{"title":"Recurrent splenic volvulus after splenopexy in an 11-year-old child: A case report","authors":"Christelle Sommer , Paola Andrea Rouge Elton , Nermin Halkic , Meriam Koob , Leonor Alamo , Sylvain Mauron , Eleuthere Stathopoulos","doi":"10.1016/j.epsc.2024.102877","DOIUrl":"10.1016/j.epsc.2024.102877","url":null,"abstract":"<div><h3>Introduction</h3><p>Recurrence of splenic volvulus after splenopexy in children is rare. A consensus on the optimal surgical strategy in splenic volvulus is lacking.</p></div><div><h3>Case Presentation</h3><p>An 11-year-old female presented left upper quadrant abdominal pain for 24 hours following a short-lived appearance of an epigastric bulge. A CT-scan demonstrated findings consistent with splenic volvulus, without distal arterial flow. She underwent an exploratory laparoscopy, splenic detorsion, and splenopexy to the abdominal wall using two non-resorbable, knotless, unidirectional barbed sutures. The patient was discharged on day 2 after the procedure. A 6-month follow-up ultrasound showed a normally perfused spleen. Then months after the operation she presented with the same abdominal symptoms. A CT scan confirmed the recurrence of the splenic volvulus. She underwent a second laparoscopy, splenic detorsion, and splenopexy with a tailor-made mesh bag anchored to the abdominal wall. She recovered well from that operation. At 10 months of follow up she has had no recurrent of symptoms and the spleen is well vascularized by ultrasound.</p></div><div><h3>Conclusion</h3><p>Simple splenopexy using direct sutures to abdominal wall may not be sufficient to create adequate adhesions and prevent recurrence. The use of a mesh may have a higher success rate.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102877"},"PeriodicalIF":0.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001052/pdfft?md5=3820c19cd172eb57a9faba6d38b555cf&pid=1-s2.0-S2213576624001052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240921","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}
Russell B. Hawkins , Michael Feely , David Saulino , Steven L. Raymond
{"title":"Symptomatic cutaneous sparaganosis (tapeworm) in a child: A case report","authors":"Russell B. Hawkins , Michael Feely , David Saulino , Steven L. Raymond","doi":"10.1016/j.epsc.2024.102864","DOIUrl":"10.1016/j.epsc.2024.102864","url":null,"abstract":"<div><h3>Introduction</h3><p>Cutaneous sparganosis is a rare parasitic infection in the United States pediatric population.</p></div><div><h3>Case presentation</h3><p>A 12-year-old female complained of persistent pain secondary to a subcutaneous nodule that had been present for approximately three months. On examination, an approximately 2.5 cm periumbilical subcutaneous mass was appreciated with severe tenderness to light palpation. She had no overlying skin changes or drainage from the area. Ultrasound findings were inconclusive for a diagnosis. MRI revealed a 2.5 x 0.8 × 1.9 cm serpiginous soft tissue lesion which was read as possible abdominal wall endometriosis. She reported worsened pain associated with the lesion during her menstrual cycle, but no significant size changes. After discussion with the patient and her family, she was taken for surgical excision of the skin lesion. During the operation, a long, narrow, tubular segment of white tissue was removed along with an associated granuloma cavity. Gross and microscopic examination demonstrated a cestode consistent with the Spirometra species (sparganosis). Postoperatively, the patient was treated with a three-day course of oral albendazole. Stool sample testing demonstrated no evidence of ova or parasites. She recovered without complications or known recurrence.</p></div><div><h3>Conclusion</h3><p>Sparaganosis can present as a persistent painful subcutaneous nodule. This case underscores the need to consider excision of subcutaneous lesions with unusual symptoms.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102864"},"PeriodicalIF":0.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000927/pdfft?md5=cd956add1a23e8cece56c81c97459476&pid=1-s2.0-S2213576624000927-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164665","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}
Veronica I. Alaniz , Kelly Harris , Kellie Woodfield , Julie Friedman , Vatche Melkonian , Andrea Bischoff
{"title":"Novel use of AlloDerm for partial vaginal replacement in a patient with cloaca: A case report","authors":"Veronica I. Alaniz , Kelly Harris , Kellie Woodfield , Julie Friedman , Vatche Melkonian , Andrea Bischoff","doi":"10.1016/j.epsc.2024.102873","DOIUrl":"10.1016/j.epsc.2024.102873","url":null,"abstract":"<div><h3>Introduction</h3><p>During cloacal reconstruction, vaginal replacement with an intestinal graft is considered when native vagina does not reach the perineum. Risks include need for revision surgery, mucus production, colitis, and rarely dysplasia. Given these concerns, alternative vaginal reconstructive procedures are being considered. We present a novel case using AlloDerm for vaginal replacement in a female infant undergoing cloacal reconstruction.</p></div><div><h3>Case presentation</h3><p>A 17-month-old female with a complex medical history including Stage 5 chronic kidney disease (CKD) underwent repair of a 4.5 cm cloaca via a posterior sagittal approach. Although the rectum was adequately mobilized off tension, the vagina remained 4 cm from the perineum when off tension. Because vaginal replacement using sigmoid colon would have required exploratory laparotomy in this medically complex child, decision was made to proceed with vaginoplasty using an AlloDerm graft. Two 2 × 4 cm pieces of AlloDermwere placed longitudinally to create the anterior and posterior vaginal walls. The lateral walls and surrounding fat were then secured and the introitus was created. Vaginoscopy was performed three months post-operatively and confirmed an intact graft approximately 2–3 cm long with a patent anastomosis to the native vagina.</p></div><div><h3>Conclusion</h3><p>AlloDerm is an acellular tissue matrix that supports tissue regeneration. This is a promising vaginal replacement option for patients with cloaca who are not good candidates for a colonic vaginoplasty. Future studies are needed to assess long-term outcomes of this graft for prepubertal vaginoplasties.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102873"},"PeriodicalIF":0.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001015/pdfft?md5=9730a4b79e617b1548d8c3665856d2cc&pid=1-s2.0-S2213576624001015-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157469","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":"Successful nonoperative management in Grade-V multiorgan injury of the spleen, liver, and kidney: A case report","authors":"Aldwin Tanuwijaya , Kshetra Rinaldhy , Rizky Amaliah","doi":"10.1016/j.epsc.2024.102867","DOIUrl":"10.1016/j.epsc.2024.102867","url":null,"abstract":"<div><h3>Introduction</h3><div>Nonoperative management (NOM) which includes bed rest, routine monitoring, and blood transfusions if needed, is recommended for all stable patients with single organ injury due to blunt trauma, regardless of the severity of the injury. However, limited guidelines and studies have addressed NOM for multiorgan injuries in children, especially in high-grade (AAST grade IV/V) injuries.</div></div><div><h3>Case presentation</h3><div>A 16-year-old male was referred to our hospital after being involved in a single motorcycle accident. Vital signs were within normal limits. Physical examination revealed visible abrasions on the left chest, and tenderness on palpation of the entire abdomen, especially in the upper right and left. Laboratory findings revealed Hb 9.3 g/dL, leucocytosis 43,850, AST 201 U/L, and ALT 237 U/L. CT-Scan revealed an AAST Grade-V spleen injury, an AAST Grade-V left kidney injury, an AAST grade II liver injury, fractures of the 6th and 7th left ribs, and a left hemothorax. The management consisted of bedrest, serial monitoring, and transfusion of packed red cells and fresh frozen plasma for a hemoglobin level of 7.9 mg/dl. A chest tube was placed in the left hemithorax. The patient gradually recovered well and was discharged 16 days after the admission. He was advised to only engage in minimal activities at home. Four months after the injury a follow-up abdominal CT scan revealed a small peri-splenic cyst and a small left kidney. Renogram found that the GFR of the left kidney was reduced, but no further management was required.</div></div><div><h3>Conclusion</h3><div>NOM guidelines used for high-grade single-organ injuries could be applicable to high-grade multi-organ injuries.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102867"},"PeriodicalIF":0.2,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000952/pdfft?md5=4fddbaef57dcc527d10ad2f795eec185&pid=1-s2.0-S2213576624000952-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315744","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}
Rahima Khatun , Marjorie J. Arca , Paul Kupicha , Nicholas Ullman , Vladimir Faustin , Nicole A. Wilson
{"title":"Bile refeeding in spontaneous bile duct perforation in a neonate: A case report","authors":"Rahima Khatun , Marjorie J. Arca , Paul Kupicha , Nicholas Ullman , Vladimir Faustin , Nicole A. Wilson","doi":"10.1016/j.epsc.2024.102868","DOIUrl":"10.1016/j.epsc.2024.102868","url":null,"abstract":"<div><h3>Introduction</h3><p>There is no true consensus on the optimal management strategy for spontaneous bile duct perforation in neonates, but previous studies favor surgical drainage over primary repair. Management of subsequent high-volume biliary drainage has not yet been reported, particularly bile refeeding after surgical drain placement.</p></div><div><h3>Case presentation</h3><p>We present a case of spontaneous bile duct perforation in a previously healthy 16-day-old female who presented with abdominal distension, acholic stools, and direct hyperbilirubinemia. Intraoperative cholangiogram demonstrated a perforation at the proximal common bile duct, which was patched with omentum. A surgical drain was placed in the sub-hepatic space. She recovered well and was discharged home, but continued to have high volumes of bile drainage. She required readmission due to dehydration, electrolyte derangement, and weight loss. Upon readmission, a nasogastric feeding tube was placed, and she was refed bile from the drain every 8 hours while continuing to breast and bottle-feed. Over the next five days, drain output decreased and she was again discharged home. At one-week follow up, there was no additional bile drainage, she was well-appearing, and gaining weight. The drain was removed in clinic. She was subsequently seen approximately four months from her operation at which time she was well and thriving.</p></div><div><h3>Conclusion</h3><p>Intraoperative cholangiogram and drain placement are safe and effective for spontaneous bile duct perforation. Bile refeeding can be used in the setting of excessive biliary losses after surgical drainage for neonatal spontaneous bile duct perforation and may decrease bile drainage.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102868"},"PeriodicalIF":0.2,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000964/pdfft?md5=2ecc35e811cf5dfebfc08a07e5ff073f&pid=1-s2.0-S2213576624000964-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167300","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}
Janet R. Julson , Rene P. Myers , William H. Gray , Jamie M. Aye , Elizabeth D. Alva , Elizabeth A. Beierle
{"title":"Clamshell thoracotomy for pediatric tumor resection: A case series","authors":"Janet R. Julson , Rene P. Myers , William H. Gray , Jamie M. Aye , Elizabeth D. Alva , Elizabeth A. Beierle","doi":"10.1016/j.epsc.2024.102870","DOIUrl":"10.1016/j.epsc.2024.102870","url":null,"abstract":"<div><h3>Introduction</h3><p>Large masses in the pleural cavity or mediastinum in pediatric patients may present an operative challenge, not only in terms of obtaining adequate space in the small chest for safe dissection, but in attaining adequate chest closure.</p></div><div><h3>Case series</h3><p>Three adolescent males presented with large masses in the mediastinum or thoracic cavity. Their presenting signs were primarily chronic cough and chest pain. Patient 1 was a 13-year-old male with a history of spina bifida and a 12 × 10 × 9 cm malignant germ cell tumor in the mediastinum/right chest. Patient 2 was an 18-year-old male with a 24 × 15 × 11 cm right thoracic synovial sarcoma in the posterior mediastinum/right hemithorax. Patient 3 was a 14-year-old male with a 19 × 14 × 10 cm lymphovascular malformation in the posterior mediastinum/right hemithorax. In all three patients, after the resection of the tumor via a clamshell throacotomy, sternal plating was employed for sternal wound closure. Post operative complications included a superficial surgical site infection and a chyle leak, but no wound dehiscence or breakdown.</p></div><div><h3>Conclusion</h3><p>The bilateral clamshell thoracotomy is a suitable approach for the resection of extensive mediastinal and thoracic masses in adolescents. The use of a sternal plate leads to adequate sternal healing.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"109 ","pages":"Article 102870"},"PeriodicalIF":0.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000988/pdfft?md5=6c3ae8e03ba71bb55ccbf6e9a02047e9&pid=1-s2.0-S2213576624000988-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142150810","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}
Nicole Cimbak , Farokh R. Demehri , Jill M. Zalieckas , Belinda Hsi Dickie
{"title":"Role of therapeutic plasma exchange in management of hemolysis associated with extracorporeal membrane oxygenation in neonates with congenital diaphragmatic hernia: A case series","authors":"Nicole Cimbak , Farokh R. Demehri , Jill M. Zalieckas , Belinda Hsi Dickie","doi":"10.1016/j.epsc.2024.102869","DOIUrl":"10.1016/j.epsc.2024.102869","url":null,"abstract":"<div><h3>Introduction</h3><p>Plasma free hemoglobin (PFH) is a product of intravascular hemolysis associated with certain disease states as well as the shearing effects of mechanical support devices, such as extracorporeal membrane oxygenation (ECMO). There are detrimental effects of intravascular hemolysis secondary to ECMO including severe hyperbilirubinemia, thrombus within the ECMO circuit causing inability to provide adequate support, and as a result, a need for ECMO circuit exchanges. Neonates can experience renal failure, kernicterus, and other significant morbidities as a result of hemolysis secondary to ECMO.</p></div><div><h3>Case series</h3><p>We present three cases of neonates with a gestational age of 35–37 weeks who had a left-sided CDH and were cannulated to VA-ECMO on the first day of life using an 8 French arterial cannula and a 10 French venous cannula. Within the first 10 days of the ECMO run all patients developed markedly elevated PFH of (peaks of 465, >500 and > 500 mg/dL), and creatinine, and underwent therapeutic plasma exchange (TPE). TPE was done using frozen fresh plasma (FFP) replacement in line with the ECMO circuit. All patients showed a remarkable decrease in the PFH levels after the TPE treatment. The number of TPE rounds ranged from 1 to 6, depending on the evolution of the PFH levels. One patient developed hypocalcemia that resulted in decreased cardiac pulsatility during the first round of TPE that resolved with aggressive calcium repletion. The total duration of the ECMO runs ranged from 16 to 29 days. None of the patients required continuous renal replacement therapy. All patients were discharged home at ages ranging from 2 to 6 months.</p></div><div><h3>Conclusion</h3><p>Mechanical cell hemolysis is a significant source of morbidity in neonatal patients on ECMO. This case series exemplifies a safe and impactful intervention to address hemolysis in a critically ill patient population.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102869"},"PeriodicalIF":0.2,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000976/pdfft?md5=17ad7bec9b19333d66b6736432f7f0b8&pid=1-s2.0-S2213576624000976-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142150514","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}
Melanie Ermler , Katelyn R. Ward , Marie A. Tominna , Pavan Brahmamdam
{"title":"Multiple bilateral paratubal cysts and recurrent bilateral fallopian tube torsion in a premenarchal female: A case report","authors":"Melanie Ermler , Katelyn R. Ward , Marie A. Tominna , Pavan Brahmamdam","doi":"10.1016/j.epsc.2024.102865","DOIUrl":"10.1016/j.epsc.2024.102865","url":null,"abstract":"<div><h3>Introduction</h3><p>Paratubal cysts are rare cystic structures that are usually asymptomatic; rarely, they may cause torsion of the adnexa.</p></div><div><h3>Case presentation</h3><p>We report the case of a 13-year-old premenarchal female who presented with left lower quadrant abdominal pain for 4 days. She had a history of a previous right fallopian tube cyst and torsion 9 months prior, treated at an outside hospital with diagnostic laparoscopy, right tubal detorsion, and paratubal cystectomy. Abdominal ultrasound demonstrated a right-sided para-ovarian fluid filled structure. She underwent diagnostic laparoscopy, which demonstrated bilateral 5 cm paratubal cysts attached to the fimbriae of both fallopian tubes, with bilateral fallopian tube torsion. Both ovaries and fallopian tubes had good blood flow. Both fallopian tubes also had findings of multiple small cysts budding from the tubular mesothelium. Bilateral detorsion was performed. The large cysts were excised, and the multiple small cysts were drained. We preserved both fallopian tubes and most of the fimbriae. Pathology resulted in benign paratubal cysts.</p></div><div><h3>Conclusion</h3><p>Adnexal torsion due to paratubal cysts can occur in the premenarchal pediatric population, affect both fallopian tubes, and recur. This case report aims to highlight unusual cause of adnexal torsion and its potential harm if not diagnosed in a timely manner.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"109 ","pages":"Article 102865"},"PeriodicalIF":0.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000939/pdfft?md5=ce1535c3b5badccab3eb5adc6d658db8&pid=1-s2.0-S2213576624000939-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142123014","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}
V. Melkonian, L. de la Torre, J. Ketzer, V. Rodriguez, A. Pena, A. Bischoff
{"title":"“Incisionless” colostomy creation: A case series","authors":"V. Melkonian, L. de la Torre, J. Ketzer, V. Rodriguez, A. Pena, A. Bischoff","doi":"10.1016/j.epsc.2024.102866","DOIUrl":"10.1016/j.epsc.2024.102866","url":null,"abstract":"<div><h3>Introduction</h3><p>The advent of laparoscopic and robotic surgery has revolutionized many operations throughout the surgical world, leading to smaller incisions, reduced post-operative pain, shorter hospital stays, and accelerated post-surgical recovery. However, these advancements come with drawbacks such as limited accessibility, high costs, and sometimes the requirement of multiple incisions. We present an alternative approach for an open “incisionless” colostomy, using an intra-rectal Foley catheter to help identify the descending colon.</p></div><div><h3>Case series</h3><p>Two patients underwent colostomy creation utilizing this minimally invasive open technique. The technique involves placement of a 24-french Foley catheter intra-rectally prior to prepping and draping the patient, making a circular incision, generally less than 3 cm in diameter over the left lower quadrant where the ostomy will be matured, and identifying of the colostomy limb through palpation of the intra-rectal catheter. This technique was utilized in two patients with minimal previous abdominal surgery and a normal or low body mass index. The first patient was 16-year-old male who had suffered a spinal cord injury, which was complicated by neurogenic bowel. He had considerable difficulties in emptying his colon appropriately, refused utilizing an enema regimen, and requested a permanent stoma. The second patient was a 10-year-old male with developmental delays, and severe idiopathic constipation refractory to medical intervention. In this case the patient's family requested a permanent stoma.</p></div><div><h3>Conclusions</h3><p>The open “incisionless” minimally invasive approach to colostomy creation provides an alternative approach to laparoscopic methods, with the benefit of minimal trauma to the abdominal wall and absence of a post-operative incision other than the colostomy itself.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"109 ","pages":"Article 102866"},"PeriodicalIF":0.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000940/pdfft?md5=278d4044cd02e16af83fa7d9a007c21a&pid=1-s2.0-S2213576624000940-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142130175","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":"Idiopathic intussusception caused by a polyp in the appendix: A case report","authors":"Mazen Kurdi","doi":"10.1016/j.epsc.2024.102859","DOIUrl":"10.1016/j.epsc.2024.102859","url":null,"abstract":"<div><h3>Introduction</h3><p>Intussusception, primary or secondary, is a common cause of mechanical obstruction in infants and children. Rarely, however, an intussusception is caused by a lesion of the appendix.</p></div><div><h3>Case presentation</h3><p>A thirty-two-month-old female was brought to the emergency department with abdominal pain and passage of red currant jelly stool. The abdominal exam revealed a palpable mass in the upper abdomen. Ultrasound examination of the abdomen showed the classical signs of an ileocolic intussusception: target sign in the transverse view and pseudokidney sign in the longitudinal view. A hydrostatic barium enema reduction was done. Successful reduction of the intussusception was confirmed by seeing the contrast reflux into the ileum. However, several hours later the abdominal pain recurred, and a follow-up ultrasound showed recurrence of the intussusception. The patient was taken to the operating room for an exploratory laparotomy. Following the manual reduction of the intussusception, a palpable mass was identified at the base of the appendix protruding into the cecum. An enterotomy was made on the cecum near the base of the appendix, and a polyp was found protruding from the inside the appendix into the cecum. We did an appendectomy, which included the polyp. The patient recovered uneventfully. The pathology analysis was consistent with a juvenile polyp.</p></div><div><h3>Conclusion</h3><p>Although rare, appendiceal polyps can serve as a lead point for intussusception of the ileocecal region. Such type of intussusception may recur after a reduction enema and may require a surgical exploration.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"109 ","pages":"Article 102859"},"PeriodicalIF":0.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000873/pdfft?md5=803e5c823ee84fdbe6e33fb3c05849b2&pid=1-s2.0-S2213576624000873-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096391","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}