Journal of Pediatric Surgery Case Reports最新文献

{"title":"Ileal arteriovenous malformation in an adolescent: A case report","authors":"Daniel Gulko ,&nbsp;Ryan Thibodeau ,&nbsp;Travis Bevington ,&nbsp;Mary Christina Whyte","doi":"10.1016/j.epsc.2025.103114","DOIUrl":"10.1016/j.epsc.2025.103114","url":null,"abstract":"<div><h3>Introduction</h3><div>Arteriovenous malformations (AVM) of the gastrointestinal tract are rare congenital vascular anomalies, particularly in the pediatric population.</div></div><div><h3>Case presentation</h3><div>A previously healthy 16-year-old male, with a past medical history of mild intermittent asthma and iron deficiency anemia presented with acute non-bilious vomiting and periumbilical abdominal pain without peritonitis. Initial abdominal radiography showed several grouped, round calcifications in the left lower quadrant. Computed tomography (CT) revealed a thickened loop of small bowel with calcifications. Focused ultrasonography demonstrated thickened loops of bowel that contained color Doppler flow, and several shadowing echogenic foci. His symptoms resolved spontaneously, and he was discharged home with a plan for potential elective surgery. He presented to the hospital 11 days later with abdominal pain and was taken to the operating room for an exploratory laparoscopy. We found a 13-cm vascular lesion in the ileum. We made a small periumbilical incision, eviscerated and resected the ileum containing the vascular lesion and did an end-to-end anastomosis. The postoperative course was uneventful, and he was discharged home on postoperative day two. The histology was consistent with an AVM, with dilated thick and thin-walled vessels and scattered calcifications.</div></div><div><h3>Conclusion</h3><div>AVM of the small bowel should be included in the differential diagnosis of children who develop abdominal pain and have localized abdominal calcifications and localized bowel wall thickening on imaging studies.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103114"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160052","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":"Unicornuate uterus and endometrial cyst of the ovary in a 15-year-old female: a case report","authors":"Justyna Kukulska,&nbsp;Magdalena Lewandowska","doi":"10.1016/j.epsc.2025.103123","DOIUrl":"10.1016/j.epsc.2025.103123","url":null,"abstract":"<div><h3>Introduction</h3><div>Müllerian duct anomalies are congenital malformations of the female reproductive tract with diverse clinical presentations, ranging from asymptomatic cases to those associated with significant reproductive and gynecological complications. An unicornuate uterus with a rudimentary horn is a rare subtype of these anomalies.</div></div><div><h3>Case presentation</h3><div>A 15-year-old girl presented with acute abdominal pain. Ultrasound revealed a solid left ovarian tumor, initially suspected to be a teratoma. Laboratory findings showed elevated Ca-125 (60 U/ml; normal: &lt;35 U/ml), while other tumor markers were normal. Pelvic magnetic resonance imaging (MRI) suggested uterus didelphys with a left ovarian mass. During laparoscopy, a unicornuate uterus with a non-communicating rudimentary horn and a left ovarian tumor was identified. The ovarian tumor was excised with preservation of residual ovarian tissue. Histopathological analysis revealed the diagnosis of an endometrial cyst. Six months later, during an elective laparoscopy, a non-communicating left rudimentary horn with the ipsilateral fallopian tube was excised using LigaSure® device. The postoperative course was uneventful. She recovered well and remains under gynecological follow-up, with regular menstrual cycles.</div></div><div><h3>Conclusion</h3><div>In pediatric and adolescent patients diagnosed with ovarian endometriotic cysts, a comprehensive evaluation of uterine anatomy is essential to exclude underlying obstructive Müllerian anomalies, as timely recognition and management may prevent progression of disease and preserve future reproductive potential.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103123"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270085","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":"Tracheal compression secondary to a bronchogenic cyst in an 18-year-old male: a case report","authors":"Shruthi Srinivas ,&nbsp;Nicholas A. Zumberge ,&nbsp;Ashley L. Miller ,&nbsp;Jennifer MacDonald ,&nbsp;Jennifer H. Aldrink ,&nbsp;Sara A. Mansfield","doi":"10.1016/j.epsc.2025.103112","DOIUrl":"10.1016/j.epsc.2025.103112","url":null,"abstract":"<div><h3>Introduction</h3><div>Asthma is the most common pediatric respiratory disease; however, misdiagnosis is steadily increasing. Identification of surgically managed conditions with similar symptoms is essential to ensuring timely management.</div></div><div><h3>Case presentation</h3><div>An 18-year-old healthy male was diagnosed with asthma after visits to the pediatrician and Emergency Department for cough and shortness of breath. For several weeks, he was prescribed antibiotics, prednisone, albuterol, and fluticasone without improvement. He acutely worsened and presented with respiratory distress attributed to status asthmaticus. He required emergent intubation, which was difficult given resistance when advancing the endotracheal tube (ETT). Cross-sectional imaging with computed tomography demonstrated a large superior mediastinal cystic mass with tracheal compression distal to the ETT. After transfer to our facility, he acutely decompensated with worsening ventilatory needs and hypotension requiring vasopressors. After a multidisciplinary discussion, he was brought to the operating room for aspiration of the mass and rigid bronchoscopy. Ultrasound-guided percutaneous drainage of the mass was achieved with immediate improvement in his tidal volumes and evidence of alleviated obstruction on bronchoscopy. He was weaned from respiratory support and extubated postoperatively. A drain contrast study demonstrated no connection to the esophagus or trachea and showed tracheal compression with instillation of contrast into the cavity. Ultimately, he underwent definitive resection of the mass and has had excellent functional recovery. Pathology confirmed a congenital bronchogenic cyst.</div></div><div><h3>Conclusion</h3><div>Bronchogenic cysts can cause airway compression, which may present as new asthma-like symptoms. They can even cause acute airway obstruction. Bronchogenic cysts should be promptly ruled out in patients who develop new asthma-like symptoms but fail to respond to standard treatments.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103112"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120412","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":"Gastrojejunostomy and Ladd's procedure for the management of obstructive preduodenal portal vein and intestinal malrotation in an adolescent: A case report","authors":"Vitalis C. Osuji,&nbsp;Michael Tirabassi","doi":"10.1016/j.epsc.2025.103121","DOIUrl":"10.1016/j.epsc.2025.103121","url":null,"abstract":"<div><h3>Introduction</h3><div>A potential cause of bowel obstruction in the setting of intestinal malrotation is preduodenal portal vein (PDPV). It is a rare congenital anomaly that can be associated with duodenal atresia, duodenal web, or annular pancreas.</div></div><div><h3>Case presentation</h3><div>A 14-year-old female with a long history of failure to thrive presented to the hospital with abdominal pain. She described the pain as intermittent, responsive to pain medication, with radiation to the back. Her mother provided a history of approximately 10–15lbs of unintentional weight loss in 3–4 months, and intermittent symptoms that had been ongoing for over one year. She underwent a computed tomography (CT) of the abdomen/pelvis with intravenous contrast and was found to have intestinal malrotation with splenosis, inverse relationship of the superior mesenteric artery and superior mesenteric vein, the appendix in the left lower quadrant, and uterine didelphys. She underwent an upper gastrointestinal (UGI) study with small bowel follow-through that confirmed the malrotation, without bowel obstruction or volvulus. Due to persistent symptoms, she was taken to the operating room for an exploratory laparoscopy. We found that she had a PDPV, which was likely the cause of her symptoms. The PDPV was very close to the pylorus. After careful dissection, we were unable to obtain adequate duodenal length proximal to the PDPV to do a duodeno-duodenostomy. Therefore, we decided to proceed with gastrojejunostomy, followed by a Ladd's procedure. She had an uncomplicated recovery and was discharged home on postoperative day 10. Nine months after the operation, she remains asymptomatic.</div></div><div><h3>Conclusion</h3><div>PDPV can present as the primary cause of duodenal obstruction. A gastrojejunostomy appears to be an effective treatment for cases in which a duodeno-duodenostomy is not doable.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103121"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270087","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":"Acute abdominal pain due to torsion and gangrene of a Meckel's diverticulum: a case report","authors":"Ashagre Gebremichael Ganta ,&nbsp;Amanu Gashaw","doi":"10.1016/j.epsc.2025.103120","DOIUrl":"10.1016/j.epsc.2025.103120","url":null,"abstract":"<div><h3>Introduction</h3><div>Meckel's diverticulum is a common congenital anomaly that can lead to serious complications. Axial torsion is a rare event that can result in vascular compromise, ischemia, and gangrene. Its clinical presentation is non-specific and can be indistinguishable from other causes of a surgical acute abdomen.</div></div><div><h3>Case presentation</h3><div>A 4-year-old male presented to the emergency department with a four-day history of progressive abdominal pain that had become constant, severe, and diffuse. His symptoms were accompanied by bilious vomiting, high-grade fever (up to 39.8 °C), profound lethargy, and anorexia. On examination, he was tachycardic, febrile, and exhibited a toxic clinical appearance. His abdomen was significantly distended, with profound tenderness, involuntary guarding, rigidity, and rebound tenderness indicative of generalized peritonitis; bowel sounds were absent. Laboratory investigations revealed leukocytosis of 40.0 × 10⁹/L with neutrophilia, and a markedly elevated CRP of 105 mg/L. Abdominal x-ray demonstrated non-specific air-fluid levels, and large volume of complex free fluid was seen on a bedside ultrasonography. Following vigorous fluid resuscitation and broad-spectrum intravenous antibiotics, the patient underwent an urgent exploratory laparotomy. Intraoperatively, the appendix appeared normal. We found a gangrenous Meckel's diverticulum located 55 cm proximal to the ileocecal valve, which had undergone a 540-degree axial torsion around its narrow pedicle, resulting in ischemia without perforation. A segmental small bowel resection with primary anastomosis was performed. Histopathology confirmed transmural hemorrhagic infarction and coagulative necrosis. The postoperative course was uneventful, with return of bowel function on the second postoperative day. The patient was discharged home on postoperative day 10.</div></div><div><h3>Conclusion</h3><div>Torsion of a Meckel's diverticulum should be included in the differential diagnosis of children who develop acute abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103120"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325494","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":"Type III pleuropulmonary blastoma in a toddler: a case report","authors":"Binyam Mulatu Habte ,&nbsp;Yoseph Mulatu Habte ,&nbsp;Esimael Musema Abdu ,&nbsp;Mintesnot Fitretu Zeberga ,&nbsp;Abay Gosaye Wondimu ,&nbsp;Yonas Girma Shumiye","doi":"10.1016/j.epsc.2025.103115","DOIUrl":"10.1016/j.epsc.2025.103115","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleuropulmonary blastoma (PPB) is an exceptionally rare and aggressive pediatric thoracic malignancy, accounting for less than 1 % of childhood lung tumors. Its nonspecific respiratory presentation often mimics common conditions, leading to delayed recognition, particularly in resource-limited settings.</div></div><div><h3>Case presentation</h3><div>A 2.5-year-old female with progressive respiratory distress since infancy managed as recurrent pneumonias without improvement was admitted to our hospital. She was tachypneic with absent air entry over the right hemithorax. Laboratory studies revealed leukocytosis and anemia. A contrast-enhanced chest computerized tomography (CT) showed a large heterogeneously enhancing right lower lobe mass with necrotic foci, encasement of hilar broncho-vascular structures, associated pleural and pericardial effusions, and mediastinal shift suspicious for a malignant process. Brain magnetic resonance (MRI) and abdominal CT were done to assess for metastasis and were normal. Given the child's critical condition, upfront surgical resection was undertaken without preoperative biopsy or neoadjuvant therapy. We did a right thoracotomy and found a large, encapsulated mass arising from the right lower lobe, which was excised via a lobectomy. Histopathology confirmed a type III pleuropulmonary blastoma, demonstrating sheets of undifferentiated mesenchymal cells with pleomorphism and necrosis. The patient had an uneventful postoperative recovery and was subsequently referred to a specialized oncology center for adjuvant chemotherapy.</div></div><div><h3>Conclusion</h3><div>Pleuropulmonary blastoma should be considered in the differential diagnosis of toddlers who present with recurrent or persistent respiratory symptoms that fail to improve with standard therapies.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103115"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160055","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":"Neonatal appendicitis in a preterm male infant: A case report","authors":"Keitumetse Teko,&nbsp;Ryan Lalbadoor,&nbsp;Leila Hartford","doi":"10.1016/j.epsc.2025.103119","DOIUrl":"10.1016/j.epsc.2025.103119","url":null,"abstract":"<div><h3>Introduction</h3><div>Neonatal appendicitis (NA) is a rare condition with a reported incidence of 0.04–0.2 %, and a high mortality rate of approximately 28 %. Preoperative diagnosis of NA remains challenging due to its nonspecific and variable clinical presentation.</div></div><div><h3>Case presentation</h3><div>The patient was a 7-day-old preterm male born at 35 weeks of gestation with a birth weight of 1400g, and Apgar scores of 9,9,10 to a 16-year-old primigravid mother. The pregnancy was uneventful, with no maternal complications and no antenatal imaging. On day 4 of life he developed abdominal distension, with associated blood-stained nasogastric aspirates. On examination, he was tachycardic (198 bpm) and febrile (38.5 °C). The abdomen was distended, tender, and had no bowel sounds on auscultation. Abdominal radiography showed pneumoperitoneum. Laboratory results showed elevated c-reactive protein (65mg/L). An emergency exploratory laparotomy revealed a perforated appendix with right iliac fossa contamination, and grossly normal small bowel, colon and stomach. An appendicectomy was performed and the abdominal cavity irrigated with saline solution. Histopathology confirmed acute appendicitis. Postoperative rectal suction biopsy done day 3 post laparotomy excluded Hirschsprung's disease. The infant's recovery was uneventful. Full feedings were reached by day 5 post laparotomy, and he was discharged home on day 10 post laparotomy. He was seen in follow up at 1 month of age at the outpatient clinic and was growing well.</div></div><div><h3>Conclusion</h3><div>Although rare, perforated appendicitis should be included in the differential diagnosis of neonates who develop an acute abdomen and have a pneumoperitoneum.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103119"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325492","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":"Sacrococcygeal epidermal inclusion cyst in a child: A case report","authors":"Saswati Behera ,&nbsp;Satvik Dharmaik ,&nbsp;Santosh Behera ,&nbsp;Ankit Rai ,&nbsp;Gargi Kapatia ,&nbsp;Ashish Kumar","doi":"10.1016/j.epsc.2025.103118","DOIUrl":"10.1016/j.epsc.2025.103118","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidermal inclusion cysts (EIC) are common benign lesions, but their occurrence in the sacrococcygeal area, particularly in the pediatric population, is an exceedingly rare event. Due to their location, they must be differentiated from other more serious retrorectal tumors.</div></div><div><h3>Case presentation</h3><div>A 10-year-old male child presented with a congenital, firm, non-fluctuant swelling over his sacrococcygeal region that had been slowly increasing in size since birth. There was no associated urine or fecal incontinence or any history of trauma. On examination, the swelling was firm to touch, non-fluctuant, mobile and located in the midline of the natal cleft just superior to the anus. There was no associated erythema, overlying skin changes, draining sinus, or pain upon handling. Per rectal examination revealed no palpable mass. Ultrasonography (USG) showed a cystic homogenous well-defined mass of 3x2.5 × 3 centimetres without any spinal communication or bony deformity. Magnetic resonance imaging (MRI) confirmed the USG findings. The patient underwent complete surgical excision of the mass under general anesthesia in jack knife prone position. Histopathological examination confirmed the diagnosis of an epidermal inclusion cyst, showing a cyst lined by stratified squamous epithelium and containing keratin flakes, with no evidence of malignancy. The patient had an uncomplicated recovery with no postoperative neurological deficits. He is doing well and under regular follow up.</div></div><div><h3>Conclusion</h3><div>Epidermal inclusion cyst must be considered in the differential diagnosis of children who present with sacrococcygeal lesions. Complete surgical resection is the treatment of choice.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103118"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325493","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":"Combined endoscopic and laparoscopic surgery for staged repair of complex cloacal anomalies: A case series","authors":"Erica M. Weidler ,&nbsp;Matthew Ralls ,&nbsp;Gwen Grimsby ,&nbsp;Marcus Jarboe ,&nbsp;Casey Calkins ,&nbsp;Kathleen van Leeuwen","doi":"10.1016/j.epsc.2025.103117","DOIUrl":"10.1016/j.epsc.2025.103117","url":null,"abstract":"<div><h3>Introduction</h3><div>The combined endoscopic and laparoscopic surgery (CELS) technique can be used during reconstruction for infants with complex congenital anomalies. In persistent cloacal malformations, this approach permits delineation of challenging anatomy and facilitates safer surgical separation of structures while minimizing tissue trauma for future procedures.</div></div><div><h3>Cases presentation</h3><div>Three patients with persistent cloacal malformations and complex upper tract reproductive anatomy underwent the CELS technique during their series of reconstructive procedures. The average age at first stage reconstruction, that included anorectoplasty, was 14 months (range 9–22). The average follow-up length from the time of reconstruction was 6.5 years (range 4–9 years). All patients have since undergone colostomy takedown. Two patients have undergone delayed vaginal pull-through and/or introitoplasty, and one patient has not yet undergone vaginoplasty.</div></div><div><h3>Conclusion</h3><div>The CELS technique may help reduce complications from open surgery, allows time for structural development, and minimizes tissue dissection and trauma at an early age. Staged repair for complex cloaca can be safely considered and allow for delay of vaginal reconstruction with minimal adverse short-term outcomes and impact on subsequent procedures.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103117"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270086","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 gastroschisis with biliary atresia: A case report","authors":"Rachel C. Bordelon ,&nbsp;Joseph Pydyn ,&nbsp;Henry W. Caplan ,&nbsp;Essam M. Imseis ,&nbsp;Allison L. Speer ,&nbsp;Charles S. Cox (Jr)","doi":"10.1016/j.epsc.2025.103097","DOIUrl":"10.1016/j.epsc.2025.103097","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastroschisis and biliary atresia (BA) are both rare surgical disorders of neonates. While neither condition has a known etiology, there is currently no clear association between the two and the estimated odds of coincidence are 1 in 30, 000, 000 livebirths. Nonetheless, a few published reports have mentioned infants diagnosed with both gastroschisis and BA but usually in the setting of poor outcomes and incomplete descriptions of management decisions.</div></div><div><h3>Case presentation</h3><div>A 1960-g female with limited prenatal care was born at 35 weeks gestation and was found to have gastroschisis, which was managed with a hand-sewn silo and serial reductions until the abdomen was closed. At 25 days old, she developed acholic stools and rising direct hyperbilirubinemia. Workup was concerning for biliary atresia, which was confirmed with an intraoperative cholangiogram and she underwent Kasai portoenterostomy, which was challenging given intestinal malrotation from gastroschisis. Postoperatively, bilirubin levels normalized and pigmented stools returned. Her course was complicated by a small perforation of the ascending colon requiring exploration and creation of a diverting colostomy on post-operative day 7. However, since that time she has done well with normal liver function now over 9 months after portoenterostomy creation, and is pending colostomy takedown.</div></div><div><h3>Conclusion</h3><div>Prompt recognition and careful consideration of abnormal intestinal anatomy are necessary in the management of concurrent biliary atresia and gastroschisis, but this can be accomplished with favorable outcomes.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103097"},"PeriodicalIF":0.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895142","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}