Journal of Pediatric Surgery Case Reports最新文献

{"title":"Transverse and left colon volvulus in a child with cerebral palsy: a case report","authors":"Younis Al-Mufargi ,&nbsp;Shiyam Al-Shaibani ,&nbsp;Balqees Al-Mujaini ,&nbsp;Mohsin Alriyami ,&nbsp;Mostafa Mahmoud Hamad ,&nbsp;Abdulmalik Al-Atar","doi":"10.1016/j.epsc.2025.103065","DOIUrl":"10.1016/j.epsc.2025.103065","url":null,"abstract":"<div><h3>Introduction</h3><div>Colonic volvulus is an uncommon cause of intestinal obstruction in children, with sigmoid volvulus being the most frequently reported type. Transverse and left colonic volvulus is exceedingly rare, particularly in patients with underlying neuromuscular disorders such as spastic cerebral palsy (CP).</div></div><div><h3>Case presentation</h3><div>A 10-year-old male child with a known history of spastic cerebral palsy (CP) presented to the emergency department with progressive abdominal distension for five days and urinary retention for two days. He had a history of chronic constipation and was on oral baclofen for the management of his spasticity. He was febrile (38 °C), tachycardic, and had a severely distended and tense abdomen. Abdominal imaging, including x-ray and computed tomography (CT) revealed grossly distended large bowel loops with no clear transition point, suggestive of large bowel obstruction. He was taken emergently to the operating room for an exploratory laparotomy. We found that the transverse and left colon had volvulized and had patchy ischemia. The right and sigmoid colon were healthy. We did a resection of the volvulized colon, followed by a primary colo-colic anastomosis. The patient's postoperative recovery was uneventful. He resumed enteral feedings on postoperative day 3 and was discharged home shortly afterwards. At the 6-week follow up he continued to do well and had regular bowel function.</div></div><div><h3>Conclusion</h3><div>Volvulus of the transverse and left colon should be considered in children who develop a bowel obstruction, particularly in those with a history of chronic constipation and/or cerebral palsy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103065"},"PeriodicalIF":0.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665862","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":"Torsion of a herniated ovary in an infant: a case report","authors":"Ismail Benomar ,&nbsp;Hidaya Zitan ,&nbsp;Loubna Aqqaoui ,&nbsp;Ali Lahrech ,&nbsp;Houda Oubejja ,&nbsp;Fouad Ettayebi","doi":"10.1016/j.epsc.2025.103066","DOIUrl":"10.1016/j.epsc.2025.103066","url":null,"abstract":"<div><h3>Introduction</h3><div>Inguinal hernias are relatively common in newborns; however, herniation of the ovary through the canal of Nuck is a rare condition that can lead to ovarian torsion and infarction if not promptly managed.</div></div><div><h3>Case presentation</h3><div>We report the case of a 3-month-old female infant, born at term following an uneventful pregnancy and neonatal period, with normal growth parameters and psychomotor development. She presented with a non-reducible, tender right inguinal mass associated with local signs of inflammation. Symptoms had been evolving over five days. Doppler ultrasonography revealed an enlarged, heterogeneous ovarian structure with absent vascular flow, indicative of adnexal torsion. Surgical exploration confirmed torsion of the right fallopian tube and a necrotic ovary within an inflamed hernia sac. A right salpingo-oophorectomy was performed. The patient was discharged 24 hours postoperatively. Histopathological examination revealed ovarian gangrene without evidence of neoplastic or dysplastic changes. Postoperative recovery was uneventful, and no complications were observed at the 3-month follow-up.</div></div><div><h3>Conclusion</h3><div>Ovaries herniated into the inguinal canal require prompt reduction and hernia repair to avoid potential complications such as torsion and infarction, as observed in our patient.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103066"},"PeriodicalIF":0.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653693","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":"Suprapubic dermoid sinus in a 9-month-old infant: A case report","authors":"Eiman Yassir Musa Hussain ,&nbsp;Tarek Abdelazeem Sabra ,&nbsp;Sarah Magdy Abdelmohsen","doi":"10.1016/j.epsc.2025.103058","DOIUrl":"10.1016/j.epsc.2025.103058","url":null,"abstract":"<div><h3>Introduction</h3><div>Suprapubic dermoid sinuses are rare congenital anomalies resulting from incomplete ectodermal separation during embryogenesis.</div></div><div><h3>Case presentation</h3><div>A 9-month-old male infant presented with a midline suprapubic dimple noted since birth and no other medical history. Ultrasound revealed a superficial sinus tract, and Magnetic Resonance Imaging (MRI) confirmed a well-defined, blind-ending tract without any deeper communication. A complete excision was done in the operating room under general anesthesia. We guided the dissection of the sinus with methylene blue injected in it. The histopathology confirmed the diagnosis of a dermoid sinus lined with keratinized squamous epithelium containing dermal appendages. The postoperative recovery was uneventful. No recurrence was observed at the 1-month, 3-month, and 6-month follow-up visits.</div></div><div><h3>Conclusion</h3><div>Dermoid sinuses, although rare, should be included in the differential diagnosis of midline congenital dimples in infants.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103058"},"PeriodicalIF":0.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679394","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":"Congenital H-type recto-vaginal fistula with normal anus: a case report","authors":"Samuel Kefiyalew Kelbessa,&nbsp;Berhanu Nigusse Bikila,&nbsp;Amanuel Mesfin Oljira","doi":"10.1016/j.epsc.2025.103054","DOIUrl":"10.1016/j.epsc.2025.103054","url":null,"abstract":"","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103054"},"PeriodicalIF":0.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633583","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":"Surgical evaluation and management of infected tailgut cysts in pediatrics: A case series","authors":"Matthew T. Parrish ,&nbsp;Ryan Watkins ,&nbsp;D. Dean Potter Jr.","doi":"10.1016/j.epsc.2025.103062","DOIUrl":"10.1016/j.epsc.2025.103062","url":null,"abstract":"<div><h3>Introduction</h3><div>Tailgut cysts are lesions occurring in the presacral space that most commonly present in early adulthood but can be identified in the pediatric population. Superimposed infection is even more rare which can lead to diagnostic and treatment uncertainty when encountered.</div></div><div><h3>Case presentations</h3><div>Patient 1 was an 8-year-old male who originally presented with lower abdominal pain and fevers. A computed tomography (CT) scan was performed identifying a 2.8 cm presacral fluid collection. Definitive management via posterior midline approach with coccygectomy was performed. He subsequently developed a small fluid collection that resolved with antibiotics. Patient 2 was a 15-year-old male who presented from an outside institution after CT revealed a presacral abscess. Attempts at transgluteal drain were unsuccessful. Subsequently, he was taken to the operating room, were an anterior, laparoscopic approach was used to partially excise the presacral cyst. After recurrence, a posterior approach with coccygectomy was performed with resolution of the cyst. Patient 3 was a 10-year-old female who was found to have a 4.3 cm presacral abscess that recurred after surgical drainage at an outside institution. The patient was taken to the operating room, where a posterior midline approach with coccygectomy was performed with resolution of the cyst.</div></div><div><h3>Conclusion</h3><div>Complete surgical excision appears to be the most definitive treatment modality for infected tailgut cysts with our preferred approach through the posterior sagittal midline. While rare, tailgut cysts should remain in the differential for any recurrent or new complex presacral infection resistant to standard medical and surgical treatment.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103062"},"PeriodicalIF":0.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633543","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":"Brunner's gland hyperplasia causing gastric outlet obstruction in a child: a case report","authors":"Saswati Behera ,&nbsp;Ram Samujh ,&nbsp;Gursewak Singh ,&nbsp;Gulshan Kumar Saini ,&nbsp;Ankita Soni ,&nbsp;Navdeep Singh Dhoat","doi":"10.1016/j.epsc.2025.103061","DOIUrl":"10.1016/j.epsc.2025.103061","url":null,"abstract":"<div><h3>Introduction</h3><div>Brunner's gland hyperplasia (BGH) is a rare, benign proliferation of the mucus-secreting glands located predominantly in the proximal duodenum. It is most often identified incidentally during endoscopic or radiologic evaluations.</div></div><div><h3>Case presentation</h3><div>A 12-year-old boy presented with several weeks of intermittent postprandial abdominal pain, non-projectile vomiting, and gradually increasing upper abdominal distension. His symptoms acutely worsened, progressing to bilious vomiting and marked abdominal bloating. On physical examination, visible gastric peristalsis and hyperactive bowel sounds were observed. Abdominal radiography showed a distended stomach, and contrast-enhanced computed tomography (CT) revealed an intraluminal mass in the third part of the duodenum. Upper gastrointestinal endoscopy identified a large, pedunculated polypoid lesion obstructing more than 50 % of the duodenal lumen. Endoscopic biopsies revealed chronic inflammation without evidence of malignancy. Due to the risk of perforation and technical limitations of endoscopic resection, the patient underwent exploratory laparotomy. Intraoperatively, hypertrophic mucosal folds were identified near the duodenojejunal junction. A mucosectomy was performed via enterotomy. Histopathological examination confirmed Brunner's gland hyperplasia without any evidence of dysplasia. The postoperative course was uneventful, and the patient remains asymptomatic at 8 months of follow-up.</div></div><div><h3>Conclusion</h3><div>Brunner's gland hyperplasia should be included in the differential diagnosis of children who develop duodenal or gastric outlet obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103061"},"PeriodicalIF":0.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614013","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":"Management of cecal volvulus in adolescents: a case series","authors":"MaKayla L. O'Guinn ,&nbsp;Preeti Singh ,&nbsp;William Farmer ,&nbsp;Tarun Kumar ,&nbsp;Ulises Garza-Serna","doi":"10.1016/j.epsc.2025.103059","DOIUrl":"10.1016/j.epsc.2025.103059","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of cecal volvulus in the pediatric population is unknown and there is no consensus on the best approach to managing in children.</div></div><div><h3>Case presentations</h3><div>Case 1: A 17-year-old female presented with one day of abdominal pain and tenderness in the right lower abdomen. Laboratory studies were notable for leukocytosis. A computed tomography scan of the abdomen and pelvis (CT-A/P) demonstrated a swirl of the right colonic mesentery, consistent with cecal volvulus. Laparoscopic detorsion was performed via three ports. The lateral peritoneal attachments were found to be redundant. The peritoneum near the colon was sutured to its attachment to the lateral abdominal wall, to shorten the attachments of the right colon in an interrupted fashion with non-absorbable suture at three points. An appendectomy was performed and the base, rather than the cecum, was fixated to the lateral abdominal wall. The patient was discharged on postoperative day one. On follow-up one week later, she was doing well and there were no concerns.</div></div><div><h3>Case 2</h3><div>A 17-year-old female presented to an outside hospital with several hours of abdominal pain, associated nausea, and tenderness in the right lower abdomen. Laboratory studies were unremarkable. A CT-A/P demonstrated a swirl of the right colonic mesentery and cecal dilation of 9 cm, consistent with cecal volvulus. The patient was then transferred to our facility for definitive care. Management was via an open approach and revealed a lack of right colon peritoneal attachments. An ileocecectomy was performed followed by a primary stapled ileocolic anastomosis. The patient recovered well and discharged home on postoperative day three. There were no reported concerns at follow-up six weeks later.</div></div><div><h3>Conclusion</h3><div>Cecopexy and ileocecectomy may have similar outcomes for the management of cecal volvulus in adolescents.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103059"},"PeriodicalIF":0.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739571","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":"Appendiceal stricture following Mini-ACE® enema button placement: a case report","authors":"Signe Olsbø ,&nbsp;Kjetil Næss Ertresvåg ,&nbsp;Kristin Bjørnland","doi":"10.1016/j.epsc.2025.103060","DOIUrl":"10.1016/j.epsc.2025.103060","url":null,"abstract":"<div><h3>Introduction</h3><div>Few studies have looked at complications related to antegrade continence enema (ACE) devices. This report discusses a complication of the Mini-ACE® button and how it was managed.</div></div><div><h3>Case presentation</h3><div>The patient was a 7-year-old boy with a history of constipation and fecal incontinence. He first experienced constipation at the age of 1 year. Hirschsprung disease was ruled out by a rectal biopsy. After a multidisciplinary evaluation, he underwent an appendicostomy procedure with a Mini-ACE® for antegrade enemas. The Mini-ACE® functioned well for 1 year. However, after a routine replacement, increased resistance was noted during water installation. When attempting to replace the device, not even a guidewire could be passed through the appendix. Contrast fluoroscopy identified a 2-cm long appendiceal stricture, located about 3 cm from the cecum. Since a new Mini-ACE® could not be inserted, conservative treatment with oral laxatives was initiated. The patient refused rectal enemas. The patient's constipation and fecal incontinence recurred. Three months later he was taken to the operating room to revise the appendicostomy. Through a laparoscopic approach, the stricture was resected, and the two ends of the appendix were anastomosed. At one year of follow-up, the patient has good symptom control, and the use of the Mini-ACE remains uncomplicated. The stricture was likely caused by the inflation of the Mini-ACE® balloon within the appendix.</div></div><div><h3>Conclusion</h3><div>ACE appendicostomies can develop fibrosis if the button balloon is inflated within the appendix. If the fibrotic segment is not too long, resection and appendiceal anastomosis may be a viable option to preserve the appendicostomy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103060"},"PeriodicalIF":0.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic heteropagus conjoined twins with associated omphalocele: a case report","authors":"Mahamoud Omid Ali Ada ,&nbsp;Mansour Issoufou Hama Sidi ,&nbsp;Hellé Moustapha ,&nbsp;Issoufou Yaro ,&nbsp;Oumarou Habou ,&nbsp;Habibou Abarchi","doi":"10.1016/j.epsc.2025.103055","DOIUrl":"10.1016/j.epsc.2025.103055","url":null,"abstract":"<div><h3>Introduction</h3><div>Heteropagus conjoined twins represent an exceptionally rare congenital malformation. A thoracic attachment is even more uncommon. The concurrent presence of omphalocele further complicates management, particularly in resource-limited settings.</div></div><div><h3>Case presentation</h3><div>A 7-day-old female neonate was admitted following a full-term pregnancy and normal vaginal delivery due to a mass in the lower thoracic region, attached to the sternum, with two pelvic limbs and one thoracic limb joined by a pelvis, resembling a parasitic twin. The parasitic twin presented a perineum with female-type external genitalia but no anal orifice. Additionally, a type 2 omphalocele (Aitken classification) with a maximum diameter of 9 cm was observed in the patient's abdomen. Thoraco-abdomino-pelvic computed tomography (CT) imaging revealed osseous segments of limbs within the anterior thoracic mass, alongside herniation of part of the liver through the abdominal wall defect. Echocardiography revealed multiple ventricular septal defects. The diagnosis of a thoracopagus parasitic twin was established. Surgical excision of the parasitic twin was performed at the age of 20 days. A circular incision above the pedunculated base exposed the parasitic pelvis, which contained a rudimentary kidney, dilated ureter, and distended bladder. We did a complete excision included the pelvis, lower limbs, rudimentary upper limb, and osseous components, and finished with a tension-free skin closure. The postoperative recovery was complicated by a minor superficial wound infection, which resolved with antibiotics. We decided to treat the omphalocele conservatively with daily dressing changes to promote skin coverage. We plan to close the omphalocele at the age of 18 months.</div></div><div><h3>Conclusion</h3><div>The management of heteropagus twins requires comprehensive imaging evaluation. In resource-limited settings, patients with a combination of malformations may benefit from a staged treatment strategy to optimize outcomes.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103055"},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midgut volvulus without intestinal malrotation in a teenager: a case report","authors":"Yasmine Houas,&nbsp;Alma Baccouche,&nbsp;Nader Bennour Ghaddab,&nbsp;Sirine Fkaier,&nbsp;Riadh Jouini","doi":"10.1016/j.epsc.2025.103056","DOIUrl":"10.1016/j.epsc.2025.103056","url":null,"abstract":"<div><h3>Introduction</h3><div>Midgut volvulus is a life-threatening surgical emergency typically associated with intestinal malrotation in neonates and infants. However, midgut volvulus without malrotation is rare and often underrecognized, particularly in older children, leading to delays in diagnosis and management.</div></div><div><h3>Case presentation</h3><div>We present the case of a previously healthy 13-year-old male with a one-week history of intermittent, crampy abdominal pain and bilious vomiting. He was initially diagnosed with viral gastroenteritis and treated symptomatically, but symptoms persisted and worsened. On admission, he was afebrile but had a distended, tender abdomen without signs of peritonitis. Abdominal X-rays were inconclusive, showing nonspecific bowel gas patterns. An abdominal ultrasound showed no definitive abnormalities. Due to ongoing symptoms, a contrast-enhanced abdominal computed tomography (CT) scan was performed, revealing a classic “whirlpool sign” of the superior mesenteric vessels and proximal bowel dilation. The patient underwent emergency exploratory laparotomy. Intraoperatively, a 360° midgut volvulus was found, caused by congenital mesenteric adhesions. The bowel appeared viable. Detorsion and complete adhesiolysis were performed without the need for resection. The postoperative course was uneventful: oral feeding was reinitiated on postoperative day 2, and the patient was discharged on postoperative day 6. At three-month follow-up, he remained asymptomatic with no signs of recurrence.</div></div><div><h3>Conclusion</h3><div>Midgut volvulus must be included in the differential diagnosis of teenagers who develop abdominal pain and/or bilious emesis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"120 ","pages":"Article 103056"},"PeriodicalIF":0.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}