Journal of Pediatric Surgery Case Reports最新文献

{"title":"Ovarian fibrothecoma in an adolescent presenting as ovarian torsion: A case report","authors":"Youssef Essebbagh,&nbsp;Khadija Errmili,&nbsp;Amina Etber,&nbsp;Othmane Elharmouchi,&nbsp;Najia Zeraidi,&nbsp;Aziz Baidada","doi":"10.1016/j.epsc.2025.102994","DOIUrl":"10.1016/j.epsc.2025.102994","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian fibrothecomas are rare benign stromal tumors, very rare in the pediatric population.</div></div><div><h3>Case presentation</h3><div>A 16-year-old adolescent with no prior medical history presented to the emergency room with acute pelvic pain and vomiting. Clinical examination revealed left iliac fossa tenderness and an adnexal mass. Pelvic ultrasound showed a well-defined, 110 mm × 80 mm, hyperechoic left ovarian mass with absent vascularization on Doppler imaging. All bood tests, including CA-125, were normal. Due to the suspicion of ovarian torsion, an emergency laparotomy was performed, confirming a 720-degree left ovarian torsion. The mass was completely resected preserving a portion of the left ovary. Histopathological analysis was consistent with a fibrothecoma. The postoperative recovery was uneventful. Follow-up ultrasounds at 1 and 6 months after the operation showed no recurrence of the tumor.</div></div><div><h3>Conclusion</h3><div>Ovarian fibrothecomas, although rare, should be included in the differential diagnosis of solid ovarian masses in adolescents.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102994"},"PeriodicalIF":0.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734622","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":"Blunt duodenal injury in a 9-year-old boy: A case report","authors":"Muhammad Arif Mateen Khan ,&nbsp;Syed Waqas Ali ,&nbsp;Zaeem Ur Rehman Khan ,&nbsp;Yaqoot Jahan","doi":"10.1016/j.epsc.2025.102990","DOIUrl":"10.1016/j.epsc.2025.102990","url":null,"abstract":"<div><h3>Introduction</h3><div>Blunt abdominal trauma leading to isolated duodenal injury is rare in children. Duodenal injuries are often accompanied by damage to adjacent organs, making their diagnosis challenging.</div></div><div><h3>Case study</h3><div>A 9-year-old boy presented with severe abdominal pain following a blunt handlebar injury the day before. He was tachycardic and tachypneic and had generalized abdominal guarding and tenderness. Computerized tomography (CT) imaging showed retroperitoneal air around the right kidney, suspicious for a duodenal injury. He underwent an exploratory laparotomy during which we identified a 2 × 2 cm perforation in the second portion of the duodenum. We repaired it primarily using interrupted 3-0 braided reabsorbable sutures in a single layer and covered the sutures with an omental patch. We also did a gastrostomy, a tube duodenostomy, and a jejunostomy. Jejunostomy feedings were initiated on postoperative day 5. Two days later, he developed severe abdominal pain and abdominal distension. Plain films suggested an intestinal obstruction. He underwent an exploratory laparotomy during which we found and took down adhesions between bowel loops and the duodenal repair site. The duodenostomy and the jejunostomy were closed at that time, and a drain was placed next to the duodenal repair site. Two days later bilious fluid was seen in the drain, indicating a duodenal leak. The patient was managed conservatively with octreotide and total parenteral nutrition (TPN). The leak resolved spontaneously by postoperative day 13, confirmed via contrast study. As oral intake was gradually reintroduced, he developed recurrent abdominal pain, distension, and bilious gastrostomy output, suggestive of another intestinal obstruction. He underwent a third exploration with lysis of adhesions. An iatrogenic jejunal perforation occurred, which was managed by a jejunostomy. He was managed with a high-protein diet. Three months after the initial intervention, the jejunostomy was taken down, and he was successfully discharged home shortly after.</div></div><div><h3>Conclusion</h3><div>While primary repair is the preferred treatment for duodenal perforations, delayed presentations may necessitate alternative approaches such as duodenal diverticulization or duodenal bypass with temporary or permanent pyloric exclusion.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102990"},"PeriodicalIF":0.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738285","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":"Amyand hernia with acute appendicitis in a patient with ambiguous genitalia: A case report","authors":"Patricia A. Ocaña ,&nbsp;Laura E. Gonzalez ,&nbsp;Elena L. Llerena ,&nbsp;Galo E. Jimenez ,&nbsp;Gabriel A. Molina ,&nbsp;Katherine E. Albuja","doi":"10.1016/j.epsc.2025.102992","DOIUrl":"10.1016/j.epsc.2025.102992","url":null,"abstract":"<div><h3>Introduction</h3><div>Inguinal hernia is a common condition in children. pathology. An Amyand hernia is defined as an inguinal hernia that contains the vermiform appendix. The occurrence of acute appendicitis in the context of an Amyand hernia is uncommon, and the diagnosis can be difficult in patient with abnormal genitalia.</div></div><div><h3>Case presentation</h3><div>The patient was a 1-year-old male diagnosed at birth with ambiguous genitalia and androgen insensitivity syndrome. His scrotal sac resembled labia majora. He underwent a complete genetic diagnosis which showed 46 XY heterozygous karyotype. He also had penoscrotal hypospadias. He had no history of prenatal conditions. There were no genetic diseases in his family. He was brought to the emergency room with an enlarged edematous right hemi-scrotum and painless erythema. He had a 3 × 3 cm painless mass with edema and erythema simulating an acute scrotum. An ultrasound was done and showed a right inguinal hernia containing omentum and bowel loops. He was taken to the operating room for an exploratory laparoscopy. We found that the appendix was partially herniated into the right inguinal canal. When we pulled it back into the abdomen, we noticed that the tip was inflamed. We did an appendectomy and closed the hernia with a non-absorbable suture. Following this, we did a trans-scrotal right orchidopexy. He recovered well from the operation ad has been doing well in all follow up visits.</div></div><div><h3>Conclusion</h3><div>Amyand hernia with inflammation of the appendix must be considered in children who present acute redness of the inguinal canal and external genitalia.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102992"},"PeriodicalIF":0.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738284","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 diagnosis of right-sided Bochdalek hernia in an infant: A case report","authors":"Majd Oweidat ,&nbsp;Mosaikah Anati ,&nbsp;Mohammed Aldwaik ,&nbsp;Haya Tariq Mohammed Taha","doi":"10.1016/j.epsc.2025.102993","DOIUrl":"10.1016/j.epsc.2025.102993","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital diaphragmatic hernia (CDH) is a rare developmental anomaly characterized by an abnormal diaphragmatic opening that allows abdominal organs to herniate into the thoracic cavity. CDH is typically diagnosed before or shortly after birth. Delayed presentations are uncommon and may lead to misdiagnosis.</div></div><div><h3>Case presentation</h3><div>An 11-month-old female, born full-term via spontaneous vaginal delivery, presented with a three-day history of mild intermittent dry cough and nasal congestion. The prenatal history was unremarkable, and a no antenatal ultrasound had been done. She had a history of recurrent respiratory symptoms, frequently diagnosed as respiratory infections. She had never undergone chest imaging. On examination, diminished air entry on the right chest was noted, prompting imaging. Chest x-ray showed multiple radiolucent areas in the lower half of the right hemithorax. Computerized tomography (CT) scan showed a right-sided congenital diaphragmatic hernia with bowel loops herniating into the right hemithorax. The patient was taken to the operating room for the repair of the CDH. We did transverse supra-umbilical laparotomy. Intraoperative findings confirmed the herniation of small bowel and the transverse colon through a right posterior diaphragmatic defect, or Bochdalek-type CDH, with normal diaphragmatic crura. We repaired the CDH primarily without the need for a prosthetic mesh. She received postoperative care in the pediatric intensive care unit and recovered without complications. At one week and at one month of follow up, she was gaining weight appropriately, had no respiratory distress, and had no hernia recurrence.</div></div><div><h3>Conclusion</h3><div>Infants with recurrent respiratory symptoms should undergo a chest x-ray to rule out a late-presenting CDH.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102993"},"PeriodicalIF":0.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714867","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":"Isolated fallopian tube torsion in young females: A case series","authors":"Bochra Aziza ,&nbsp;Yasmine Houas ,&nbsp;Asma Slimani ,&nbsp;Riadh Jouini","doi":"10.1016/j.epsc.2025.102991","DOIUrl":"10.1016/j.epsc.2025.102991","url":null,"abstract":"<div><h3>Introduction</h3><div>Isolated fallopian tube torsion (IFTT) is rare in the pediatric population. Its diagnosis is not always straightforward.</div></div><div><h3>Case presentation</h3><div>Case 1: A 10-year-old premenarchal girl presented after four days of intermittent right iliac fossa pain, nausea, and vomiting. Pelvic ultrasound (US) initially suggested a left ovarian torsion, showing an enlarged, 60 × 50 mm left ovary with no Doppler flow. She was taken to the operating room for an exploratory laparoscopy. We found an IFTT, with a totally normal left ovary. The left fallopian tube was completely necrotic, so a salpingectomy was done preserving the ovary. Case 2: A 13-year-old girl was admitted after 48 hours of pelvic pain and vomiting. US and computerized tomography (CT) scan showed an enlarged left ovary with preserved vascular flow, and an adjacent 32 x 25-mm cystic tubular formation. Suspecting ovarian torsion, she was taken to the operating room for an exploratory laparoscopy. The right fallopian tube was torsed, whereas the right ovary was normal. The left ovary and the left Fallopian tube were normal as well. Despite having a bluish discoloration after the detorsion, the right Fallopian tube was preserved. Case 3: A 12-year-old girl presented to our emergency department with severe intermittent abdominal pain and bilious vomiting. Abdominal US suggested IFTT, so she underwent a laparoscopic exploration. The right fallopian tube was enlarged and torsed. The right ovary was normal. We confirmed good reperfusion after the detorsion, so the right Fallopian tube was preserved. No obvious etiology for the torsion was found.</div></div><div><h3>Conclusion</h3><div>IFTT in young females is rare and can be misdiagnosed as ovarian torsion on US or CT studies.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102991"},"PeriodicalIF":0.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724888","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":"Cervicothoracic lipoma in a child: A case report","authors":"Garett L. Ozmer ,&nbsp;Jaclyn R. Dempsey ,&nbsp;Nikhil R. Shah ,&nbsp;Susana Fortich ,&nbsp;Bindi Naik-Mathuria","doi":"10.1016/j.epsc.2025.102989","DOIUrl":"10.1016/j.epsc.2025.102989","url":null,"abstract":"<div><h3>Introduction</h3><div>Lipomas are typically slow-growing tumors with the highest incidence in the fourth through sixth decades of life, less commonly occurring in pediatric patients, particularly extending across multiple body compartments. Excision is often reserved for cases that cause cosmetic or compressive symptoms and, due to the slow growth pattern, is less likely to be necessary in younger patients.</div></div><div><h3>Case presentation</h3><div>A 2-year-old female with congenital albinism presented with a painless but visible 3 × 4 cm non-mobile left lateral neck mass that had been present for 2 months. MRI without contrast demonstrated a lobulated lesion in the left inferolateral supraclavicular region extending into the left thoracic inlet and thoracic apex. Due to concern for developing mass effect on carotid space structures, resection of the mass was performed. Complete excision was achieved through a single lower cervical incision, requiring dissection from the brachial plexus, carotid sheath, subclavian vessels, and extrapleural thoracic apex. Final pathology revealed an adipocytic neoplasm consistent with a lipoma with a total specimen size measuring 9 x 6.5 × 5 cm. The patient was discharged on postoperative day one and was healing well without complaint at the time of follow-up.</div></div><div><h3>Conclusion</h3><div>Despite their benign nature, cases such as the one presented here demonstrate the capability of lipomas to adhere to and involve surrounding critical structures, particularly when located in the cervicothoracic region and occurring in younger patients. However, with careful surgical planning involving cross-sectional imaging, such lesions can successfully be completely resected through a single cervical incision without morbidity.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"116 ","pages":"Article 102989"},"PeriodicalIF":0.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705839","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":"Cystic hygroma of the shoulder in an 8-year-old boy: A case report","authors":"Suleiman Ayalew Belay ,&nbsp;Michael A. Negussie ,&nbsp;Mesenbet Tsegaye Ferede ,&nbsp;Manayeh Ayenew Mekonnen ,&nbsp;Endeshaw Asaye Kindie ,&nbsp;Endalew Demoz Worku","doi":"10.1016/j.epsc.2025.102987","DOIUrl":"10.1016/j.epsc.2025.102987","url":null,"abstract":"<div><h3>Introduction</h3><div>Cystic hygromas are rare congenital malformations of the lymphatic system, most commonly occurring in the head and neck regions. Involvement of the shoulder region is very rare.</div></div><div><h3>Case presentation</h3><div>An 8-year-old boy presented with a painless, progressively enlarging swelling on his right shoulder since birth. Physical examination revealed a soft, cystic, non-tender mass with mild restriction of shoulder abduction. Routine laboratory tests were normal. Ultrasound showed a 4 cm thick subcutaneous cystic hygroma with septations, and a CT scan revealed a multiloculated, fluid-attenuating mass measuring 9 x 8 × 2.7 cm over the proximal humerus. The diagnosis of a right shoulder cystic hygroma was made, and the patient was scheduled for elective cystectomy. Intraoperatively, a multiseptated cystic mass measuring 18 × 18 cm with a smooth surface was found, and complete cystectomy was performed. Histopathological analysis revealed large, irregular lymphatic channels lined by flattened endothelium, separated by collagenous stroma with lymphoid infiltration, confirming the diagnosis of cystic hygroma without malignancy. The patient had an uneventful recovery and was discharged on postoperative day 3. Follow-up at 2 weeks, 1 month, and 6 months showed full recovery with a normal range of motion and no complications.</div></div><div><h3>Conclusion</h3><div>Cystic hygromas of the shoulder are rare but should be considered in the differential diagnosis of pediatric soft tissue shoulder masses.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"116 ","pages":"Article 102987"},"PeriodicalIF":0.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684583","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":"Omphalocele and patent omphalomesenteric duct: A case report","authors":"Wassie Almaw Yigzaw,&nbsp;Abebe Tsegaye Danole,&nbsp;Abay Gosaye Wondimu","doi":"10.1016/j.epsc.2025.102988","DOIUrl":"10.1016/j.epsc.2025.102988","url":null,"abstract":"<div><h3>Introduction</h3><div>The omphalomesenteric duct (OMD) is an embryonic structure that connects the yolk sac to the midgut. Under normal circumstances, it closes and self absorbes before birth. When the OMD does not obliterate, it remains patent after birth. Patent OMD are hardly ever associated with other congenital anomalies.</div></div><div><h3>Case presentation</h3><div>A 1-day-old term male neonate was referred to our hospital with a postnatal diagnosis of omphalocele minor. The omphalocele had not been seen on any of the prenatal ultrasounds. He was born by vaginal delivery with a weight of 2700 g. In addition to the omphalocele, the physical exam revealed a mucosal opening on the membrane of the omphalocele. A patent OMD was suspected, since meconium was draining through the mucosal opening. Abdominopelvic ultrasound showed bowel loops within the omphalocele sac. All other intra-abdominal organs appeared normal. Echocardiography revealed tricuspid atresia and a large ventricular septal defect. On the second day of life the patient was taken to the operating room for an exploratory laparotomy. The abdomen was accessed through an incision on the junction between the skin and the membrane of the omphalocele. The bowel was detached bluntly from the inner surface of the omphalocele membrane. While the bowel was exposed, a Meckel's diverticulum was found close to the ileo-cecal valve. The tip of the Meckel's diverticulum was open and fused wo the membrane of the omphalocele. We resected the segment of the small bowel that contained the Meckel's diverticulum and did an end-to-end anastomosis. After that, the omphalocele defect was closed. The patient died on the second postoperative day from his congenital heart disease.</div></div><div><h3>Conclusion</h3><div>Patent OMD should be suspected in patients with omphalocele who have a mucosal opening on the omphalocele membrane that drains meconium.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"116 ","pages":"Article 102988"},"PeriodicalIF":0.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684585","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":"Meckel's diverticulum causing massive lower intestinal bleeding in a teenager: A case report","authors":"Abate Bane Shewaye ,&nbsp;Mohan Ramchandani ,&nbsp;Kaleb Assefa Berhane ,&nbsp;Dawit Taye Endalew ,&nbsp;Asteraye Tsige Minyilshewa ,&nbsp;Tamrat Petros Elias","doi":"10.1016/j.epsc.2025.102986","DOIUrl":"10.1016/j.epsc.2025.102986","url":null,"abstract":"<div><h3>Introduction</h3><div>Meckel's diverticulum (MD), the most common congenital gastrointestinal (GI) abnormality, results from incomplete obliteration of the vitelline duct and is often asymptomatic. Its diagnosis can be challenging in older patients due to nonspecific symptoms and reduced sensitivity of Technetium-99m pertechnetate scans.</div></div><div><h3>Case presentation</h3><div>A 15-year-old male presented with a 4-day history of hematochezia, vomiting, and symptoms of anemia. Upon admission, he experienced a massive lower GI bleed (∼2 L), leading to hemodynamic instability, which improved after resuscitation. Laboratory tests revealed hemoglobin (Hb) of 7.7 g/dL, international normalized ratio (INR) of 1.5, and platelet (PLT) count of 131,000/μL. Initial imaging, including esophagogastroduodenoscopy (EGD), colonoscopy, and contrast-enhanced abdominal computed tomography (CT), failed to identify the bleeding source. A subsequent Meckel's scan was also negative. However, CT angiography revealed a diverticular structure with edematous, enhancing walls, consistent with MD. Laparoscopic resection of the diverticulum, located 50 cm from the ileocecal junction, was performed with a stapled side-to-side anastomosis. Histopathology confirmed MD with ectopic gastric mucosa. The patient recovered well, was discharged on postoperative day two, and remained asymptomatic at follow-up.</div></div><div><h3>Conclusions</h3><div>MD must be suspected as a source of lower gastrointestinal bleeding in teenagers, even in cases with a negative Meckel's scan.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"116 ","pages":"Article 102986"},"PeriodicalIF":0.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654621","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":"Pneumatosis cystoides intestinalis as a pathologic lead point of an ileocolic intussusception: A case report","authors":"Teren W.A. Culbertson ,&nbsp;David P. Bliss Jr.","doi":"10.1016/j.epsc.2025.102984","DOIUrl":"10.1016/j.epsc.2025.102984","url":null,"abstract":"<div><h3>Introduction</h3><div>Ileocolic intussusception is an acute intestinal obstruction that requires prompt diagnosis and treatment. This case presents a rare pathologic lead point for ileocolic intussusception.</div></div><div><h3>Case presentation</h3><div>A nine-year-old female with a history of functional abdominal pain and constipation presented to the emergency department with acute abdominal pain, bilious emesis and one episode of non-bloody diarrhea. Abdominal x-rays were concerning for a bowel obstruction and an abdominal ultrasound showed an intussusception of unclear location. Subsequent abdominal/pelvic computerized tomography scan identified an ileocolic intussusception with pneumatosis cystoides intestinalis (PCI) acting as a pathologic lead point. The patient underwent two air enema reduction procedures that were deemed to be incomplete. As a result, a diagnostic laparoscopy was performed, which confirmed PCI and identified a previously reduced ileocolic intussusception. Post-operatively, she completed a seven-day course of oral metronidazole and had an unmarkable recovery. At a three-week follow-up visit, persistent PCI was present on abdominal radiographs, which resolved after an additional 14-day course of metronidazole. Further outpatient evaluation revealed no other potential lead points other than that of the known PCI.</div></div><div><h3>Conclusion</h3><div>This case highlights the rare occurrence of pneumatosis cystoides intestinalis acting as a pathologic lead point for ileocolic intussusception in a pediatric patient. Ileocolic intussusception should be considered a potential complication for young patients with PCI.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"116 ","pages":"Article 102984"},"PeriodicalIF":0.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684584","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}