Journal of Pediatric Surgery Case Reports最新文献

{"title":"Pacemaker migration into the peritoneal cavity in children: a case series","authors":"Nicole H. Chicoine ,&nbsp;Patrick J. Javid ,&nbsp;David H. Rothstein ,&nbsp;Samuel E. Rice-Townsend ,&nbsp;Kimberly J. Riehle ,&nbsp;Terrence U. Chun ,&nbsp;Sarah L.M. Greenberg","doi":"10.1016/j.epsc.2025.103016","DOIUrl":"10.1016/j.epsc.2025.103016","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac pacemakers can have a variety of complications, one of which is migration into the peritoneal cavity. This complication, which can have variable clinical manifestations, has rarely been reported in pediatric patients.</div></div><div><h3>Case presentations</h3><div>Patient 1 was an 8-year-old female who had a pacemaker placed at the age of 1 year due to periodic asystole. She presented with rectal extrusion of a pacemaker lead. Computerized tomography (CT) scan confirmed the migration of the pacemaker generator and the lead to the area of the rectum. The devices were successfully removed transrectally. Patient 2 was a 19-year-old male with complete AV block who had a dual chamber pacemaker placed at the age of 7 years. Migration was detected at the age of 17 years on a routine abdomen/chest x-ray, and was confirmed on a CT. Laparoscopic retrieval was done at the age of 19 years. Patient 3 was a 1-year-old male with congenital heart disease requiring pacemaker placement at the age of 3 months. During a transvenous lead replacement at the age of 15 months, intraperitoneal migration was incidentally noticed at the time of the abdominal wall incision. The device was removed and replaced through the same incision. Patient 4 was a former 27 weeker male who had a pacemaker placed at the age of 5 months. At the age of 7 months, an abdominal x-ray done for unrelated reasons suggested possible pacemaker migration. Given that the patient was asymptomatic, and that the pacemaker was functioning properly, the pacemaker was left in place at that time and removed much later when the patient was 3 years old.</div></div><div><h3>Conclusion</h3><div>Migration of abdominal wall pacemakers in pediatric patients may present with or without symptoms. In select asymptomatic cases with preserved device function, delayed or elective surgical intervention may be considered.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103016"},"PeriodicalIF":0.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868522","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":"Distal vaginal agenesis reconstruction with interval buccal graft vaginoplasty followed by anastomosis to the upper vagina: A case report","authors":"Taryn Wassmer ,&nbsp;Viktoriya Tulchinskaya ,&nbsp;Aimee Morrison ,&nbsp;Aaron Garrison ,&nbsp;Lesley Breech","doi":"10.1016/j.epsc.2025.103011","DOIUrl":"10.1016/j.epsc.2025.103011","url":null,"abstract":"<div><h3>Introduction</h3><div>Pull-through vaginoplasty, commonly performed for management of distal vaginal agenesis, risks post-operative stenosis if the proximal vagina is &gt; 3 cm from the introitus. An alternative may be staged reconstruction using buccal graft vaginoplasty followed by interval anastomosis to native vagina.</div></div><div><h3>Case presentation</h3><div>A 12-year-old pubertal female with history of multiple laryngopharyngeal congenital anomalies presented with acute on chronic back pain. Spinal MRI incidentally identified hematometrocolpos measuring 7.3 × 8 × 15.6 cm with inflammation of atretic native upper vagina leading to a diagnosis of distal vaginal atresia. The distal aspect of the native upper vagina was found to be over 6 cm from the introitus. Given this distance, she was not deemed to be an ideal candidate for native pull-through vaginoplasty. IR-guided drainage of hematometrocolpos was performed for symptomatic relief. Hormonal suppression was used to allow sufficient time for resolution of vaginal wall inflammation bridging to staged surgical procedures. A buccal graft neovagina was created first, followed by routine postoperative dilation to allow for optimal development of the lower buccal graft. After 8 months, laparoscopic mobilization of Müllerian structures with transvaginal anastomosis to the interposition buccal graft neovagina was completed. 5 months postoperatively a stricture was identified that was injected with triamcinolone and bupivacaine. The final total vaginal length approached 9 cm without evidence of strictures or stenosis.</div></div><div><h3>Conclusion</h3><div>This novel staged surgical approach allows graft maturity and optimizes time utilization and healing, and may be an alternative for patients at risk of complications from native pull-through vaginoplasty.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103011"},"PeriodicalIF":0.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826322","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":"Giant splenic mesothelial cyst in a child: A case report","authors":"Saad Andaloussi ,&nbsp;Omar Dalero ,&nbsp;Abdelkrim Haita ,&nbsp;Jinane Kharmoum ,&nbsp;Zakarya Alami Hassani ,&nbsp;Aziz Elmadi","doi":"10.1016/j.epsc.2025.103010","DOIUrl":"10.1016/j.epsc.2025.103010","url":null,"abstract":"<div><h3>Introduction</h3><div>Splenic mesothelial cysts are rare, accounting for a small fraction of primary non-parasitic splenic cysts. They often present as incidental findings but can become symptomatic when they reach a significant size.</div></div><div><h3>Case presentation</h3><div>An 8-year-old girl presented with a 30-day history of progressive left upper quadrant abdominal pain. Physical exam revealed a firm, tender mass in the left upper quadrant. Laboratory tests including complete white count and inflammatory markers were all within normal limits. Hydatid serology was normal. Abdominal ultrasonography (US) revealed splenomegaly with a large hypoechoic cystic lesion arising from the spleen without Doppler flow. Contrast-enhanced computed tomography scan of the abdomen and pelvis confirmed the splenomegaly and a large unilocular cystic lesion measuring 15 × 10 × 14 cm, occupying nearly the entire splenic parenchyma, displacing adjacent organs. No internal enhancement, solid components, or calcifications were observed. Preoperative vaccinations were administered. Due to the size of the cyst and the persistence of pain, the patient was taken to the operating room for a laparoscopic exploration. We found minimal residual splenic tissue around the large cyst, so we proceeded with a total splenectomy after aspirating the cyst. The histopathology analysis was consistent with a mesothelial cyst. The postoperative course was uneventful. The patient was enrolled in a structured vaccination program and remains asymptomatic with no complications at two years of follow-up.</div></div><div><h3>Conclusion</h3><div>For symptomatic giant splenic cysts involving the splenic hilum, laparoscopic total splenectomy remains a safe and effective option when spleen-preserving alternatives are anatomically unfeasible.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103010"},"PeriodicalIF":0.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824139","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":"Barrett's metaplasia complicating gastro-oesophageal reflux disease in a 3-year-old child: A case report","authors":"Ipsita Sarkar ,&nbsp;Astor Rodrigues ,&nbsp;Merrill McHoney","doi":"10.1016/j.epsc.2025.103009","DOIUrl":"10.1016/j.epsc.2025.103009","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastro-oesophageal reflux disease (GORD) can cause significant complications in children. Barrett's oesophagus (BO) is an uncommon and late-presenting complication that is rare in children but has significant life-long implications.</div></div><div><h3>Case presentation</h3><div>A 3-year-old boy presented with faltering growth, weight loss, and episodes of haematochezia and melaena. His past medical history included primary gastrostomy at 10 months for incoordinate swallowing, and gastro-oesophageal reflux disease managed with omeprazole (1mg/kg once daily). On admission, his haemoglobin was 85 g/L. Oesophagogastroduodenoscopy (OGD) revealed severe oesophagitis with a tight, impassable stricture 15 cm from the incisors. Contrast swallow confirmed the stricture and biopsy showed mild spongiosis above it. Four weeks later, a single balloon dilation was performed using a CRE PRO™ Balloon Dilatation Catheter, dilating the stricture to 8 mm. A nasojejunal (NJ) tube was inserted due to his emaciated state. Biopsy of the distal oesophagus showed metaplasia consistent with BO. Post dilation, he was admitted for a two-week period of NJ tube feeding, after which he underwent laparoscopic Nissen fundoplication with hiatal hernia repair and new Stamm gastrostomy. Postoperatively, he transitioned to gastrostomy feeding and following a transient dumping syndrome he gained significant weight. At 6-month follow-up, repeat OGD and biopsy showed resolution of his stenosis and metaplasia. The patient was tolerating bolus feeding through his gastrostomy, with continued weight improvement. At his 18-month review, he remained well and was scheduled for ongoing endoscopic surveillance.</div></div><div><h3>Conclusion</h3><div>Gastro-oesophageal reflux disease, even when managed with anti-acid medication, can lead to Barrett's oesophagus in children as young as 3 years of age.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103009"},"PeriodicalIF":0.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826321","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":"Volvulus of the ascending and transverse colon in a 4-year-old child: a case report","authors":"Eya Lamloum,&nbsp;Yosra Ben Ahmed,&nbsp;Mariem Marzouki,&nbsp;Intissar Chibani,&nbsp;Faouzi Nouira,&nbsp;Said Jlidi","doi":"10.1016/j.epsc.2025.103008","DOIUrl":"10.1016/j.epsc.2025.103008","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of colonic volvulus in the pediatric population is unknown, with literature limited to case reports and small case series. Volvulus of the transverse colon is very rare and only a few cases have been documented so far.</div></div><div><h3>Case presentation</h3><div>A 4-year-old boy with no medical or surgical history who was brought to the emergency department due to acute abdominal pain and vomiting. Physical exam revealed a distended and tender abdomen, mostly in the epigastrium and right side. Basic blood tests were not revealing. A plain abdominal x-ray was done and appeared normal. A subsequent computed tomography (CT) scan showed a largely distended colon and a whirl sign in the mesocolon, suspicious for a colonic volvulus. He was taken to the operating room for an emergency laparotomy during which we found that the ascending and the transverse colon had volvulized 360° in an anticlockwise direction. The volvulized colon had no signs of ischemia. We detorsed the colon and confirmed that the perfusion was completely normal. The patient had an uneventful initial recovery. However, 48 hours after the operation he developed acute abdominal pain, which prompted us to take him back to the operating room for a re-laparotomy. We found that the segment of colon that had initially volvulized, despite not being ischemic at the time of the first operation, was now severely ischemic. We decided to do a resection of the ischemic segment and followed with an end-to-end anastomosis. The patient had an uneventful recovery and was discharged home on the fourth postoperative day. The pathology of the resected segment was unremarkable. At six months of follow-up, he remains in good health.</div></div><div><h3>Conclusion</h3><div>Transverse colonic volvulus, though rare in children, should be considered in children who develop acute abdominal pain and vomiting, even in the absence of abnormal findings on the plain abdominal films. Close postoperative monitoring is crucial for detecting potential early complications.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103008"},"PeriodicalIF":0.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800530","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":"Alternative treatment for refractory Jacquet dermatitis after Hirschsprung disease surgery: A case report","authors":"Sinan Kılıç ,&nbsp;Ahmet Güven ,&nbsp;Sakine Işık","doi":"10.1016/j.epsc.2025.103004","DOIUrl":"10.1016/j.epsc.2025.103004","url":null,"abstract":"<div><h3>Introduction</h3><div>Jacquet's erosive diaper dermatitis (JDD) is a severe form of diaper dermatitis, characterized by papuloerythematous erosions with crater-like borders in the genital and perianal regions.</div></div><div><h3>Case presentation</h3><div>A 2-year-old male patient was diagnosed with Hirschsprung disease (HD) during the neonatal period. A transition zone was detected in the rectosigmoid region on a contrast enema. Full-thickness rectal biopsy confirmed aganglionosis, and a colostomy was created from the transverse colon. At 18 months of age, the patient underwent the Swenson procedure, and the colostomy was closed during the same session. Following the operation, spontaneous stool passage was achieved. Approximately six months after surgery, ulcerative lesions characteristic of Jacquet dermatitis developed in the perianal region. Despite six months of treatment with moisturizers, regenerative, epithelializing, and barrier therapies (e.g., zinc oxide, madecassoside, shea butter, glycerin, oatmeal, hyaluronic acid), the lesions did not improve. However, after initiating treatment with pure Aloe Vera gel, including a 10 % diluted natural extract applied four times daily, plus a dairy-free diet for three weeks, a rapid clinical response was observed, with visible improvement within the same period.</div></div><div><h3>Conclusion</h3><div>The combination of Aloe Vera-based ointment plus dairy-free diet seems to be an effective management strategy for children with post pull-through Jacquet's dermatitis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103004"},"PeriodicalIF":0.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800531","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":"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}