Journal of Pediatric Surgery Case Reports最新文献

{"title":"Chronically retained esophageal foreign body, a case report","authors":"Nardos Mulu Admasu,&nbsp;Fisseha Temesgen Gebru,&nbsp;Tihitena Negussie Mamo,&nbsp;Eden Belay Tilahun,&nbsp;Etsub Abebaw","doi":"10.1016/j.epsc.2024.102904","DOIUrl":"10.1016/j.epsc.2024.102904","url":null,"abstract":"<div><h3>Introduction</h3><div>Foreign body ingestion is one of the most common pediatric emergencies among infants and young children. Between 80 % and 90 % of ingested foreign bodies pass spontaneously, 10 %–20 % require endoscopic removal, and about 1 % necessitates an open approach for removal.</div></div><div><h3>Case presentation</h3><div>A 13-year-old female developed progressive dysphagia over the course of 11 years. The parents reported a history of a foreign body ingestion (a plastic candlepin holder) 11 years before. They were informed that the foreign body would pass spontaneously but they did not recall ever having recovered it. Over the years she was repeatedly taken to various healthcare facilities where chest X-rays were performed and reported as normal, and she was sent home without interventions. When she presented to our clinic, she could swallow chewed solid food only with liquids. A neck examination revealed a bulge on the right anterolateral side. The remainder of the physical examination was unremarkable. An esophagogram revealed an upper esophageal stricture with a diverticulum. Upper GI endoscopy demonstrated a proximal esophageal stricture, while a neck CT scan showed narrowing of the proximal esophagus and a foreign body with a central hole. The impacted foreign body was successfully removed by endoscopy. She was able to swallow solid food for about a year, after which she developed dysphagia again. Endoscopy revealed narrowing at the proximal esophagus. An attempt at esophageal dilation was unsuccessful. She subsequently underwent a cervical exploration, which showed a short proximal esophageal stricture and a diverticulum proximal to the stricture. A diverticulectomy and resection with end-to-end anastomosis were done. Six months after the operation she continues to eat solid foods with some difficulty, but is gaining weight, and remains under close surveillance.</div></div><div><h3>Conclusion</h3><div>Diagnosing non-radiopaque esophageal foreign bodies is challenging in centers with limited resources. Chronically impacted foreign bodies and their complications are difficult to treat due to the lack of a standardized approach.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102904"},"PeriodicalIF":0.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433999","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":"Congenital rib absence with liver herniation: A case report","authors":"Yirgalem Teklebirhan Gebreziher ,&nbsp;Feven Mekonen Tadesse ,&nbsp;Hadush Tesfay Negash ,&nbsp;Berihu Tadish Gebre","doi":"10.1016/j.epsc.2024.102903","DOIUrl":"10.1016/j.epsc.2024.102903","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital rib absence with liver herniation is an extremely rare condition. Only a few cases have been reported, and most of them have been associated with Poland syndrome.</div></div><div><h3>Case presentation</h3><div>A full-term female newborn, born at 38 weeks of gestation with a birth weight of 3100 g, delivered vaginally following a normal pregnancy was brought to our clinic at 11 days of life for a right lower thoracic bulge. There was no relevant family history. The physical exam was completely normal except for a 4 × 5 cm round protrusion in the right lower anterolateral chest. The ribs in the area were clearly absent. The skin, the subcutaneous tissue and the muscles appeared normal. He had normal vital signs and breath sounds. The abdominal exam was normal. A plain chest X-ray showed normal lung fields, absence of the right lower ribs, a right diaphragmatic eventration, and a soft tissue herniation. A three-dimensional computed tomography (3D-CT) reconstruction confirmed the diagnosis of congenital hypoplastic 6th and 7th right ribs, absent 8th and 9th right ribs, and a foramen in the right 10th rib. It also showed that the visible bulge was the liver protruding through the weakened chest wall. The only other anatomical anomaly was 6th to 9th thoracic butterfly vertebrae. The patient is being managed conservatively and is doing well.</div></div><div><h3>Conclusion</h3><div>Congenital intercostal liver herniation with absent ribs is an extremely rare condition and can be managed conservatively in asymptomatic cases. We recommend 3D-CT reconstruction as an effective way to confirm the diagnosis and rule out associated malformations.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102903"},"PeriodicalIF":0.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533015","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":"Esophageal placement of a biliary stent to manage a iatrogenic esophageal perforation: A case report","authors":"Saurin Dipak Dani,&nbsp;Dravina Shetty,&nbsp;Abhaya R. Gupta,&nbsp;Paras R. Kothari","doi":"10.1016/j.epsc.2024.102898","DOIUrl":"10.1016/j.epsc.2024.102898","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-operative anastomotic stricture can occur after a gastric tube esophagoplasty in children with esophageal atresia, resulting in difficulty swallowing. Endoscopic dilatation is commonly used to treat these strictures. The dilatations carry a risk of esophageal perforation.</div></div><div><h3>Case presentation</h3><div>A two-year-old male was admitted to the intensive care unit for an esophageal perforation that resulted from an esophageal dilatation. He had a history of long-gap type-C esophageal atresia/tracheo-esophageal, which had been managed with a cervical esophagostomy and a gastrostomy at birth, followed by an esophageal replacement by reverse gastric tube at the age of 17 months. At the age of 20 months, he developed dysphagia. An esophageal stricture was diagnosed by endoscopy. He underwent several balloon dilatations, followed by dilatations with solid dilators. The last dilatation was complicated by the esophageal perforation that prompted his hospital admission. At the time of the admission, we placed a chest tube, started antibiotics, and kept him NPO. We resumed enteral feedings 12 days after the perforation but immediately noticed that the formula was draining out of the chest tube. A surgical repair of the persistent fistula was deemed unsafe. We decided to place a biliary stent to cover the perforation endoscopically. Nasogastric feeds were reinitiated. The stent was kept in place for six weeks, while the patient was fed by a nasogastric tube. After 6 weeks, a contrast study confirmed that the perforation had sealed. Oral feedings were started at that time and the chest tube was removed. He has had no recurrence of the perforation or the stricture since then.</div></div><div><h3>Conclusion</h3><div>Biliary stents could be an option for the management of iatrogenic esophageal perforations in children.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102898"},"PeriodicalIF":0.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417726","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":"Chest wall reconstruction with biological mesh, rib stabilization, and latissimus dorsi rotation: A case report","authors":"Lucía Fein ,&nbsp;Bruno Cuturi ,&nbsp;Ruver Berazategui ,&nbsp;Sylvia Duarte","doi":"10.1016/j.epsc.2024.102899","DOIUrl":"10.1016/j.epsc.2024.102899","url":null,"abstract":"<div><h3>Introduction</h3><div>Children with chest wall tumors may require extensive chest wall resections. The reconstruction of large chest wall defects can be surgically challenging. We present a new chest wall reconstruction method.</div></div><div><h3>Case presentation</h3><div>A 2.5-year-old male who developed respiratory symptoms and chest pain was diagnosed with an Askin's tumor of the left chest wall. The tumor originated in the posterior segments of the seventh and eighth ribs. Computed tomography of the chest revealed a large mass filling the left hemithorax, causing flattening of the hemidiaphragm and mediastinal shift. No distant metastases were identified. The patient underwent six cycles of neoadjuvant chemotherapy with vincristine, adriamycin, cyclophosphamide, ifosfamide, and etoposide. Post-chemotherapy, magnetic resonance imaging revealed a significant reduction in tumor size. The patient was taken to the operating room for the resection of the tumor. The posterior segments of the left sixth, seventh, eighth, and ninth ribs were surgically excised. The chest wall was reconstructed using a biological mesh (Permacol™), sutures for costal arch stabilization using the lattice technique, and a rotated latissimus dorsi muscle flap for defect coverage. An 18 Fr pleural drainage was left in place. The patient tolerated the operation well and was successfully extubated 48 hours later. Pain was effectively managed via paravertebral block. The patient was discharged on the 14th postoperative day. The resected specimen had negative margins. He subsequently underwent several more cycles of chemotherapy. Eighteen months after the operation he has developed no scoliosis and has full range of motion on the left chest wall.</div></div><div><h3>Conclusion</h3><div>A combination of a biological mesh, rib stabilization and latissimus dorsi rotation seems to be a valid technique to cover large chest wall defects.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102899"},"PeriodicalIF":0.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425195","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":"Hydrosalpinx leading to fallopian tube torsion in a 10-year-old female: A case report","authors":"Joanna Sajdlowska ,&nbsp;Pasha Shenasan ,&nbsp;Nicole Clarke ,&nbsp;Nishith Bhattacharyya","doi":"10.1016/j.epsc.2024.102895","DOIUrl":"10.1016/j.epsc.2024.102895","url":null,"abstract":"<div><h3>Introduction</h3><div>Isolated fallopian tube torsion (IFTT) is a rare complication in the pediatric population, especially among the pre-adolescent and pre-menarcheal population.</div></div><div><h3>Case report</h3><div>A10-year-old prepubertal girl with no past surgical history and a history of autoimmune hepatitis, ADHD, hyperlipidemia and constipation presented with a 4-day history of sharp abdominal pain. Initially the pain was localized to the suprapubic region, but it later became diffuse. She was hemodynamically stable, and all laboratory values were unremarkable. An initial ultrasound showed preserved vascular flow to non-enlarged ovaries. Computerized tomography of the abdomen and pelvis with contrast demonstrated an indeterminate fluid structure in the right lower quadrant. A follow-up ultrasound showed right hydrosalpinx measuring 5.1 x 5.7 × 5.6 cm with free fluid adjacent to the right ovary. Magnetic resonance imaging re-demonstrated a tubular structure in the right lower quadrant adjacent to the right ovary with preserved ovaries. The patient underwent diagnostic laparoscopy, which confirmed isolated right fallopian tube torsion with ischemic changes. The Fallopian tube was detorsed and regained proper vascularization. The fluid within the Fallopian tube was evacuated. The right ovary was intact. She recovered well from the operation and was discharged home shortly thereafter. One week after the operation she was free of symptoms.</div></div><div><h3>Conclusion</h3><div>Fallopian tube torsion should be included in the differential diagnosis of pre-adolescent and pre-menarcheal females with abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102895"},"PeriodicalIF":0.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417727","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":"Retroperitoneal Castleman's disease and ovarian torsion: A case report","authors":"Mingjun Jin ,&nbsp;Tengfei Li ,&nbsp;Qianhui Yang ,&nbsp;Linsheng Zhao ,&nbsp;Liang Dong ,&nbsp;Jianghua Zhan","doi":"10.1016/j.epsc.2024.102897","DOIUrl":"10.1016/j.epsc.2024.102897","url":null,"abstract":"<div><h3>Introduction</h3><div>Castleman's Disease (CD) is a rare lymphoproliferative disorder with diverse clinical manifestations. It is primarily characterized by painless lymph node enlargement, most commonly in the mediastinum, neck, retroperitoneum, axillary regions, and pelvis.</div></div><div><h3>Case presentation</h3><div>A 12-year-old female was admitted to our hospital with persistent abdominal pain and vomiting that were not alleviated by initial treatments. Physical examination revealed tenderness in the right lower abdomen. Pelvic ultrasound revealed a mass in the pelvic region. Due to persistent pain, she underwent a laparoscopic exploration during which it was discovered that the right ovary was twisted 360°, and it was adjacent to the pelvic mass. It appeared that the mass was pushing the ovary, and this phenomenon could have been the cause of the torsion. The nature of the mass could not be conclusively determined during the intraoperative assessment, but a biopsy with a fine needle was obtained. Pathological examination was suggestive of a tumor related to the lymphatic system. She underwent a pelvic MRI that confirmed a round, soft tissue mass on the right side of the pelvis measuring approximately 63 × 50 × 56 mm. We did a subsequent laparoscopy and completely resected the mass. The patient recovered well and was discharged without complications. At 2 years of follow up she is in good health. The final pathology diagnosis of the mass was CD.</div></div><div><h3>Conclusion</h3><div>CD is often asymptomatic, but symptoms can arise when the enlarged lymph nodes cause compression on surrounding organs.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"111 ","pages":"Article 102897"},"PeriodicalIF":0.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417725","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":"A novel approach to pediatric chest wall reconstruction using a 3D-printed biodynamic prosthesis: A case report","authors":"Keerthi Burgi ,&nbsp;Nikhil R. Shah ,&nbsp;Tammy Stoll ,&nbsp;James D. Geiger","doi":"10.1016/j.epsc.2024.102896","DOIUrl":"10.1016/j.epsc.2024.102896","url":null,"abstract":"<div><h3>Introduction</h3><div>Chest wall reconstruction in children continues to be a challenging undertaking, aiming to restore both form and function. An optimal chest wall reconstruction material has not been identified that would provide dynamic chest function and would ideally avoid potential long-term sequelae.</div></div><div><h3>Case presentation</h3><div>A 15-year-old female with Li Fraumeni syndrome and a history of hepatic rhabdomyosarcoma presented with increasing left back and left scapular pain initially attributed to her known scoliosis. Computed tomography revealed a 12 x 6 × 7 cm mass encasing ribs 3–5 extending into the left chest wall and axilla. Image-guided biopsy confirmed a high-grade osteosarcoma without extra-thoracic metastatic disease. She underwent neoadjuvant chemotherapy after which a three-dimensional (3D) anatomic model of the tumor was printed using the post-therapy imaging reconstruction. The surgical team collaborated with Osteobionix (Osteobionics S.L., Santa Lucia de Tirajana, Spain) to create a patient-specific dynamic chest wall reconstruction implant, based on 3D modeling of the planned resection zone. The final implant was 3D printed with a titanium alloy using electron-beam manufacturing technology, sterilized prior to implantation. She underwent left thoracotomy and rib resection with prosthesis fixation to the T3, T4, and T5 vertebral bodies posteriorly and to the sternum anteriorly. More than2 years after the operation, she is doing well without evidence of recurrent disease. She has an excellent cosmetic result, there has been no progression of her scoliosis, and she has returned to competitive sports.</div></div><div><h3>Conclusion</h3><div>Our titanium-based 3D-printed, patient-specific implant seems to be a valuable option for the reconstruction of the chest wall in children who require an extensive chest wall resection.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102896"},"PeriodicalIF":0.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425194","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":"Intraductal papilloma presenting as a breast mass in an 8-month-Old male infant: A case report","authors":"Maen Kamal ,&nbsp;Nesma Ghanim ,&nbsp;Raima Hashmi ,&nbsp;Zachary Patterson ,&nbsp;Qazi Azher ,&nbsp;Antonio J. Williams Sr","doi":"10.1016/j.epsc.2024.102894","DOIUrl":"10.1016/j.epsc.2024.102894","url":null,"abstract":"<div><h3>Introduction</h3><div>Intraductal papilloma is an exceptionally rare condition in the pediatric population, particularly among males in infancy and early childhood, typically most prevalent among women aged between 35 and 55 years presenting as sanguineous or serosanguineous nipple discharge and a discrete breast mass. Despite its historical classification as benign, emerging research indicates a potential for malignant transformation, prompting a reevaluation of its clinical significance.</div></div><div><h3>Case presentation</h3><div>We present the case of a healthy 8-month-old male infant with a right subareolar breast swelling that appeared non tender, well-circumscribed, smooth, mobile, rubbery, without any associated nipple discharge or regional lymphadenopathy, clinically measuring 10 × 10 mm in diameter, and exhibited a bluish green hue with no associated changes in overlying skin. Ultrasound confirmed presence of a right retro areolar breast mass, characterized as a multiseptated complex cyst-like structure with tubular anechoic formations within, measuring 21 x 20 × 6 mm. The findings were suggestive of possible duct ectasia classified as Bi-Rads Category 3 with a benign probability. Due to parental concern for increase in size over 2 months, the mass was resected under general anesthesia through a subareolar incision. Microscopic analysis confirmed dilated cystic ducts and an intraductal papilloma with calcifications. The patient recovered well from the operation, and follow-up at nine months, he has experienced no recurrences.</div></div><div><h3>Conclusion</h3><div>Although rare, this case underscores the importance of including intraductal papilloma in the differential diagnosis of breast nodules in male infants.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102894"},"PeriodicalIF":0.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425286","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":"Traumatic rupture of a yolk sac tumor: A case report","authors":"Hannah Z. Weiss ,&nbsp;Michael Dedwylder ,&nbsp;Faris Azar ,&nbsp;Thomas Bolton ,&nbsp;Melanie Altizer ,&nbsp;Anne Fischer","doi":"10.1016/j.epsc.2024.102893","DOIUrl":"10.1016/j.epsc.2024.102893","url":null,"abstract":"<div><h3>Introduction</h3><div>Yolk sac tumors are rare neoplasms with a risk of rupture due to their rapid growth and vascularity. There is only one reported case of a ruptured yolk sac tumor in the literature.</div></div><div><h3>Case presentation</h3><div>A nine-year-old girl presented to an outside hospital with worsening bilateral lower quadrant abdominal pain following a handlebar injury. The patient was tachycardic and tachypneic with a hemoglobin of 7.4 g per deciliter, lactic acid of 7.7 mmol/L, and white blood cell count of 45,000 per μL. A Computed Tomography (CT) scan revealed a large, hypodense 19.1 × 11.4 cm abdominal mass and free fluid concerning for a hematoma with possible peritoneal carcinomatosis. The patient was transfused with one unit of packed red blood cells (PBRCs) given her tachycardia. After transfer from the outside hospital, the patient continued to be tachycardic (143 beats per minute) and tachypneic (36 breaths per minute). A repeat CT was performed, revealing a 6 × 5.5 cm right subhepatic mass and a 16 × 12 cm pelvic mass. In the OR (operating room), a large, multi-cystic hemorrhagic tumor measuring 16.8 cm was discovered in the left pelvis. A second mass was found in the subhepatic space that was a large tumor nodule. The patient underwent left oophorectomy and salpingectomy for tumor resection. An omentectomy was performed due to omental carcinomatosis, with tumor nodules reaching up to 9.5 cm in length. A smaller tumor nodule was resected from the left round ligament. During the operation, the patient received a transfusion of five units of PBRCs, four units of fresh frozen plasma, one unit of platelets, and 2.5 units of crystalloids. Labs taken at the time of surgery revealed an alpha fetal protein (AFP) level of 17,523 ng/mL. The patient was staged as a stage IIIC mixed germ cell tumor with 99% yolk sac and 1% mature teratoma cells. Post-operatively, the patient was treated with BEP chemotherapy, achieving normalization of AFP levels by the end of the fourth cycle.</div></div><div><h3>Conclusion</h3><div>The aggressive growth pattern of yolk sac tumors places patients at risk of tumor rupture, potentially leading to an acute abdomen. These patients require prompt surgical intervention followed by chemotherapy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102893"},"PeriodicalIF":0.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328166","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":"Sigmoid perforation after endoscopic clip placement in an infant: A case report","authors":"Lucia Fein,&nbsp;Gabriela Carro,&nbsp;Bernardo Berazategui","doi":"10.1016/j.epsc.2024.102892","DOIUrl":"10.1016/j.epsc.2024.102892","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal perforation following endoscopic clip placement is an uncommon complication that has been reported in adult patients but, as far as we now, not in pediatric patients.</div></div><div><h3>Case presentation</h3><div>An 8-month-old female infant with a history of metabolic encephalopathy was admitted with a convulsive disorder requiring mechanical ventilation. On the seventh day of hospitalization in the intensive care unit, the patient experienced three bowel movements with dark blood clots. Despite being hemodynamically stable upon physical examination, her hemoglobin level decreased to 8.6 g/dL. Upper endoscopy findings were normal, and exploratory laparoscopy ruled out Meckel's diverticulum or other visible parietal causes of bleeding. Lower gastrointestinal endoscopy revealed ulcers in the rectum, sigmoid, and terminal ileum, where hemostatic clips were placed. No repeated bleeding events occurred. However, 20 days later she presented with fever, abdominal pain, and distension. Abdominal radiography revealed pneumoperitoneum, leading to an emergency exploratory laparotomy. A perforation of the sigmoid colon from one of the clips was found. We resected the short segment of sigmoid colon that contained the perforation and did an end-to-end anastomosis. She recovered well and had no complications.</div></div><div><h3>Conclusion</h3><div>Hemostatic clips placed endoscopically in the colon can lead to perforation even several weeks after placement.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102892"},"PeriodicalIF":0.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328215","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}