribs. Computed tomography of the chest revealed a large mass filling the left hemithorax, causing flattening of the hemidiaphragm and mediastinal shift. No distant metastases were identified. The patient underwent six cycles of neoadjuvant chemotherapy with vincristine, adriamycin, cyclophosphamide, ifosfamide, and etoposide. Post-chemotherapy, magnetic resonance imaging revealed a significant reduction in tumor size. The patient was taken to the operating room for the resection of the tumor. The posterior segments of the left sixth, seventh, eighth, and ninth ribs were surgically excised. The chest wall was reconstructed using a biological mesh (Permacol™), sutures for costal arch stabilization using the lattice technique, and a rotated latissimus dorsi muscle flap for defect coverage. An 18 Fr pleural drainage was left in place. The patient tolerated the operation well and was successfully extubated 48 hours later. Pain was effectively managed via paravertebral block. The patient was discharged on the 14th postoperative day. The resected specimen had negative margins. He subsequently underwent several more cycles of chemotherapy. Eighteen months after the operation he has developed no scoliosis and has full range of motion on the left chest wall.</div></div><div><h3>Conclusion</h3><div>A combination of a biological mesh, rib stabilization and latissimus dorsi rotation seems to be a valid technique to cover large chest wall defects.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102899"},"PeriodicalIF":0.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425195","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":"Hydrosalpinx leading to fallopian tube torsion in a 10-year-old female: A case report","authors":"Joanna Sajdlowska ,&nbsp;Pasha Shenasan ,&nbsp;Nicole Clarke ,&nbsp;Nishith Bhattacharyya","doi":"10.1016/j.epsc.2024.102895","DOIUrl":"10.1016/j.epsc.2024.102895","url":null,"abstract":"<div><h3>Introduction</h3><div>Isolated fallopian tube torsion (IFTT) is a rare complication in the pediatric population, especially among the pre-adolescent and pre-menarcheal population.</div></div><div><h3>Case report</h3><div>A10-year-old prepubertal girl with no past surgical history and a history of autoimmune hepatitis, ADHD, hyperlipidemia and constipation presented with a 4-day history of sharp abdominal pain. Initially the pain was localized to the suprapubic region, but it later became diffuse. She was hemodynamically stable, and all laboratory values were unremarkable. An initial ultrasound showed preserved vascular flow to non-enlarged ovaries. Computerized tomography of the abdomen and pelvis with contrast demonstrated an indeterminate fluid structure in the right lower quadrant. A follow-up ultrasound showed right hydrosalpinx measuring 5.1 x 5.7 × 5.6 cm with free fluid adjacent to the right ovary. Magnetic resonance imaging re-demonstrated a tubular structure in the right lower quadrant adjacent to the right ovary with preserved ovaries. The patient underwent diagnostic laparoscopy, which confirmed isolated right fallopian tube torsion with ischemic changes. The Fallopian tube was detorsed and regained proper vascularization. The fluid within the Fallopian tube was evacuated. The right ovary was intact. She recovered well from the operation and was discharged home shortly thereafter. One week after the operation she was free of symptoms.</div></div><div><h3>Conclusion</h3><div>Fallopian tube torsion should be included in the differential diagnosis of pre-adolescent and pre-menarcheal females with abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102895"},"PeriodicalIF":0.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417727","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":"Retroperitoneal Castleman's disease and ovarian torsion: A case report","authors":"Mingjun Jin ,&nbsp;Tengfei Li ,&nbsp;Qianhui Yang ,&nbsp;Linsheng Zhao ,&nbsp;Liang Dong ,&nbsp;Jianghua Zhan","doi":"10.1016/j.epsc.2024.102897","DOIUrl":"10.1016/j.epsc.2024.102897","url":null,"abstract":"<div><h3>Introduction</h3><div>Castleman's Disease (CD) is a rare lymphoproliferative disorder with diverse clinical manifestations. It is primarily characterized by painless lymph node enlargement, most commonly in the mediastinum, neck, retroperitoneum, axillary regions, and pelvis.</div></div><div><h3>Case presentation</h3><div>A 12-year-old female was admitted to our hospital with persistent abdominal pain and vomiting that were not alleviated by initial treatments. Physical examination revealed tenderness in the right lower abdomen. Pelvic ultrasound revealed a mass in the pelvic region. Due to persistent pain, she underwent a laparoscopic exploration during which it was discovered that the right ovary was twisted 360°, and it was adjacent to the pelvic mass. It appeared that the mass was pushing the ovary, and this phenomenon could have been the cause of the torsion. The nature of the mass could not be conclusively determined during the intraoperative assessment, but a biopsy with a fine needle was obtained. Pathological examination was suggestive of a tumor related to the lymphatic system. She underwent a pelvic MRI that confirmed a round, soft tissue mass on the right side of the pelvis measuring approximately 63 × 50 × 56 mm. We did a subsequent laparoscopy and completely resected the mass. The patient recovered well and was discharged without complications. At 2 years of follow up she is in good health. The final pathology diagnosis of the mass was CD.</div></div><div><h3>Conclusion</h3><div>CD is often asymptomatic, but symptoms can arise when the enlarged lymph nodes cause compression on surrounding organs.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102897"},"PeriodicalIF":0.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417725","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}