Journal of Pediatric Surgery Case Reports最新文献_第7页

Intrapancreatic common bile duct duplication presenting with choledocholithiasis in a toddler: a case report 胰内总胆管复制表现为幼儿胆总管结石：1例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-11-06 DOI: 10.1016/j.epsc.2025.103143

Audrey Viger , Camille Plourde , Anna Wieckowska , Caroline P. Lemoine

{"title":"Intrapancreatic common bile duct duplication presenting with choledocholithiasis in a toddler: a case report","authors":"Audrey Viger , Camille Plourde , Anna Wieckowska , Caroline P. Lemoine","doi":"10.1016/j.epsc.2025.103143","DOIUrl":"10.1016/j.epsc.2025.103143","url":null,"abstract":"<div><h3>Introduction</h3><div>Common bile duct (CBD) duplication is an extremely rare congenital anomaly, with most cases reported in adults.Only 14 cases have been reported in children.</div></div><div><h3>Case presentation</h3><div>A previously healthy 14-month-old girl (8.3 kg) presented with intermittent fevers and diarrhea. There was no history of abdominal pain, jaundice, weight loss, or anorexia. Physical examination was unremarkable. Liver function tests (LFTs) were elevatedelevated (aspartate aminotransferase (AST) 562 U/L, alanine transaminase (ALT) 540 U/L, gamma-glutamyl transferase (GGT) 678 U/L) except for a normal bilirubin. An abdominal ultrasound revealed both dilated intrahepatic and extrahepatic bile ducts. A magnetic resonance cholangiopancreatography (MRCP) demonstrated an intrapancreatic CBD duplication and multiple choledocholithiasis. An endoscopic retrograde cholangiopancreatography (ERCP) was attempted but failed as the endoscope could not pass the child's pylorus. A percutaneous transhepatic cholangiogram confirmed the patient's anatomy and successfully removed the choledocholithiasis. An external-internal biliary drain was placed due to extensive biliary manipulations, and intravenous antibiotics were administered. One week later, definitive surgical management was performed; the patient underwent a laparoscopic CBD resection with a Roux-en-Y hepaticojejunostomy. The postoperative course was unremarkable, and she was discharged on postoperative day 4. One year after surgery, she is doing well with normal LFTs and no recurrence of choledocholithiasis.</div></div><div><h3>Conclusion</h3><div>Even though they are rare, duplications of the common bile duct should be included in the differential diagnosis of children who develop abdominal pain and have dilatation of the intrahepatic and/or extrahepatic biliary tree.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103143"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526283","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}

引用次数: 0

Appendiceal band syndrome in an 8-year-old patient: a case report 8岁儿童阑尾束综合征1例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI: 10.1016/j.epsc.2025.103140

Zelalem Assefa Semgn , Chibahew Lante kebede , Ayanle Badmah Maigag , Maru Gamma Erge

{"title":"Appendiceal band syndrome in an 8-year-old patient: a case report","authors":"Zelalem Assefa Semgn , Chibahew Lante kebede , Ayanle Badmah Maigag , Maru Gamma Erge","doi":"10.1016/j.epsc.2025.103140","DOIUrl":"10.1016/j.epsc.2025.103140","url":null,"abstract":"<div><h3>Introduction</h3><div>Small bowel obstruction (SBO) secondary to appendiceal band syndrome is an exceptionally rare surgical condition in children.</div></div><div><h3>Case presentation</h3><div>An 8-year-old boy presented with a 3-day history of progressive abdominal distension, frequent episodes of bilious vomiting, and failure to pass feces and flatus. Physical examination revealed a distended, tender abdomen without a palpable mass. Laboratory investigations showed leukocytosis (WBC 15,000/mm<sup>3</sup>) with 88 % neutrophils, while hemoglobin and platelet counts were within normal limits. Abdominal radiography demonstrated multiple dilated small bowel loops consistent with mechanical obstruction. After initial resuscitation and nasogastric decompression, an exploratory laparotomy was performed. Intraoperatively, the distal 35 cm of the ileum was found to be constricted by the perforated tip of the appendix, which had formed a fibrous band attaching to the adjacent small bowel mesentery. The involved bowel segment was viable, and an appendectomy alone was sufficient. The postoperative course was uneventful, with satisfactory urine output and early return of bowel function. The patient was discharged home in good condition on the second postoperative day.</div></div><div><h3>Conclusion</h3><div>Appendiceal band syndrome must be included in the differential diagnosis of children who develop a small bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103140"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419271","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}

引用次数: 0

Phytobezoar causing small bowel obstruction in a 4-year-old girl: a case report 植牛黄致4岁女童小肠梗阻1例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-10-23 DOI: 10.1016/j.epsc.2025.103138

Hailemariam Yohannes Asefa , Mesfin Tesera Wassie , Belete Chaklu Assefa , Berhanu Shetie Sefene , Yonas Fekadu Yilma , Wondwosen Mengist Dereje

{"title":"Phytobezoar causing small bowel obstruction in a 4-year-old girl: a case report","authors":"Hailemariam Yohannes Asefa , Mesfin Tesera Wassie , Belete Chaklu Assefa , Berhanu Shetie Sefene , Yonas Fekadu Yilma , Wondwosen Mengist Dereje","doi":"10.1016/j.epsc.2025.103138","DOIUrl":"10.1016/j.epsc.2025.103138","url":null,"abstract":"<div><h3>Introduction</h3><div>Bezoar-induced small bowel obstruction is an uncommon condition. Its diagnosis is frequently difficult because of nonspecific symptoms, and surgical exploration remains the definitive treatment to restore bowel function and relieve the obstruction.</div></div><div><h3>Case presentation</h3><div>A four-year-old girl with Down syndrome was admitted to the malnutrition ward due to failure to thrive since birth. She was diagnosed with severe acute malnutrition and started on appropriate management. On her second day, she developed repeated vomiting of ingested material mixed with grass, followed 12 h later by progressive abdominal distension and inability to pass feces or flatus. Her vital signs showed a pulse of 126 bpm, respiratory rate 26/min, and temperature 37.4 °C. Surgical consultation and abdominal radiography suggested small bowel obstruction. She was taken to the operating room, and exploratory laparotomy revealed a completely obstructing mass 40 cm from the ileocecal valve. An enterotomy was performed, and the bezoar was carefully removed. Other bowel segments were examined to rule out additional bezoars. Postoperatively, she remained stable and was transferred back to the malnutrition ward after two days. She continued nutritional management for two weeks and was discharged with significant improvement. Outpatient Department follow-up at two, four, and eight weeks revealed no new complaints. Her parents were counseled and she was discharged from the hospital.</div></div><div><h3>Conclusion</h3><div>Bezoars should be included in the differential diagnosis of children who develop a small bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103138"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419270","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}

引用次数: 0

Posterior sagittal anorectoplasty for a recto-urethral fistula on a 14-year-old boy: a case report 后矢状肛门直肠成形术治疗14岁男孩直肠尿道瘘1例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.epsc.2025.103124

Fekadu Mengesha WoldeAmanuel, Ephrem Nidaw Kergo, Hana Abebe Gebreselassie, Zelalem Assefa Semegn

{"title":"Posterior sagittal anorectoplasty for a recto-urethral fistula on a 14-year-old boy: a case report","authors":"Fekadu Mengesha WoldeAmanuel, Ephrem Nidaw Kergo, Hana Abebe Gebreselassie, Zelalem Assefa Semegn","doi":"10.1016/j.epsc.2025.103124","DOIUrl":"10.1016/j.epsc.2025.103124","url":null,"abstract":"<div><h3>Introduction</h3><div>Anorectal malformations (ARMs) are typically diagnosed and managed during infancy. Delayed treatment in adolescents is exceptionally rare.</div></div><div><h3>Case presentation</h3><div>A 14-year-old boy from a rural area was seen at our pediatric surgery unit with a sigmoid colostomy placed during the neonatal period. He had been lost to follow-up since the neonatal discharge. On examination, he was well-nourished and weighed 46 kg. He had no anal opening, but his gluteal muscles were well developed, the intergluteal cleft was prominent, and an anal dimple was present. A distal colostogram demonstrated a mildly dilated rectum terminating just below the sacrum, and a rectobulbar urethral fistula. His sacral ratio was 0.78. He was taken to the operating room for an elective posterior sagittal anorectoplasty (PSARP). Electrocautery mapping of the sphincter complex guided a midline posterior sagittal incision from the sacrum to the anal dimple. We ligated and repaired the rectobulbar urethral fistula with interrupted 4-0 reabsorbable braided sutures. The rectum was mobilized, tapered to fit tension-free within the sphincter complex, and the neoanus was positioned centrally. The colo-cutaneous anastomosis was fashioned with sixteen interrupted 3-0 reabsorbable braided sutures. The postoperative course was uneventful. Anal dilations began on postoperative day 14 and continued for three months, achieving an adequate anal caliber. The colostomy was closed safely in the fourth postoperative month. He is currently fully continent.</div></div><div><h3>Conclusion</h3><div>Posterior sagittal anorectoplasty seems to be an effective approach for the repair of anorectal malformations in teenagers who had not had the repair done during infancy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103124"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419272","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}

引用次数: 0

Letter to the editor in response to: "Laparoscopic gastroduodenal anastomosis (Billroth I) for the management of type-II pyloric atresia in Carmi syndrome: A case report." 致编辑的回复信：“腹腔镜胃十二指肠吻合术（Billroth I）治疗Carmi综合征ii型幽门闭锁1例报告。”

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-10-25 DOI: 10.1016/j.epsc.2025.103136

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Nonoperative management of grade III pancreatic injuries in children: a case series 儿童III级胰腺损伤的非手术治疗：一个病例系列

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-11-06 DOI: 10.1016/j.epsc.2025.103144

Takeshi Hirabayashi , Tamotsu Kobayashi , Takeshi Saito , Daiki Kasai , Keinosuke Ishido , Kenichi Hakamada

{"title":"Nonoperative management of grade III pancreatic injuries in children: a case series","authors":"Takeshi Hirabayashi , Tamotsu Kobayashi , Takeshi Saito , Daiki Kasai , Keinosuke Ishido , Kenichi Hakamada","doi":"10.1016/j.epsc.2025.103144","DOIUrl":"10.1016/j.epsc.2025.103144","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric American Association for the Surgery of Trauma (AAST) Grade III pancreatic injuries—complete transections of the main pancreatic duct (MPD)—are rare, and long-term outcomes following nonoperative management are not well defined.</div></div><div><h3>Case presentations</h3><div>Three hemodynamically stable children with American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) grade III pancreatic injuries were managed nonoperatively (nil per os, total parenteral nutrition, protease inhibitor therapy, and analgesia.</div><div>Case 1 (male, injured at age 10) had early MRCP (day 3) confirming MPD transection; MRCP was repeated at 6 months and 1 year; distal pancreatic atrophy was first detected at 2 years 3 months and remained stable at 7 years 11 months.</div><div>Case 2 (female, injured at age 14) had early MRCP (day 5) confirming MPD transection; MRCP was repeated at 6 months and 1 year; distal atrophy was first detected at 1 year 9 months and persisted at 6 years 2months.</div><div>Case 3 (male, injured at age 10) had early MRCP (day 7) confirming MPD transection; subsequent MRCPs at 1 month, 8 months, 1 year 10 months, and 2 years 11months were unremarkable, without atrophy.</div><div>No patient developed clinically evident endocrine or exocrine insufficiency during follow-up.</div></div><div><h3>Conclusion</h3><div>Atrophy of the distal pancreas can developed in children who sustained grade-III pancreatic injuries that were managed non-operatively. Long-term pancreatic functional assessment is recommended.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103144"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474793","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}

引用次数: 0

Non-operative management of a rare late gastrocolic fistula after percutaneous endoscopic gastrostomy in pediatrics 儿科经皮内镜胃造口术后罕见晚期胃结肠瘘的非手术治疗

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-10-25 DOI: 10.1016/j.epsc.2025.103134

Medhat elsayed , Eiman Yassir Musa Hussain , Sarah Magdy Abdelmohsen , Youmna Medhat , Ibrahim El Kashlan , Mohamed Mostafa Shabab

{"title":"Non-operative management of a rare late gastrocolic fistula after percutaneous endoscopic gastrostomy in pediatrics","authors":"Medhat elsayed , Eiman Yassir Musa Hussain , Sarah Magdy Abdelmohsen , Youmna Medhat , Ibrahim El Kashlan , Mohamed Mostafa Shabab","doi":"10.1016/j.epsc.2025.103134","DOIUrl":"10.1016/j.epsc.2025.103134","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastrocolic fistula is a rare but serious complication of percutaneous endoscopic gastrostomy (PEG).</div></div><div><h3>Case presentation</h3><div>A 13-year-old male with quadriplegic cerebral palsy and a PEG inserted two years prior presented with a one-month history of watery, foul-smelling diarrhea, weight loss, and bilateral lower-limb edema. Laboratory tests revealed anemia and <strong>hypoalbuminemia (1.9 g/dL)</strong>, with otherwise unremarkable sepsis workup. Despite nutritional support and albumin infusions, his condition deteriorated. A contrast study performed via the PEG demonstrated opacification of the colon, confirming a <strong>gastrocolic fistula with the gastrostomy tube positioned within the transverse colon</strong>. The PEG was removed, and the patient was managed conservatively with total parenteral nutrition for ten days. A repeat contrast study confirmed <strong>complete fistula closure</strong>, after which nasogastric feeding was resumed. Three weeks later, a new gastrostomy was safely reinserted under laparoscopic guidance, with sustained clinical recovery.</div></div><div><h3>Conclusion</h3><div>Gastrocolic fistula must be suspected in patients that have a percutaneous endoscopic gastrostomy and develop new-onset diarrhea and malnutrition. Conservative management may lead to spontaneous closure of the fistula.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103134"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419383","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}

引用次数: 0

Ultrasound-guided retrieval of a retain guidewire in the femoral region of a 4-year-old male with anasarca: a case report 超声引导下股骨区保留导丝取出一例4岁男性无腹股沟：一例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.epsc.2025.103132

Saswati Behera , Raksha Ranjan , Navdeep Singh Dhoat , Gopal Krishan Jalwal , Charmi Patidar , Sourabh Meena

{"title":"Ultrasound-guided retrieval of a retain guidewire in the femoral region of a 4-year-old male with anasarca: a case report","authors":"Saswati Behera , Raksha Ranjan , Navdeep Singh Dhoat , Gopal Krishan Jalwal , Charmi Patidar , Sourabh Meena","doi":"10.1016/j.epsc.2025.103132","DOIUrl":"10.1016/j.epsc.2025.103132","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous central venous catheters (CVCs) are essential for children with difficult intravenous access but carry a risk of complications. Guidewire-related incidents, such as fracture or retention, are rare but serious. These challenges are exacerbated in patients with severe generalized anasarca, where physiological changes can complicate even standard procedures.</div></div><div><h3>Case scenario</h3><div>A 4-year-old male with nephrotic syndrome and severe anasarca on mechanical ventilation required a central venous access. During an ultrasound guided attempt via the right femoral vein, the J-shaped guidewire met with some resistance, after which it was withdrawn with some force. Due to severe anasarca, bedside ultrasonography (USG) failed to localize the retained segment thus making it impossible to explore. The child was sick and intubated. Upon gradual decrease in anasarca, as the bedside X-ray confirmed a knotted, retained piece in the thigh, two more attempts of bedside USG guided exploration under sedation was tried but failed. Two days later, cellulitis developed at the site. The child was taken to the operating room, where an ultrasound-guided needle was used to mark the exact location of the foreign body. This guided surgical incision and dissection, leading to the successful retrieval of the knotted guidewire.</div></div><div><h3>Conclusion</h3><div>Ultrasound guidance seems to be an effective way to localize retained fragments of guidewires located in the soft tissue of the thigh in children.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103132"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365552","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}

引用次数: 0

Laparoscopic gastroduodenal anastomosis (Billroth I) for the management of type II pyloric atresia in Carmi syndrome: a case report 腹腔镜胃十二指肠吻合（Billroth I）治疗Carmi综合征II型幽门闭锁1例

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-11-01 Epub Date: 2025-09-23 DOI: 10.1016/j.epsc.2025.103113

Joel Cazares , Jorge Colín-Garnica , Eduardo de la Rosa-Bustamante , Rubi Beatriz Martínez-Carmona , Arturo Guillen-Cárdenas , Jorge Alberto Cantú-Reyes

{"title":"Laparoscopic gastroduodenal anastomosis (Billroth I) for the management of type II pyloric atresia in Carmi syndrome: a case report","authors":"Joel Cazares , Jorge Colín-Garnica , Eduardo de la Rosa-Bustamante , Rubi Beatriz Martínez-Carmona , Arturo Guillen-Cárdenas , Jorge Alberto Cantú-Reyes","doi":"10.1016/j.epsc.2025.103113","DOIUrl":"10.1016/j.epsc.2025.103113","url":null,"abstract":"<div><h3>Introduction</h3><div>Pyloric atresia accounts for less than 1 % of all congenital intestinal obstructions, with an estimated incidence of 1:100,000 live births. Its association with epidermolysis bullosa, known as Carmi syndrome, is rare but well documented. Minimally invasive techniques can be employed in the surgical management of complex neonatal conditions.</div></div><div><h3>Case report</h3><div>A male neonate was delivered vaginally at 35 weeks of gestation to a 16-year-old mother, with reported consanguinity between the parents. At birth, he presented with widespread bullous skin lesions involving the extremities, thorax, and face, along with a positive Nikolsky sign, findings that raised strong suspicion for epidermolysis bullosa. Birth weight was 2000 g, and no resuscitative maneuvers were required.</div><div>Following the initiation of enteral feeding, the patient developed non-bilious vomiting. Abdominal radiography showed a single gastric bubble with absence of distal gas. A contrast study confirmed gastric outlet obstruction. Endoscopy on day three revealed complete pyloric occlusion and mucosal fragility. A laparoscopic procedure was performed, confirming type II pyloric atresia. A Laparoscopic gastroduodenostomy (Billroth I) was successfully carried out without intraoperative complications. Postoperative contrast imaging confirmed adequate anastomotic patency. Unfortunately, the patient developed sepsis due to extensive skin involvement and died on postoperative day three.</div></div><div><h3>Conclusions</h3><div>Minimally invasive gastroduodenal anastomosis (Billroth I) seems to be technically feasible in newborns with pyloric atresia.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103113"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160054","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}

引用次数: 0

Hybrid interventional radiological and surgical approach to treat biliary obstruction post Kasai portoenterostomy: A case report 开赛门静脉肠造口术后胆道梗阻的介入治疗：1例报告

IF 0.2

Journal of Pediatric Surgery Case Reports Pub Date : 2025-11-01 Epub Date: 2025-09-24 DOI: 10.1016/j.epsc.2025.103116

Anand Dhatt , Ravjot Dhatt , Erik D. Skarsgard , Manraj K.S. Heran

{"title":"Hybrid interventional radiological and surgical approach to treat biliary obstruction post Kasai portoenterostomy: A case report","authors":"Anand Dhatt , Ravjot Dhatt , Erik D. Skarsgard , Manraj K.S. Heran","doi":"10.1016/j.epsc.2025.103116","DOIUrl":"10.1016/j.epsc.2025.103116","url":null,"abstract":"<div><h3>Introduction</h3><div>Kasai procedure is used in the management of biliary atresia. Complications can include stricturing at anastomoses which can result in impeded bile flow and subsequently ascending cholangitis that requires management.</div></div><div><h3>Case report</h3><div>We present a case of a 4-year old with multiple episodes of ascending cholangitis in the context of prior Kasai portoenterostomy at day 56 of life for non-syndromic biliary atresia. After prolonged hospital admission, imaging in the form of US and MR-cholangiopancreatography showed an obliterated portoenterostomy. A combined surgical and Interventional Radiology approach was utilized in the form of the surgical creation of a loop jejunostomy within the Roux limb and then traversing of the portoenterostomy under fluoroscopy to dilate the stricture and place an internal-external biliary drain. Subsequently, the patient's hyperbilirubinemia resolved with no further episodes of ascending cholangitis in 3 years of follow-up.</div></div><div><h3>Conclusion</h3><div>A hybrid, percutaneous and surgical approach is a feasible option to restore bile flow in patients post-Kasai who develop delayed cholestasis due to obliteration of the portoenterostomy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103116"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160056","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}

引用次数: 0