Journal of Pediatric Surgery Case Reports最新文献

{"title":"Bowel obstruction due to small bowel fistulization seven years after magnet ingestion: a case report","authors":"Chloe Savino,&nbsp;Kristen Calabro","doi":"10.1016/j.epsc.2025.103014","DOIUrl":"10.1016/j.epsc.2025.103014","url":null,"abstract":"<div><h3>Introduction</h3><div>Accidental ingestion of magnets by children is known to cause complications in the acute period, including tissue necrosis, perforation, obstruction, and fistulization. There are limited case reports in the literature describing complications several years after the initial ingestion of the magnet.</div></div><div><h3>Case presentation</h3><div>A 17-year-old male with autism spectrum disorder presented with 1 day of abdominal pain and several episodes of emesis. On exam, he was distended and tender to palpation in the lower abdomen. Blood tests were notable for leukocytosis of 21.4 thousand/ul. A computerized tomography (CT) of the abdomen and pelvis without contrast showed evidence of a small bowel obstruction possibly with a transition point involving an ileal loop in the mid-abdomen. Given the fact that the patient had no previous abdominal operations, he was taken to the operating room for a diagnostic laparoscopy. We found an entero-enteric fistulous tract that was causing a closed loop obstruction through an internal hernia in the mid jejunum. The bowel was healthy and viable. Using a single fire of a stapler, the fistulous track was divided in a transverse fashion, freeing the loops connected by it. Upon further investigation, the patient's parents recalled that the patient had ingested three magnets seven years prior that passed within 24 hours with no known complications at the time. The patient had an uncomplicated recovery, with return of bowel function on post-operative day 1 and was discharged home on post-operative day 2.</div></div><div><h3>Conclusion</h3><div>Fistulas from magnet ingestion can present years after the inciting event with symptoms of bowel obstruction due to an internal hernia and may require urgent surgical intervention.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103014"},"PeriodicalIF":0.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170089","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":"Fourth branchial cleft cyst presenting as a mediastinal mass in a neonate: a case report","authors":"Marisa E. Schwab ,&nbsp;Karthik Balakrishnan ,&nbsp;Stephanie D. Chao","doi":"10.1016/j.epsc.2025.103017","DOIUrl":"10.1016/j.epsc.2025.103017","url":null,"abstract":"<div><h3>Introduction</h3><div>Fourth branchial cleft anomalies are a rare congenital condition with varying presentations. Pediatricians and pediatric subspecialists must be familiar with this entity.</div></div><div><h3>Case presentation</h3><div>A 4-day old term female presented with increased work of breathing. Exam was notable for intermittent subcostal retractions. X-ray showed a mediastinal shadow. Chest CT showed a large mass extending from the neck into the mediastinum. Interventional radiology placed a pigtail into the mass via the left neck. This drained milky cloudy fluid for seven weeks. After transfer to a quaternary children's hospital, an MRI showed a persistent large thick-walled cyst tracking into the neck.</div><div>Laryngoscopy, bronchoscopy and esophagoscopy initially didn't show anomalies. Methylene blue dye was injected into the drain and seen to exit from a left pyriform sinus tract. This was confirmed with on-table fluoroscopy.</div><div>Two days later, she underwent injection of sclerosing agents and contrast via the drain under fluoroscopy. The sinus tract was cauterized and suture ligated using laryngoscopy. Laryngoscopy a few days later revealed no patent sinus tract. Sclerosant was again injected. Ultrasound after one month showed a slightly decreased mediastinal mass. Ultrasound three months later was significantly decreased size. At 7-month follow-up, the patient remains asymptomatic, feeding and growing well.</div></div><div><h3>Conclusion</h3><div>Fourth branchial anomalies are rare but must be considered in a pediatric patient of any age presenting with a neck or mediastinal mass.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103017"},"PeriodicalIF":0.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850171","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":"Successful conservative management of Chilaiditi syndrome in a 6-year-old boy: a case report","authors":"Yacine Zouirech ,&nbsp;Bashar Al Jabary ,&nbsp;Abir Manni ,&nbsp;Jaouad Bouljrouf ,&nbsp;Monim Ochan ,&nbsp;Mounir Kisra","doi":"10.1016/j.epsc.2025.103013","DOIUrl":"10.1016/j.epsc.2025.103013","url":null,"abstract":"<div><h3>Introduction</h3><div>Chilaiditi syndrome (CS) is a rare clinical entity in which a portion of the colon becomes interposed between the liver and the diaphragm. It can potentially mimic pneumoperitoneum and lead to unnecessary surgical interventions.</div></div><div><h3>Case presentation</h3><div>A 6-year-old boy with a known history of idiopathic exocrine pancreatic insufficiency and chronic constipation since the age of 4 years was brought to the emergency department with a four-week history of intermittent abdominal pain and progressive distension. Initial upright abdominal radiographs revealed bilateral subdiaphragmatic colonic air with visible haustral markings and a large fecaloma, consistent with Chilaiditi syndrome. The patient was not kept NPO but did not tolerate his oral intake well. He was managed conservatively with intravenous fluids, acetaminophen (15 mg/kg every 6 hours), phloroglucinol (40 mg twice daily), and daily rectal enemas composed of 400 mL saline and 15 mL glycerin. A contrast enema performed on day 2 confirmed sigmoid and colonic distension due to a fecal impaction. He started passing stool two days after the enemas were initiated. A follow-up abdominal radiograph on day 3 showed complete resolution of the colonic interposition and the stool burden. The patient remained symptom-free and had no recurrence at 6 months of follow-up.</div></div><div><h3>Conclusion</h3><div>Chilaiditi syndrome should be considered in children with abdominal pain who present air between the diaphragm and the liver, as this condition can mimic pneumoperitoneum but typically does not require a surgical intervention.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103013"},"PeriodicalIF":0.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887103","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 a failed esophageal atresia repair in an infant asylee: a case report","authors":"Tina Huang,&nbsp;John Spencer Laue,&nbsp;Zaria Murrell","doi":"10.1016/j.epsc.2025.103012","DOIUrl":"10.1016/j.epsc.2025.103012","url":null,"abstract":"<div><h3>Introduction</h3><div>Anastomotic leaks are not uncommon after the surgical repair of esophageal atresia (EA) and can cause significant morbidity. Inadequate medical infrastructure and supplies in Central American countries can be associated with poor outcomes. Access to care in resource-rich countries may be considered for patients from low-income countries who have surgical complications and have exhausted all local resources.</div></div><div><h3>Case presentation</h3><div>A female newborn born in Mexico with type-C esophageal atresia underwent primary esophago-esophagostomy two days after birth, near the Mexican Guatemalan border. One week later, an anastomotic leak was noticed, and the local surgeons proceeded with a repeat thoracotomy and re-do anastomosis. The patient was maintained without nutrition because parenteral nutrition was not available. Three weeks later, a recurrent leak was noticed after feedings were introduced. The local surgeons proceeded with a thoracotomy, distal esophageal closure, gastrostomy tube placement, and spit fistula. Having exhausted all local resources, the local surgeon advised the family to seek medical asylum in the U.S. She arrived at the U.S. at the age of 8 months and was first seen at another hospital due to dislodgement of the gastrostomy tube, which was replaced for a button. She was subsequently referred to our hospital. We did a thorough evaluation by rigid bronchoscopy and contrast studies and confirmed the feasibility of an esophageal anastomosis. We communicated extensively through a video platform with the local surgeon from Mexico to discuss the details of all prior procedures in preparation for the anastomosis. We proceeded with a fourth thoracotomy, spit fistula take-down and esophageal anastomosis. She developed a small leak that resolved spontaneously by postoperative day 22. She was supported by jejunal feedings through a GJ tube since postoperative day 1. She was discharged on postoperative day 28 on oral feedings plus GJ supplemental feedings.</div></div><div><h3>Conclusion</h3><div>Direct communication between surgeons across international borders can help in the surgical planning of patients who develop complications and come to the U.S. needing further care.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103012"},"PeriodicalIF":0.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850211","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":"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}