Journal of Pediatric Surgery Case Reports最新文献

{"title":"Massive gastroduodenal trichobezoar removed with hydrodissection: A case report","authors":"Seth Saylors,&nbsp;Cory Nonnemacher,&nbsp;Irene Isabel P. Lim","doi":"10.1016/j.epsc.2024.102954","DOIUrl":"10.1016/j.epsc.2024.102954","url":null,"abstract":"<div><h3>Introduction</h3><div>Trichobezoars are a rare cause of gastrointestinal obstruction in children. Trichobezoars are primarily confined to the stomach but in some cases can grow to substantial sizes and extend into the duodenum. Most trichobezoars require surgical removal through an often large gastrotomy.</div></div><div><h3>Case presentation</h3><div>A previously healthy 15-year-old female presented with 4 days of nausea, vomiting, and diarrhea. Examination was concerning for hypotension, severe abdominal distension, and diffuse peritonitis. Abdominal x-ray showed distended bowel loops in the upper abdomen and concern for pneumoperitoneum. Laboratory studies showed leukocytosis, anion gap metabolic acidosis, and acute kidney injury. The patient underwent emergent exploratory laparotomy which revealed a massive trichobezoar (42 cm × 12 cm) with distal portion in the duodenum, a closed loop obstruction of small bowel with a small trichobezoar in the proximal jejunum with bowel necrosis nearby, and pneumatosis from the proximal ileum to the transverse colon. The patient underwent anterior gastrotomy with successful removal of the bezoar in a single piece. During removal of the bezoar, we utilized a hydrodissection technique with warm saline that allowed separation of the entwined hairs from the gastric mucosa while also making the mass malleable as it absorbed the liquid. Additionally, she underwent small bowel resection x2 and temporary abdominal closure with wound vac placement. She returned to the OR two more times for washout and eventual anastomosis of small bowel and abdominal closure. Her post-operative course was complicated by refeeding syndrome, and she was discharged on POD 17 tolerating regular diet.</div></div><div><h3>Conclusion</h3><div>Large trichobezoars traditionally are removed via large anterior gastrotomy. The use of hydrodissection with warm irrigation can soften the bezoar and make it more pliable for removal through a smaller gastrotomy and minimize iatrogenic mucosal damage.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102954"},"PeriodicalIF":0.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148247","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":"Duodenal perforation in a child due to lollipop stick ingestion: A case report","authors":"Hercules Magalhães Olivense do Carmo ,&nbsp;Miguel Lucas Silva Valente ,&nbsp;Sthefanie da Silva Bessa ,&nbsp;Pedro Lucas Melo Brilhante ,&nbsp;Melayne Silva de Oliveira ,&nbsp;Luana Livelli Becker ,&nbsp;João Lucas de Melo Bardi ,&nbsp;Angela Claudia Paixão Soares de Magalhães","doi":"10.1016/j.epsc.2024.102944","DOIUrl":"10.1016/j.epsc.2024.102944","url":null,"abstract":"<div><h3>Background</h3><div>Foreign body ingestion is common in children. While most ingested objects pass harmlessly through the gastrointestinal tract, some can cause severe complications like perforation, which may be life-threatening.</div></div><div><h3>Case presentation</h3><div>A 4-year-old boy who presented with a 24-h history of abdominal pain, fever, and vomiting. Physical examination revealed a distended and tender abdomen with signs of peritonitis. An abdominal radiograph showed free air under the diaphragm and gastric and intestinal distension. Abdominal ultrasonography confirmed intestinal dilation and the presence of free fluid. An emergency exploratory laparotomy was performed, revealing a punctiform perforation on the fourth portion of the duodenum caused by a lollipop stick protruding into the retroperitoneal space. The foreign body was removed, and a primary repair of the duodenal perforation was performed. A drain was placed near the repair site, and a nasogastric tube left in place for gastric decompression. The postoperative course was uneventful. The patient received intravenous antibiotics until the day of his discharge. He resumed oral diet on the third postoperative day. The drain was removed on the fifth postoperative day. He was discharged home on the seventh postoperative day.</div></div><div><h3>Conclusion</h3><div>Duodenal perforation due to foreign body ingestion is rare but should be included in the differential diagnosis of young children who present with peritonitis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102944"},"PeriodicalIF":0.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147295","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":"Ovarian torsion in a 5-month-old infant: A case report","authors":"Mohammed Alra'e ,&nbsp;Majd Oweidat ,&nbsp;Shareef Hassan ,&nbsp;Radwan Abukarsh","doi":"10.1016/j.epsc.2025.102965","DOIUrl":"10.1016/j.epsc.2025.102965","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian torsion is a rare gynecological emergency in infants. Its rarity and its nonspecific symptoms make its early diagnosis challenging.</div></div><div><h3>Case presentation</h3><div>A previously healthy 5-month-old infant presented with inconsolable irritability, diarrhea and signs of dehydration. She was a former 32 weeker born by Cesarean section with a weight of 1600 g after an uneventful pregnancy. On physical exam she was tachycardic and tachypneic, but afebrile. She had diffuse abdominal tenderness but no abdominal distension. Bloodwork showed leukocytosis but no other abnormalities. Abdominal ultrasonography (US) showed an enlarged, ovoid, hyperechogenic right ovary (3.6 × 1.9 cm) with multiple internal follicles but no detectable vascular flow, suggestive of right ovarian torsion. The left ovary appeared normal in size and vascularity. She was taken to the operating room emergently for an exploratory laparotomy which was done through an infraumbilical midline incision. We found a swollen, torsed right ovary with signs of ischemia. We detorsed the ovary and wrapped it in gauze soaked in warm normal saline solution. To alleviate intraovarian pressure and further improve perfusion we made several small incisions on the surface of the ovary. The ovary regained normal perfusion within 10 min. The postoperative course was uneventful. She was discharged home shortly after the operation. An US done one month later showed the right ovary still slightly larger than the left ovary but with normal vascular flow.</div></div><div><h3>Conclusion</h3><div>It is important to include ovarian torsion in the differential diagnosis of female infants that develop acute abdominal pain. Early surgical intervention is key to preserve the viability of a torsed ovary.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102965"},"PeriodicalIF":0.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147718","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":"Giant mesenteric cyst with ascites in a 3-year-old boy: A case report","authors":"Anagheem Albaho ,&nbsp;Alaa Alsafadi ,&nbsp;Batoul Alraya ,&nbsp;Sherine Alahmad ,&nbsp;Hazem Kamil ,&nbsp;Jaber Mahmod","doi":"10.1016/j.epsc.2025.102962","DOIUrl":"10.1016/j.epsc.2025.102962","url":null,"abstract":"<div><h3>Introduction</h3><div>Mesenteric cysts are rare, benign intra-abdominal lesions that predominantly affect children. They have an estimated incidence of 1 case per 20,000 children and 1 case per 105,000 adults. They are often discovered incidentally during imaging studies done for unrelated reasons.</div></div><div><h3>Case report</h3><div>A 3-year-old child presented to the hospital with a year-long history of abdominal distension and recent weight loss. He had no relevant medical history. Clinical examination showed a distended abdomen dull on percussion, but he was otherwise in good general condition. The initial working diagnosis was ascites from portal hypertension. An abdominal ultrasound (US) showed free fluid in the peritoneal cavity, and the fluid was sampled. The serum-ascites albumin gradient (SAAG) was 1.3, suggestive of portal hypertension. He had an echocardiogram that showed mild left ventricular dilation, and he was therefore started on captopril, spironolactone and furosemide. He underwent an upper gastrointestinal endoscopy which revealed a sliding hiatal hernia and mild duodenitis, but no signs of portal hypertension. He subsequently underwent an abdominal CT scan that showed a large, multi-loculated mesenteric cyst displacing the bowel intestinal loops posteriorly. The patient underwent a laparotomy with complete resection of the mesenteric cyst. The postoperative echocardiogram showed good systolic function and all medications were stopped. After two years of follow-up, he has no recurrence of the mesenteric cyst.</div></div><div><h3>Conclusion</h3><div>Despite being rare, giant mesenteric cysts should be included in differential diagnoses of patients with unexplained abdominal distension.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102962"},"PeriodicalIF":0.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147294","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":"Phytobezoar caused by ingestion of air cooler husk in a 6-year-old boy: A case report","authors":"Umar Mahmood,&nbsp;Hamza Malik,&nbsp;Muhammad Usama Aziz,&nbsp;Rija Khalid,&nbsp;Chaudhary Ehtsham Azmat,&nbsp;Sunaina Siddique","doi":"10.1016/j.epsc.2025.102961","DOIUrl":"10.1016/j.epsc.2025.102961","url":null,"abstract":"<div><h3>Introduction</h3><div>Bezoars are conglomerates of indigestible material that accumulate in the gastrointestinal tract. Phytobezoars, derived from plant matter, are the most common type.</div></div><div><h3>Case presentation</h3><div>A 6-year-old boy presented with a one-week history of severe continuous abdominal pain, projectile vomiting, and constipation. He had experienced intermittent abdominal pain over the preceding three months, temporarily relieved by over-the-counter medications. Despite being well-developed, the child had a habit of chewing air cooler husk strips. Physical examination revealed a firm mass in the epigastrium extending to the right hypochondrium. An erect abdominal X-ray showed a distended stomach, without any distal obstruction. Abdominal ultrasound identified a mass with posterior shadowing, suggestive of a bezoar. Computerized tomography (CT) of the abdomen confirmed a mottled, heterogeneous mass in the stomach. The patient underwent an upper gastrointestinal endoscopy that confirmed a bezoar composed of air cooler husks, extending into the lower esophagus, but endoscopic removal was unsuccessful. The patient underwent a laparotomy and through an anterior gastrotomy we entirely removed the bezoar. The gastric wall had no signs of pressure necrosis or ulceration. The stomach was closed in 2 layers with running sutures. The patient recovered uneventfully. He remained nil per os (NPO) for 5 days, resumed oral feedings on the 6th postoperative day, and was discharged home on the 7th postoperative day having regular bowel movements and tolerating his diet well.</div></div><div><h3>Conclusion</h3><div>Phytobezoars must be included in the differential diagnosis of children with recurrent abdominal pain, particularly those with abnormal eating habits.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102961"},"PeriodicalIF":0.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147676","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":"Small bowel volvulus secondary to ascariasis in a 4-year-old boy: A case report","authors":"Mihret S. Tesfaye ,&nbsp;Hiwot Y. Anley ,&nbsp;Samuel Kefiyalew ,&nbsp;Samuel Gashu ,&nbsp;Jejaw Endale","doi":"10.1016/j.epsc.2025.102960","DOIUrl":"10.1016/j.epsc.2025.102960","url":null,"abstract":"<div><h3>Introduction</h3><div>Small bowel volvulus occurs when a section of the small bowel rotates abnormally around its mesentery. Small bowel volvulus due to Ascaris infestation is a rare surgical occurrence.</div></div><div><h3>Case presentation</h3><div>A 4-year-old boy from rural Ethiopia was brought to our pediatric emergency department with a four-day history of worsening abdominal pain, distension, and multiple episodes of bilious vomiting. He had a history of passing worms per rectum. On physical exam he was tachycardic, febrile, and had a distended, tender abdomen with guarding and rigidity. A plain abdominal X-ray showed multiple air-fluid levels and dilated bowel loops, suggestive of a small bowel obstruction. He was taken emergently to the operating room for an exploratory laparotomy. We found a volvulized partially necrotic segment of small intestine, 40 cm proximal to the ileocecal valve. The volvulized bowel was filled with worms. We devolvulized the bowel manually, did an enterotomy to remove the worms, resected 10 cm of necrotic bowel, and did an end-to-end anastomosis. On the 4th postoperative day, he exhibited signs of an anastomotic leak and was taken back to the operating room. We found no leak but could palpate more intraluminal Ascaris worms. We did a resection of a short segment of the ileum, removed all palpable Ascaris and did a re-anastomosis. He had an uneventful recovery following the second operation. Once he resumed bowel function, he received mebendazole 100 mg twice daily for 3 days. A second round of treatment was given 6 weeks later.</div></div><div><h3>Conclusion</h3><div>Patients with intestinal Ascaris infestation carry a risk of developing small bowel volvulus and should therefore be closely monitored for that while they receive medical treatment. In the event of a volvulus, early intervention is critical to optimize outcomes.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102960"},"PeriodicalIF":0.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148244","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":"Pelvic schwannoma in a 2-year-old boy: A case report","authors":"Maria Koenen ,&nbsp;Scott Keckler ,&nbsp;Jon Ryckman","doi":"10.1016/j.epsc.2025.102957","DOIUrl":"10.1016/j.epsc.2025.102957","url":null,"abstract":"<div><h3>Introduction</h3><div>Schwannomas are benign tumors that arise from the Schwann cells found in peripheral nerve sheaths. These uncommon masses are rare tumors of childhood. When they do occur, the vast majority are located in the head and neck region. Pelvic schwannomas are exceedingly rare in patients under 10 years old.</div></div><div><h3>Case presentation</h3><div>A previously healthy 2-year-old boy presented with intermittent abdominal pain and poor appetite. Physical exam revealed a large, palpable abdominal mass that extended from the pelvis to well above the umbilicus. Ultrasound and CT imaging delineated a 14 cm mass that seemed to originate from the pre-sacral area. Rhabdomyosarcoma was the primary differential diagnosis, along with teratoma. An open biopsy was performed, and pathology revealed a cellular schwannoma. Given that the mass was non-malignant but symptomatic, the patient was taken for surgical resection. A midline laparotomy was performed and the mass carefully freed from surrounding structures. It was adherent but not invasive. Complete resection was performed without injury to surrounding structures. The patient discharged home on post-operative day 3 and has since had full symptom resolution. The final pathology was consistent with the original biopsy results. Genetic testing was negative for neurofibromatosis. While recurrence is unlikely, yearly ultrasounds are planned for monitoring.</div></div><div><h3>Conclusion</h3><div>Pelvic schwannoma is an uncommon, but important, addition to the differential diagnosis for pediatric pelvic masses and should be managed with surgical resection and genetic testing when encountered.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102957"},"PeriodicalIF":0.2,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147677","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":"Anterior mediastinal mature teratoma in a 13-month-old girl: A case report","authors":"Gashaw Arega ,&nbsp;Nibretu Bekele ,&nbsp;Daniel Hailu ,&nbsp;Fathia Omer ,&nbsp;Michael A. Negussie ,&nbsp;Tihitena Negussie","doi":"10.1016/j.epsc.2025.102958","DOIUrl":"10.1016/j.epsc.2025.102958","url":null,"abstract":"<div><h3>Introduction</h3><div>Mature teratomas in the anterior mediastinum are rare, making up only 1–5% of mediastinal tumors. While they are usually seen in adults, it is uncommon for toddlers to have such tumors, especially large ones with concomitant pericardial effusion.</div></div><div><h3>Case presentation</h3><div>A 13-month-old female toddler presented with a one-month history of dry cough, progressively worsening respiratory distress, low-grade fever, intermittent rapid breathing, and non-drenching night sweats. Despite multiple evaluations and treatments for presumed hyperactive airway disease with antibiotics and salbutamol inhalers, her symptoms persisted. There was no history of prior hospitalizations, and the child was fully vaccinated with normal growth and developmental milestones. On examination, she appeared in significant respiratory distress with tachypnea, nasal flaring, subcostal and intercostal retractions, and oxygen saturation of 85 % on room air. Respiratory examination revealed decreased air entry bilaterally. Other systemic examinations were unremarkable. A chest x-ray film at the referring center revealed a mediastinal mass with an associated pleural effusion. A chest ultrasound identified a multiseptated cystic anterior mediastinal mass. A contrast-enhanced CT confirmed a 13 × 12 × 8 cm heterogeneous mass with cystic, fatty, and calcified components compressing and displacing the superior vena cava, pulmonary artery, and aorta without invasion. The trachea and mainstem bronchi were narrowed and displaced posteriorly. Serum alpha-fetoprotein and beta-human chorionic gonadotropin levels were normal, favoring a benign diagnosis. Surgical excision was performed via clamshell thoracotomy, achieving complete resection of the solid portion and aspiration of the cystic components. Histopathology confirmed a mature cystic teratoma with no immature or malignant elements. The child recovered well postoperatively, was discharged home on postoperative day seven, and is in good health at five months of follow up.</div></div><div><h3>Conclusion</h3><div>Large anterior mediastinal mature teratomas in toddlers are rare but manageable with early diagnosis and complete surgical resection.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102958"},"PeriodicalIF":0.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147673","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":"Pediatric pancreatic perineurioma: A case report","authors":"Eakes A ,&nbsp;Hill B ,&nbsp;Beierle EA","doi":"10.1016/j.epsc.2025.102959","DOIUrl":"10.1016/j.epsc.2025.102959","url":null,"abstract":"<div><h3>Introduction</h3><div>Perineuriomas are rare, benign, peripheral nerve sheath tumors that are distinguished from other lesions such as neurofibroma with specific immunohistochemical stains.</div></div><div><h3>Case presentation</h3><div>The patient was an 18-year-old female with a history of spina bifida and neuroblastoma. She was asymptomatic but at a follow up visit for urinary issues related to her spina bifida, an ultrasound of the kidneys revealed a retroperitoneal mass near the left kidney. Cross sectional imaging was completed and identified a left paraspinous mass measuring 13.3 x 10.1 × 11.2 cm, arising from the pancreas. Laboratory evaluations including liver function tests, complete blood count, renal panel, urine metanephrines, alpha fetoprotein and beta-hCg were normal. Complete resection of the mass required a distal pancreatectomy and splenectomy performed via laparotomy. Histologic evaluation of the mass was consistent with perineurioma. Postoperative recovery was unremarkable and the patient remains free of disease at one year followup with ultrasound imaging.</div></div><div><h3>Conclusion</h3><div>Perineurioma, a rare peripheral nerve sheath neoplasm, should be considered in the differential diagnosis for retroperitoneal masses in the pediatric population.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102959"},"PeriodicalIF":0.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148249","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":"Hepatic basidiobolomycosis in a 2-year-old child: A case report","authors":"Ahmed Ateik ,&nbsp;Saif Ghabisha ,&nbsp;Ali Almutamaiz ,&nbsp;Amar Almutawakel ,&nbsp;Azza Mohamed ,&nbsp;Faisal Ahmed","doi":"10.1016/j.epsc.2025.102956","DOIUrl":"10.1016/j.epsc.2025.102956","url":null,"abstract":"<div><h3>Introduction</h3><div>Isolated hepatic basidiobolomycosis is infrequently reported in the literature. Hepatic involvement is typically associated with disseminated disease. Hepatic basidiobolomycosis can mimic hepatic malignancies, posing a diagnostic and therapeutic challenge.</div></div><div><h3>Case presentation</h3><div>A 2-year-old male was referred to us with a two-month history of abdominal pain and a right upper quadrant abdominal mass. He had no history of vomiting, jaundice, decreased appetite, or diarrhea. Laboratory tests showed leukocytosis (white blood cell count of 15.5 × 10⁹/L) with normal eosinophil count, elevated C-reactive protein (CRP; 30 mg/L; normal: &lt;3 mg/L) and elevated erythrocyte sedimentation rate (ESR; 83 mm/h; normal: &lt;10 mm/h). Liver function tests were within normal limits. Abdominal ultrasonography (USG) showed a well-defined isoechoic homogenous 7 × 7 × 6 cm mass-like lesion in the right hepatic lobe. An abdominal computed tomography (CT) scan confirmed a localized irregular hypodense area in the right hepatic lobe, raising concerns for a hepatic abscess or malignancy. However, tumor markers were not able to be measured. A true-cut needle biopsy showed primarily normal liver tissue with eosinophilic infiltration, proving inconclusive. Fungal cultures were unavailable. The patient was taken to the operating room for an exploration. We find a non-encapsulated mass in the right hepatic lobe, without any other gastrointestinal involvement. Intraoperative biopsies were not available, so we decided to proceed with a complete resection of the mass. The histopathological analysis showed Splendore-Hoeppli bodies and eosinophils around thin-walled hyphae, strongly supporting the diagnosis of basidiobolomycosis. The patient recovered well from the operation and received voriconazole (6 mg/kg every 12 hours) for six months. At two years of follow-up, he has no signs of recurrence.</div></div><div><h3>Conclusion</h3><div>Hepatic basidiobolomycosis should be included in the differential diagnosis of children with a painful hepatic mass. The lack of proper diagnosis can lead to unnecessary liver resections.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"114 ","pages":"Article 102956"},"PeriodicalIF":0.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147675","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}