Journal of Pediatric Surgery Case Reports最新文献

{"title":"Portal vein reconstruction using bovine pericardium graft after traumatic injury in a 6-year-old male: A case report","authors":"Ahsan Ali Ghauri,&nbsp;Zubair Shoukat,&nbsp;Faiz Rasool,&nbsp;Imran Hashim,&nbsp;Muhammad Saleem","doi":"10.1016/j.epsc.2025.102997","DOIUrl":"10.1016/j.epsc.2025.102997","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic portal vein injury (PVI) is a rare but life-threatening condition with a high mortality rate. Despite advancements in surgical techniques, the management of complex portal vein injuries remains challenging.</div></div><div><h3>Case presentation</h3><div>A 6-year-old male presented with abdominal trauma after being hit by a motor rickshaw. Despite inconclusive initial diagnostic imaging including a bedside abdominal ultrasound showing minimal ascites, the deterioration of all clinical parameters prompted an exploratory laparotomy. Intra-operative exploration revealed a transected portal vein with significant tissue loss and an avulsed common bile duct. Portal vein reconstruction was done using commercially available bovine pericardium, which was tubularized and grafted proximally and distally with polypropylene 6–0. Intra-operative Doppler ultrasound confirmed the successful restoration of portal venous flow. Additionally, we closed the common bile duct and did a cholecysto-duodenostomy to restore bile flow. Postoperative anticoagulation therapy included unfractionated heparin (10U/kg/hour) for 72 hours followed by aspirin (75mg daily) for six months, frequently monitoring the patency of the graft by Doppler ultrasound. He had a brief cardiac arrest 3 days after the operation due to ventilator-associated complications and suffered an ischemic brain injury that led to sensorimotor deficits. After an initial recovery in the intensive care unit, he was transferred to a rehabilitation unit and was discharged on postoperative day 19. At six-month of follow-up, Doppler ultrasound have confirmed graft patency. Liver function tests remain normal.</div></div><div><h3>Conclusion</h3><div>Bovine pericardium grafts appear to be a valuable option for the management of complex portal vein injuries.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102997"},"PeriodicalIF":0.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784061","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":"Midgut volvulus in a child with left isomerism: A case report","authors":"Amir Abadi ,&nbsp;Abdoh Numan Abdallah ,&nbsp;Noura Khalil Abu-Baji ,&nbsp;Tawfeeq Ali Al-Shobaki ,&nbsp;Kamal Jamil Abed ,&nbsp;Marwan Joma","doi":"10.1016/j.epsc.2025.102999","DOIUrl":"10.1016/j.epsc.2025.102999","url":null,"abstract":"<div><h3>Introduction</h3><div>Left isomerism, also known as polysplenia syndrome, is a rare condition characterized by abnormal lateralization of organs during embryonic development. It is associated with multiple anatomical abnormalities, including mirror image arrangement of thoracic and abdominal organs, disrupted vascular patterns, and increased susceptibility to cardiac and extra-cardiac anomalies.</div></div><div><h3>Case presentation</h3><div>An 8-year-old previously healthy girl presented to the emergency department with recurrent vomiting and general fatigue. Two days prior, she fell while playing and sustained a direct abdominal impact upon hitting the ground. Following the injury, she developed diffuse abdominal pain and frequent episodes of non-bloody, non-bilious vomiting. Over the next 48 hours, her vomiting became progressively projectile and green. She visited a pediatric clinic twice, where she received intravenous fluids and antiemetics, with only minimal symptomatic improvement. On arrival at the ED, she appeared dehydrated, with borderline blood pressure and persistent diffuse abdominal pain. There were no known chronic medical conditions and no family history of gastrointestinal disorders, On physical exam, patient was ill-appearing, fatigued, and mildly lethargic, with dry mucous membranes, and delayed capillary refill. On abdominal examination, there was diffuse tenderness, predominantly in the epigastric and periumbilical regions along with mild abdominal distension with guarding but no rebound tenderness and decreased bowel sounds. An ultrasound was done and was inadequate. A CT abdomen with contrast revealed a left isomerism along with midgut volvulus. Finally, an urgent exploratory laparotomy was done with an uneventful recovery.</div></div><div><h3>Conclusion</h3><div>Although rare, midgut volvulus should be ruled out in patients with left isomerism who develop abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102999"},"PeriodicalIF":0.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826320","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":"Laparoscopic repositioning of a malpositioned peritoneal dialysis catheter using an abdominal wall anchoring technique: A case report","authors":"Naoki Hashizume ,&nbsp;Hiroki Yoshida ,&nbsp;Shiori Tsuruhisa ,&nbsp;Naruki Higashidate ,&nbsp;Seiji Tanaka ,&nbsp;Tatsuru Kaji","doi":"10.1016/j.epsc.2025.102998","DOIUrl":"10.1016/j.epsc.2025.102998","url":null,"abstract":"<div><h3>Introduction</h3><div>Peritoneal dialysis (PD) catheters can sometimes change their position spontaneously and become dysfunctional, typically requiring a complete replacement.</div></div><div><h3>Case presentation</h3><div>A 6-year-old boy with Wolf–Hirschhorn syndrome and chronic kidney disease had a PD catheter placed laparoscopically via a left pararectal incision, with the catheter tip positioned in the pouch of Douglas. On the 20th postoperative day, the PD catheter became dysfunctional. Evaluation by a plain abdominal film showed that the PD catheter had migrated spontaneously to the upper abdomen. Instead of replacing it, we decided to reposition the PD catheter and anchor it to the abdominal wall to prevent further migration. To do that, we placed two percutaneous stitches of non-reabsorbable material under laparoscopic guidance. To manipulate the catheter and place the stitches around it, we did a trans-umbilical laparoscopic approach with two ports through an ad-hoc device placed in the umbilicus. The percutaneous stitches went in and out the abdomen through the abdominal and anchored the PD catheter in such a way that the end was in the pouch of Douglas, unable to become dislodged again. The two stitches were spaced 10 mm apart from each other. The postoperative course was uneventful, and the PD catheter remained functional and in the correct position for 6 months until it was removed because it was no longer needed.</div></div><div><h3>Conclusion</h3><div>Malpositioned PD catheters may be repositioned and secured by anchoring them to the abdominal wall with transparietal stitches.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 102998"},"PeriodicalIF":0.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747907","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":"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}