Joanna Sajdlowska , Agron Zuta , John Paul Bustamante , Nishith Bhattacharyya
{"title":"Marfan syndrome coagulopathy in a patient undergoing bilateral video assisted thoracic surgery (VATS): A case report","authors":"Joanna Sajdlowska , Agron Zuta , John Paul Bustamante , Nishith Bhattacharyya","doi":"10.1016/j.epsc.2025.102968","DOIUrl":"10.1016/j.epsc.2025.102968","url":null,"abstract":"<div><h3>Introduction</h3><div>Marfan syndrome is an inherited connective tissue disease that contributes to a wide range of health challenges, many of which can cause potential harm to several organs due to underlying coagulopathy.</div></div><div><h3>Case presentation</h3><div>A 20-year-old male with Marfan syndrome underwent an elective bilateral video-assisted thoracic surgery (VATS) for the management of recurrent pneumothorax after three prior episodes that required hospitalization. The procedure included mechanical and chemical pleurodesis, stapling of the apex of the right lung due to the presence of subpleural blebs, and placement of bilateral chest tubes (one per side). The patient was electively admitted to the pediatric intensive care unit (PICU) after the operation. The postoperative chest x-ray done for hours after the operation showed a large amount of fluid in the left pleural cavity, suspicious for a left hemothorax. A unit of fresh frozen plasma (FFP) was promptly administered, and the patient was taken back to the operating room for a VATS evacuation of the hemothorax and to upsize the chest tube. All clots were removed from the left chest, which was copiously irrigated with 8 L of fluid. No arterial bleeding was identified. A thromboelastography (TEG) test was performed and the resuscitation continued with two additional units of packed red blood cells intra-operatively plus postoperative 1:1:1 administration of FFP, platelets and cryoprecipitate. The patient remained hemodynamically stable overnight in the PICU. Four days later, he was medically cleared for a safe discharge.</div></div><div><h3>Conclusion</h3><div>Patients with Marfan syndrome have an intrinsic coagulopathy and need closer surveillance, as well as prompt intervention if needed, during and after surgical procedures.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102968"},"PeriodicalIF":0.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148246","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":"Posterior mediastinal Müllerian duct cyst in a child: A case report","authors":"Ryota Dobashi , Yoshihiro Kubota , Yuma Takeuchi , Atsuki Uchibori , Shinya Ito","doi":"10.1016/j.epsc.2025.102969","DOIUrl":"10.1016/j.epsc.2025.102969","url":null,"abstract":"<div><h3>Introduction</h3><div>Müllerian duct cysts were described in 2005 and are most common in peri- and postmenopausal women. Müllerian cysts have not been described in young children.</div></div><div><h3>Case presentation</h3><div>A previously healthy 4-year-old girl with bronchitis was admitted to our hospital. A plain chest X-ray showed an abnormal mediastinal shadow. A contrast-enhanced computed tomography of the chest revealed a homogeneous tumor in the left posterior mediastinum, showing no contrast enhancement or calcifications. The tumor measured 9.1 × 4.7 × 3.8 cm and extended from the 5th to the 10th vertebral bodies. A chest magnetic resonance imaging confirmed the cystic posterior mediastinal mass with low signal intensity on T1-weighted and high signal intensity on T2-weighted images. With the presumed diagnosis of lymphangioma, the patient was taken to the operating room for a thoracoscopic mediastinal tumor resection. The patient was placed in right lateral decubitus and three ports were placed in the left pleural space. We found the cyst on the dorsal side of the lower lobe of the left lung. The cyst was not adherent to the diaphragm or the lower lobe itself, but was located near the intercostal arteries and veins, hemiazygos vein, and the sympathetic trunk. The cyst was carefully dissected off all surrounding structures. We opened the cyst, drained its serous fluid, and removed it entirely. The pathological analysis showed a monolayer of cuboidal cells with atypical round nuclei covering the cyst wall. The immunohistochemical analysis revealed positivity for PAX8 and estrogen receptor, and negativity for progesterone receptor and calretinin. These findings confirmed the diagnosis of a Müllerian duct cyst. The postoperative course was uneventful, and the patient was discharged home on the fifth postoperative day. At 6 months follow-up, no recurrence has been observed.</div></div><div><h3>Conclusion</h3><div>Müllerian duct cysts are extremely rare in the pediatric population but should be considered in the differential diagnosis of mediastinal cysts in children.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102969"},"PeriodicalIF":0.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147296","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":"Saving the neo-Malone for later: A case report","authors":"Wendy Jo Svetanoff, Richard Wood","doi":"10.1016/j.epsc.2025.102967","DOIUrl":"10.1016/j.epsc.2025.102967","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with complex anorectal malformations may undergo multiple abdominal operations, which may result in a hostile abdomen. We report a case of fashioning a neo-Malone during the creation of an ileovesicostomy that was kept in the subcutaneous tissue until antegrade flushes were needed.</div></div><div><h3>Case presentation</h3><div>A premature female born at 32 weeks of gestation was found to have a cloaca malformation at birth. She developed severe pulmonary hypertension and abdominal compartment syndrome, requiring an exploratory laparotomy and placement of a temporary abdominal closure. She subsequently required five more operations before the abdomen was closed and a proper ostomy was created. At the age of one year, she underwent a cloacagram, a cystoscopy and a vaginoscopy. The length of the common cloacal channel was 4 cm at that time. She subsequently underwent a posterior sagittal anorectal vaginal urethral plasty (PSARVUP), reversed rectal neovagina creation, and urethroplasty. At the age of three years, she underwent an ileovesicostomy due to hostile urodynamics. Anticipating that she could need antegrade enemas in the future, a neo-Malone was created at the time of the ileovesicostomy. A pedicle of tissue was dissected out of the anti-mesenteric wall of the colon to create the channel. A valve was fashioned around the base. Metal clips were placed for future identification. The neo-Malone was pulled through a 3-mm fascial defect and sutured to the deep dermis. At the age of six years, the neo-Malone was matured. Using fluoroscopy to visualize the clips, the neo-Malone was identified, and a Y opening created. Patency of the Neo-Malone was confirmed by fluoroscopy. The neo-Malone was sutured to the skin. At one year of follow-up, she remains free of accidents between antegrade flushes.</div></div><div><h3>Conclusion</h3><div>Patients with complex anorectal malformations may require multiple operations that may lead to a hostile abdomen. Anticipating potential future surgical needs and combining procedures, when possible, constitutes an important aspect of the care of these patients.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102967"},"PeriodicalIF":0.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147719","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}
Megan A. Read, Chelsea A. Kebodeaux, Geri Hewitt, Richard J. Wood
{"title":"Letter to the editor re: “Novel use of AlloDerm for partial vaginal replacement in a patient with cloaca: A case report”","authors":"Megan A. Read, Chelsea A. Kebodeaux, Geri Hewitt, Richard J. Wood","doi":"10.1016/j.epsc.2025.102964","DOIUrl":"10.1016/j.epsc.2025.102964","url":null,"abstract":"","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102964"},"PeriodicalIF":0.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148295","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":"Torsion of accessory spleen mimicking acute appendicitis in a 4-year-old female: A case report","authors":"Addisu Andargie , Absalat Serawit Negussie","doi":"10.1016/j.epsc.2025.102966","DOIUrl":"10.1016/j.epsc.2025.102966","url":null,"abstract":"<div><h3>Introduction</h3><div>Accessory spleens are masses of splenic tissue commonly located near the splenic hilum and found in 10 %–30 % of the population. Accessory spleens can be either solitary or multiple. Due to their variable location, complications of accessory spleens can mimic other acute abdominal conditions.</div></div><div><h3>Case presentation</h3><div>A 4-year-old girl presented with classical signs and symptoms of acute appendicitis of two days of duration. Physical examination showed an uncomfortable appearing girl with a slight tachycardia and tachypnea. She had discrete tenderness to palpation over the right iliac fossa. Complete blood count (CBC) and electrolyte levels were within normal limits. Abdominal ultrasound findings were not contributory. Because of the unavailability of other imaging studies and the persistence of her pain she was taken to the operating room with a presumed diagnosis of early acute appendicitis.The abdomen was entered through a transverse incision in the right lower quadrant. An encapsulated, rounded, 4 x 4 x 5-cm solid mass was identified on the mesenteric side of the terminal ileum. The mass had a 270-degree torsion around its pedicle. The appendix appeared normal. The pedicle of the solid mass was ligated, the mass was fully excised and was sent for a pathology analysis. The histopathological examination showed infarcted splenic tissue, consistent with torsion of an accessory spleen. The postoperative course was uneventful, and the patient was discharged home on the third postoperative day.</div></div><div><h3>Conclusion</h3><div>Torsion of an accessory spleen should be considered in the differential diagnosis of acute abdomen in children and adolescents, particularly in those with inconclusive imaging studies.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102966"},"PeriodicalIF":0.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148294","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}
Hercules Magalhães Olivense do Carmo , Miguel Lucas Silva Valente , Sthefanie da Silva Bessa , Pedro Lucas Melo Brilhante , Melayne Silva de Oliveira , Luana Livelli Becker , João Lucas de Melo Bardi , Angela Claudia Paixão Soares de Magalhães
{"title":"Duodenal perforation in a child due to lollipop stick ingestion: A case report","authors":"Hercules Magalhães Olivense do Carmo , Miguel Lucas Silva Valente , Sthefanie da Silva Bessa , Pedro Lucas Melo Brilhante , Melayne Silva de Oliveira , Luana Livelli Becker , João Lucas de Melo Bardi , Angela Claudia Paixão Soares de Magalhães","doi":"10.1016/j.epsc.2024.102944","DOIUrl":"10.1016/j.epsc.2024.102944","url":null,"abstract":"<div><h3>Background</h3><div>Foreign body ingestion is common in children. While most ingested objects pass harmlessly through the gastrointestinal tract, some can cause severe complications like perforation, which may be life-threatening.</div></div><div><h3>Case presentation</h3><div>A 4-year-old boy who presented with a 24-h history of abdominal pain, fever, and vomiting. Physical examination revealed a distended and tender abdomen with signs of peritonitis. An abdominal radiograph showed free air under the diaphragm and gastric and intestinal distension. Abdominal ultrasonography confirmed intestinal dilation and the presence of free fluid. An emergency exploratory laparotomy was performed, revealing a punctiform perforation on the fourth portion of the duodenum caused by a lollipop stick protruding into the retroperitoneal space. The foreign body was removed, and a primary repair of the duodenal perforation was performed. A drain was placed near the repair site, and a nasogastric tube left in place for gastric decompression. The postoperative course was uneventful. The patient received intravenous antibiotics until the day of his discharge. He resumed oral diet on the third postoperative day. The drain was removed on the fifth postoperative day. He was discharged home on the seventh postoperative day.</div></div><div><h3>Conclusion</h3><div>Duodenal perforation due to foreign body ingestion is rare but should be included in the differential diagnosis of young children who present with peritonitis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102944"},"PeriodicalIF":0.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147295","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}
Seth Saylors, Cory Nonnemacher, Irene Isabel P. Lim
{"title":"Massive gastroduodenal trichobezoar removed with hydrodissection: A case report","authors":"Seth Saylors, Cory Nonnemacher, Irene Isabel P. Lim","doi":"10.1016/j.epsc.2024.102954","DOIUrl":"10.1016/j.epsc.2024.102954","url":null,"abstract":"<div><h3>Introduction</h3><div>Trichobezoars are a rare cause of gastrointestinal obstruction in children. Trichobezoars are primarily confined to the stomach but in some cases can grow to substantial sizes and extend into the duodenum. Most trichobezoars require surgical removal through an often large gastrotomy.</div></div><div><h3>Case presentation</h3><div>A previously healthy 15-year-old female presented with 4 days of nausea, vomiting, and diarrhea. Examination was concerning for hypotension, severe abdominal distension, and diffuse peritonitis. Abdominal x-ray showed distended bowel loops in the upper abdomen and concern for pneumoperitoneum. Laboratory studies showed leukocytosis, anion gap metabolic acidosis, and acute kidney injury. The patient underwent emergent exploratory laparotomy which revealed a massive trichobezoar (42 cm × 12 cm) with distal portion in the duodenum, a closed loop obstruction of small bowel with a small trichobezoar in the proximal jejunum with bowel necrosis nearby, and pneumatosis from the proximal ileum to the transverse colon. The patient underwent anterior gastrotomy with successful removal of the bezoar in a single piece. During removal of the bezoar, we utilized a hydrodissection technique with warm saline that allowed separation of the entwined hairs from the gastric mucosa while also making the mass malleable as it absorbed the liquid. Additionally, she underwent small bowel resection x2 and temporary abdominal closure with wound vac placement. She returned to the OR two more times for washout and eventual anastomosis of small bowel and abdominal closure. Her post-operative course was complicated by refeeding syndrome, and she was discharged on POD 17 tolerating regular diet.</div></div><div><h3>Conclusion</h3><div>Large trichobezoars traditionally are removed via large anterior gastrotomy. The use of hydrodissection with warm irrigation can soften the bezoar and make it more pliable for removal through a smaller gastrotomy and minimize iatrogenic mucosal damage.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102954"},"PeriodicalIF":0.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148247","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}
Mohammed Alra'e , Majd Oweidat , Shareef Hassan , Radwan Abukarsh
{"title":"Ovarian torsion in a 5-month-old infant: A case report","authors":"Mohammed Alra'e , Majd Oweidat , Shareef Hassan , Radwan Abukarsh","doi":"10.1016/j.epsc.2025.102965","DOIUrl":"10.1016/j.epsc.2025.102965","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian torsion is a rare gynecological emergency in infants. Its rarity and its nonspecific symptoms make its early diagnosis challenging.</div></div><div><h3>Case presentation</h3><div>A previously healthy 5-month-old infant presented with inconsolable irritability, diarrhea and signs of dehydration. She was a former 32 weeker born by Cesarean section with a weight of 1600 g after an uneventful pregnancy. On physical exam she was tachycardic and tachypneic, but afebrile. She had diffuse abdominal tenderness but no abdominal distension. Bloodwork showed leukocytosis but no other abnormalities. Abdominal ultrasonography (US) showed an enlarged, ovoid, hyperechogenic right ovary (3.6 × 1.9 cm) with multiple internal follicles but no detectable vascular flow, suggestive of right ovarian torsion. The left ovary appeared normal in size and vascularity. She was taken to the operating room emergently for an exploratory laparotomy which was done through an infraumbilical midline incision. We found a swollen, torsed right ovary with signs of ischemia. We detorsed the ovary and wrapped it in gauze soaked in warm normal saline solution. To alleviate intraovarian pressure and further improve perfusion we made several small incisions on the surface of the ovary. The ovary regained normal perfusion within 10 min. The postoperative course was uneventful. She was discharged home shortly after the operation. An US done one month later showed the right ovary still slightly larger than the left ovary but with normal vascular flow.</div></div><div><h3>Conclusion</h3><div>It is important to include ovarian torsion in the differential diagnosis of female infants that develop acute abdominal pain. Early surgical intervention is key to preserve the viability of a torsed ovary.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102965"},"PeriodicalIF":0.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147718","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":"Giant mesenteric cyst with ascites in a 3-year-old boy: A case report","authors":"Anagheem Albaho , Alaa Alsafadi , Batoul Alraya , Sherine Alahmad , Hazem Kamil , Jaber Mahmod","doi":"10.1016/j.epsc.2025.102962","DOIUrl":"10.1016/j.epsc.2025.102962","url":null,"abstract":"<div><h3>Introduction</h3><div>Mesenteric cysts are rare, benign intra-abdominal lesions that predominantly affect children. They have an estimated incidence of 1 case per 20,000 children and 1 case per 105,000 adults. They are often discovered incidentally during imaging studies done for unrelated reasons.</div></div><div><h3>Case report</h3><div>A 3-year-old child presented to the hospital with a year-long history of abdominal distension and recent weight loss. He had no relevant medical history. Clinical examination showed a distended abdomen dull on percussion, but he was otherwise in good general condition. The initial working diagnosis was ascites from portal hypertension. An abdominal ultrasound (US) showed free fluid in the peritoneal cavity, and the fluid was sampled. The serum-ascites albumin gradient (SAAG) was 1.3, suggestive of portal hypertension. He had an echocardiogram that showed mild left ventricular dilation, and he was therefore started on captopril, spironolactone and furosemide. He underwent an upper gastrointestinal endoscopy which revealed a sliding hiatal hernia and mild duodenitis, but no signs of portal hypertension. He subsequently underwent an abdominal CT scan that showed a large, multi-loculated mesenteric cyst displacing the bowel intestinal loops posteriorly. The patient underwent a laparotomy with complete resection of the mesenteric cyst. The postoperative echocardiogram showed good systolic function and all medications were stopped. After two years of follow-up, he has no recurrence of the mesenteric cyst.</div></div><div><h3>Conclusion</h3><div>Despite being rare, giant mesenteric cysts should be included in differential diagnoses of patients with unexplained abdominal distension.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102962"},"PeriodicalIF":0.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147294","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}
Umar Mahmood, Hamza Malik, Muhammad Usama Aziz, Rija Khalid, Chaudhary Ehtsham Azmat, Sunaina Siddique
{"title":"Phytobezoar caused by ingestion of air cooler husk in a 6-year-old boy: A case report","authors":"Umar Mahmood, Hamza Malik, Muhammad Usama Aziz, Rija Khalid, Chaudhary Ehtsham Azmat, Sunaina Siddique","doi":"10.1016/j.epsc.2025.102961","DOIUrl":"10.1016/j.epsc.2025.102961","url":null,"abstract":"<div><h3>Introduction</h3><div>Bezoars are conglomerates of indigestible material that accumulate in the gastrointestinal tract. Phytobezoars, derived from plant matter, are the most common type.</div></div><div><h3>Case presentation</h3><div>A 6-year-old boy presented with a one-week history of severe continuous abdominal pain, projectile vomiting, and constipation. He had experienced intermittent abdominal pain over the preceding three months, temporarily relieved by over-the-counter medications. Despite being well-developed, the child had a habit of chewing air cooler husk strips. Physical examination revealed a firm mass in the epigastrium extending to the right hypochondrium. An erect abdominal X-ray showed a distended stomach, without any distal obstruction. Abdominal ultrasound identified a mass with posterior shadowing, suggestive of a bezoar. Computerized tomography (CT) of the abdomen confirmed a mottled, heterogeneous mass in the stomach. The patient underwent an upper gastrointestinal endoscopy that confirmed a bezoar composed of air cooler husks, extending into the lower esophagus, but endoscopic removal was unsuccessful. The patient underwent a laparotomy and through an anterior gastrotomy we entirely removed the bezoar. The gastric wall had no signs of pressure necrosis or ulceration. The stomach was closed in 2 layers with running sutures. The patient recovered uneventfully. He remained nil per os (NPO) for 5 days, resumed oral feedings on the 6th postoperative day, and was discharged home on the 7th postoperative day having regular bowel movements and tolerating his diet well.</div></div><div><h3>Conclusion</h3><div>Phytobezoars must be included in the differential diagnosis of children with recurrent abdominal pain, particularly those with abnormal eating habits.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102961"},"PeriodicalIF":0.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147676","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}