Journal of Pediatric Surgery Case Reports最新文献

Appendiceal inflammatory vascular congestion in a child: a case report 儿童阑尾炎性血管充血1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-29 DOI: 10.1016/j.epsc.2026.103206

Hussein Ibrahim , Ahmed Maher , Ahmed zuhry Yassin Osman , Mahmoud H. Abdelrazik

Introduction

Appendiceal varices are an exceedingly rare entity in pediatric patients and are usually associated with portal hypertension. Severe inflammatory vascular congestion in acute appendicitis may closely mimic this condition intraoperatively.

Case presentation

An 8-year-old female child presented with a 24-h history of right lower quadrant abdominal pain associated with low-grade fever and vomiting. There was no history of gastrointestinal bleeding, liver disease, portal hypertension, or previous abdominal surgery. Physical examination revealed localized tenderness and guarding in the right iliac fossa. Laboratory investigations showed leukocytosis with neutrophil predominance. Abdominal ultrasonography demonstrated a non-compressible tubular structure in the right iliac fossa with surrounding inflammatory changes, consistent with acute appendicitis. Open appendectomy was performed through a Lanz incision. Intraoperatively, the appendix was markedly inflamed, edematous, and dusky in appearance with very large, prominent serpiginous vessels along the mesoappendix and appendiceal wall. These dilated veins were not detected preoperatively on imaging and raised suspicion of appendiceal varices. The dilated vessels were carefully controlled using standard ligation of the mesoappendix, and appendectomy was completed uneventfully without excessive bleeding. Gross examination showed a thickened inflamed appendix. Histopathological examination demonstrated transmural acute inflammation with marked vascular congestion but no venous ectasia or true varices. The postoperative course was uncomplicated, and the patient was discharged on the second postoperative day. At follow-up, the child remained asymptomatic with no clinical or radiological evidence of portal hypertension or recurrent symptoms.

Conclusion

Appendiceal varices in the context of acute appendicitis may be secondary to the inflammatory process and not a sign of portal hypertension.

阑尾静脉曲张在儿科患者中极为罕见，通常与门静脉高压有关。急性阑尾炎的严重炎症性血管充血可能与术中类似。病例表现：一名8岁女童，24小时右下腹部疼痛，伴有低烧和呕吐。没有胃肠道出血、肝脏疾病、门静脉高压症或既往腹部手术史。体格检查显示右髂窝局部压痛和守卫。实验室检查显示白细胞增多，中性粒细胞占优势。腹部超声示右侧髂窝不可压缩管状结构，周围有炎性改变，符合急性阑尾炎。通过Lanz切口进行开放性阑尾切除术。术中阑尾明显发炎、水肿，外观呈暗色，沿阑尾系膜和阑尾壁有非常大、突出的蛇形血管。术前影像学未发现扩张静脉，怀疑为阑尾静脉曲张。使用标准阑尾系膜结扎术仔细控制扩张的血管，阑尾切除术顺利完成，无大量出血。大体检查显示阑尾增厚发炎。组织病理学检查显示全壁急性炎症伴明显血管充血，但无静脉扩张或真静脉曲张。术后疗程简单，患者于术后第二天出院。随访时，患儿无症状，无门静脉高压或复发症状的临床或影像学证据。结论急性阑尾炎的阑尾静脉曲张可能是继发于炎症过程，而不是门静脉高压的征象。

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引用次数: 0

Anorectal malformation, duodenal atresia, and intestinal malrotation: a case report 肛肠畸形、十二指肠闭锁、肠旋转不良1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-29 DOI: 10.1016/j.epsc.2026.103207

Camila Dardanelli, Georgina Falcioni, Luzia Toselli, Lucía Gutiérrez Gammino, Maximiliano Maricic

Introduction

The combination of anorectal malformation, intestinal malrotation, and duodenal atresia is exceptionally rare. Such cases usually require staged surgical management.

Case presentation

A full-term female newborn (3.32 kg), prenatally diagnosed with duodenal atresia, Down syndrome, and imperforate anus without fistula, was admitted. Abdominal x-ray confirmed a double-bubble sign, and ultrasound revealed no other anomalies. A single minimally invasive surgery was planned on day of life three. First step: an exploratory laparoscopy was performed via a paraumbilical port and additional flank ports using 3-mm instruments and a 30-degree scope. Duodenal atresia and intestinal malrotation were identified, and Ladd bands were released. Second step: an intraoperative diagnostic contrast enema was done by a transabdominal puncture, followed by injection of water-soluble contrast. This demonstrated a 5-mm distance between the rectal pouch and the theoretical anal site, without evidence of a fistula. Third step: a side-to-end duodeno-duodenal anastomosis was performed. The anterior walls of both duodenal ends were opened, and a continuous running suture was done using 5-0 polydioxanone, starting on the posterior wall. Next, the patient was placed in prone position for a standard posterior sagittal anorectoplasty. The postoperative course was uneventful. Enteral feeding began on postoperative day six and anal dilatations on postoperative day nine. The patient was discharged home at one month of age having normal function. No reinterventions have been required at one year of follow-up.

Conclusion

The combination of anorectal malformation, duodenal atresia, Down syndrome, and intestinal malrotation is very rare. Repairing all defects in a single surgical stage seems safe and effective.

摘要肛肠畸形、肠旋转不良及十二指肠闭锁合并是极为罕见的。这类病例通常需要分阶段手术治疗。病例介绍1例足月女新生儿（3.32 kg），产前诊断为十二指肠闭锁、唐氏综合征、肛门闭锁无瘘。腹部x线证实双泡征，超声未见其他异常。计划在第三天进行一次微创手术。第一步：使用3毫米器械和30度镜通过脐旁口和额外的侧腹口进行腹腔镜探查。发现十二指肠闭锁和肠道旋转不良，并释放Ladd带。第二步：术中诊断性造影剂灌肠，经腹穿刺，然后注射水溶性造影剂。显示直肠袋和理论上的肛门部位之间有5mm的距离，没有瘘管的证据。第三步：侧端十二指肠-十二指肠吻合。打开双十二指肠前壁，用5-0聚二恶酮从后壁开始连续行缝合。接下来，将患者置于俯卧位进行标准后矢状肛肠成形术。术后过程平淡无奇。术后第6天开始肠内喂养，术后第9天开始肛门扩张。患者于一个月大时出院，功能正常。随访1年时不需要再次干预。结论肛肠畸形、十二指肠闭锁、唐氏综合征合并肠道旋转不良是非常罕见的。在一次手术中修复所有的缺陷似乎是安全有效的。

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引用次数: 0

Primary Ewing sarcoma of the breast in a male adolescent: A case report 男性青少年乳腺原发性尤文氏肉瘤1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-29 DOI: 10.1016/j.epsc.2026.103205

Joie Sheen A. Bastian, Willie T. Hao, Lawrence Faith A. Lucañas-Yap

Introduction

Ewing sarcoma predominantly affects children and adolescents. Breast Ewing sarcoma is exceptionally uncommon, with only 16 documented cases globally, just one being pediatric.

Case presentation

A 14-year-old male was referred by a pediatrician for evaluation of a rapidly growing right breast mass over the course of 2 months. Diagnosis was confirmed via tumor tissue biopsy, immunohistochemistry (CD99+, NKX2.2+), and fluorescent in situ hybridization, which showed an EWSR1 break-apart on chromosome 22q12. Initial contrast-enhanced computed tomography of the chest revealed a huge tumor on the right breast with 2nd to 6th anterior rib involvement measuring 16.8x18.1x9.5 cm, and prominent right axillary lymph nodes. No distant metastasis was seen on positron emission tomography during metastatic work-up. The patient received neoadjuvant chemotherapy using vincristine, doxorubicin, and cyclophosphamide alternating with ifosfamide and etoposide over 12 weeks. The tumor size decreased significantly post-neoadjuvant chemotherapy, now measuring 3.9x12.2x6.5cm. After reassessment, the patient underwent wide excision of the right chest mass, en-bloc anterior 5th rib resection, right axillary lymph node dissection, with latissimus dorsi flap reconstruction with an uneventful perioperative course. He remained recurrence-free at the six-month follow-up.

Conclusion

Although rare, Ewing sarcoma must be included in the differential diagnosis of rapidly growing breast masses in male adolescents.

尤文氏肉瘤主要影响儿童和青少年。乳腺尤因肉瘤非常罕见，全球只有16例记录在案的病例，其中只有1例是儿科。病例介绍：一名14岁的男性被儿科医生推荐去评估一个快速增长的右乳房肿块超过2个月的过程。通过肿瘤组织活检、免疫组化（CD99+、NKX2.2+）和荧光原位杂交证实诊断，在22q12染色体上发现EWSR1断裂。胸部初始增强计算机断层扫描显示右侧乳房有一巨大肿瘤，累及第2至第6前肋，尺寸为16.8x18.1x9.5 cm，右侧腋窝淋巴结突出。在转移性检查中，正电子发射断层扫描未见远处转移。患者接受新辅助化疗，使用长春新碱、阿霉素、环磷酰胺与异环磷酰胺和依托泊苷交替化疗12周。新辅助化疗后肿瘤大小明显减小，现在尺寸为3.9x12.2x6.5cm。重新评估后，患者接受了右胸部肿物广泛切除，前5肋骨整体切除，右腋窝淋巴结清扫，背阔肌皮瓣重建，围手术期顺利进行。在6个月的随访中，他没有复发。结论Ewing肉瘤虽然罕见，但在男性青少年快速生长的乳房肿块中必须纳入鉴别诊断。

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引用次数: 0

Pancreatic Kaposiform haemangioendothelioma complicated by Kasabach-Merritt phenomenon and recurrent cholangitis in an infant: A case report 婴儿胰卡泊样血管内皮瘤合并卡萨巴赫-梅里特现象和复发性胆管炎1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-28 DOI: 10.1016/j.epsc.2026.103199

Hannah Triscott , Halah Hassan , Craig A. McBride , Roy M. Kimble

Introduction

Kaposiform haemangioendothelioma (KHE) is a rare, locally aggressive vascular tumour which primarily affects children. Pancreatic involvement is exceptionally uncommon, and its association with Kasabach-Merritt Phenomenon (KMP), a life-threatening consumptive coagulopathy, poses significant diagnostic and therapeutic challenges.

Case presentation

A 6-month-old female presented with a five-day history of bilious vomiting, lethargy, and poor oral intake. Initial investigations revealed severe anaemia (Hb 57 g/L), coagulopathy (INR 9.3) and thrombocytopenia (platelets 57 × 10⁹/L). Imaging identified bilateral subdural haemorrhages and a retroperitoneal pancreatic mass encasing vital structures causing obstructive hepatopathy, biliary dilation, and ascites. Biopsy confirmed KHE, with spindle cell proliferation and immunohistochemical features consistent with the diagnosis. The clinical course was complicated by KMP, recurrent cholangitis with Pseudomonas bacteraemia, and a pancreatic leak. Management included sirolimus, vincristine, corticosteroids, biliary drainage, and a feeding jejunostomy. Despite significant complications, including failure to thrive and prolonged jejunostomy site issues, the patient achieved resolution of coagulopathy, stabilisation of hepatic function, and stable disease on maintenance sirolimus therapy. Chemotherapy was discontinued after six months, with ongoing outpatient monitoring.

Conclusion

A combination of sirolimus, vincristine and supportive therapy including percutaneous biliary drainage seems to be a safe and effective management option for children with pancreatic KHE with KMP and cholestasis.

卡波西样血管内皮瘤是一种罕见的局部侵袭性血管肿瘤，主要影响儿童。胰腺受累异常罕见，其与危及生命的消耗性凝血病卡萨巴赫-梅里特现象（KMP）相关，给诊断和治疗带来了重大挑战。病例表现：一名6个月大的女性，有5天胆汁性呕吐、嗜睡和口腔摄入不良史。初步调查显示严重贫血（Hb 57 g/L），凝血功能障碍（INR 9.3）和血小板减少（血小板57 × 109/L）。影像学发现双侧硬膜下出血和腹膜后胰腺肿块包围重要结构，导致梗阻性肝病、胆道扩张和腹水。活检证实KHE，梭形细胞增生和免疫组织化学特征与诊断一致。临床过程中并发KMP，复发性胆管炎伴假单胞菌菌血症和胰漏。治疗包括西罗莫司、长春新碱、皮质类固醇、胆道引流和喂养式空肠造口术。尽管出现了严重的并发症，包括发育不全和空肠造口部位问题延长，患者在维持西罗莫司治疗下实现了凝血功能的解决、肝功能的稳定和病情的稳定。化疗在6个月后停止，并持续进行门诊监测。结论西罗莫司、新碱联合经皮胆道引流等支持治疗是治疗胰腺KHE合并KMP合并胆汁淤积患儿安全有效的方法。

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引用次数: 0

Fetal thoracic-amniotic shunt and postnatal repair in the management of a right congenital diaphragmatic hernia complicated by a large prenatal pleural effusion: A case report 胎儿胸羊膜分流术和产后修复术治疗右侧先天性膈疝合并大量产前胸腔积液1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-26 DOI: 10.1016/j.epsc.2026.103201

Mihai Puia-Dumitrescu , Carrie Foster , Emily Watson , Bettina Paek , Martin Walker , Rebecca Stark

Introduction

Congenital diaphragmatic hernia (CDH) complicated by fetal pleural effusion and hydrops is rare and carries a poor prognosis, particularly when associated with severe pulmonary hypoplasia.

Case presentation

A male fetus was diagnosed at 22 weeks’ gestation with severe right-sided CDH containing liver and bowel, complicated by large pleural effusion, ascites, and hydrops. At 25 weeks, a thoraco-amniotic shunt was placed for persistent chylous effusion, with improvement in O/E TFLV from 15–16 % to 32–33 %. The infant was delivered at 31 + 4 weeks and required surfactant, inhaled nitric oxide, and vasoactive support. He underwent patch repair of large type B defect at two weeks of life. He was extubated on postoperative day 6, weaned to room air by day of life 69, pulmonary hypertension resolved, and discharged on day of life 71. At follow-up, he is feeding fully by mouth and is progressing appropriately.

Conclusion

Fetuses with CDH who develop large pleural effusions may benefit from prenatal thoraco-amniotic shunt placement.

先天性膈疝（CDH）合并胎儿胸腔积液和积液是一种罕见且预后较差的疾病，尤其是合并严重肺发育不全时。一例男性胎儿在妊娠22周时被诊断为严重的右侧CDH，包括肝脏和肠道，并伴有大量胸腔积液、腹水和积液。在25周时，由于持续乳糜积液，进行了胸羊膜分流术，O/E TFLV从15 - 16%改善到32 - 33%。婴儿在31 + 4周时出生，需要表面活性剂、吸入一氧化氮和血管活性支持。他在出生两周后接受了大B型缺陷的补片修复。术后第6天拔管，第69天停用室内空气，肺动脉高压消退，第71天出院。在随访中，他完全靠口进食，并且进展正常。结论对发生大量胸腔积液的CDH胎儿，产前放置胸-羊膜分流器可能有益。

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引用次数: 0

Post-traumatic rupture of primary solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas in a male adolescent: a case report 男性青少年胰腺原发性实性假乳头上皮瘤（SPEN）创伤后破裂：1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-26 DOI: 10.1016/j.epsc.2026.103203

Paulo Castro , Heather Hartman , Yashasvi Shukla , Michael Moore , Dennis Drehner , Harish Lavu

Introduction

Solid pseudopapillary epithelial neoplasm (SPEN) is a rare pancreatic tumor that typically presents in adult women and is usually asymptomatic.

Case presentation

A 12-year-old male presented to the emergency department with worsening abdominal pain one day after suffering mild abdominal trauma during a soccer match. Physical exam showed diffuse abdominal tenderness and guarding. CT abdomen with IV contrast showed a heterogeneous, round structure adjacent to the pancreatic tail with mass effect upon the spleen. MRI abdomen revealed a “claw sign” of pancreatic tissue surrounding the structure, suggesting a an underlying pancreatic mass with capsular rupture measuring 8.3 x 8.1 × 8cm. This finding indicated the need for open distal pancreatectomy. Intraoperatively, safe separation of the splenic vasculature from the mass proved impossible and splenectomy was performed. A drain was left in place. Postoperatively, the patient recovered without complication. At one month follow-up, the patient was seen doing well. A drain amylase did not show evidence of a pancreatic leak and was removed. Histopathology later confirmed the diagnosis of SPEN of the pancreas.

Conclusion

Traumatic rupture of SPEN of the pancreas is a rare initial presentation. Distal pancreatectomy shortly after presentation appears to be safe and may require splenectomy if the splenic vasculature appears inseparable from the tumor.

实性假乳头状上皮瘤（SPEN）是一种罕见的胰腺肿瘤，通常出现在成年女性，通常无症状。病例介绍一名12岁男性，在足球比赛中遭受轻微腹部创伤，一天后腹痛加重，来到急诊室。体格检查显示腹部弥漫性压痛和守卫。腹部CT伴静脉造影显示胰腺尾部附近一不均匀圆形结构，伴脾脏肿块。腹部MRI显示该结构周围胰腺组织呈“爪状征”，提示胰底肿块伴包膜破裂，尺寸为8.3 x 8.1 x 8cm。这一发现表明需要进行远端胰腺切除术。术中，脾血管与肿物的安全分离被证明是不可能的，因此进行了脾切除术。排水沟还在原地。术后患者康复，无并发症。在一个月的随访中，患者恢复良好。引流淀粉酶未显示胰腺渗漏的迹象，并被移除。组织病理学证实了胰腺SPEN的诊断。结论外伤性胰腺SPEN破裂是一种罕见的首发表现。发病后不久行远端胰腺切除术似乎是安全的，如果脾血管与肿瘤不可分离，则可能需要脾切除术。

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引用次数: 0

Congenital intramesenteric hernia presenting as small bowel obstruction in children: A case series 儿童先天性肠内疝表现为小肠梗阻：一个病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-26 DOI: 10.1016/j.epsc.2026.103204

Sachini Arunarathne , Mathula Hettiarachchi

Introduction

Intramesenteric hernia is an exceedingly rare congenital internal hernia characterized by herniation of bowel loops between the two layers of the mesentery, forming a true sac.

Cases presentation

Case 1: A 1-year-and-6-month-old boy presented with bilious vomiting and abdominal distension for two days. He appeared ill and dehydrated, was afebrile and tachycardic, with normal blood pressure. The abdomen was distended without tenderness or guarding. Plain radiograph and ultrasound demonstrated features of small bowel obstruction. After initial resuscitation with intravenous fluids and antibiotics, surgery was undertaken due to radiological evidence of obstruction. Exploratory laparotomy revealed a sac within the distal ileal mesentery containing viable small bowel loops, which was plicated using absorbable sutures. His postoperative recovery was uneventful. Oral feedings were started on postoperative day 2, and he was discharged on postoperative day 5. Case 2: A 2-year-old girl presented with similar features. She was afebrile and in pain, hemodynamically stable, with a distended, tender abdomen. Ultrasonography demonstrated dilated small bowel loops. Supine abdominal X-ray showed multiple dilated small bowel loops with absent rectal gas. Laparoscopic exploration revealed an intramesenteric pouch containing viable bowel near the distal ileum, which was reduced and plicated through a limited incision. She had an uncomplicated postoperative course. Oral feedings were started on postoperative day 2, and she was discharged on postoperative day 6. At the 3-month follow-up, both children were asymptomatic.

Conclusion

Intramesenteric hernia should be considered in the differential diagnosis of pediatric small bowel obstruction.

肠系膜内疝是一种极为罕见的先天性内疝，其特征是肠系膜两层之间的肠袢突出，形成一个真正的囊。病例1:1岁零6个月大的男婴，表现为胆汁性呕吐和腹胀2天。他表现出生病和脱水，发热和心动过速，血压正常。腹部膨胀无压痛或守卫。x线平片及超声表现为小肠梗阻。在最初的静脉输液和抗生素复苏后，由于放射证据显示梗阻，进行了手术。剖腹探查发现回肠远端肠系膜内有一个囊，其中含有可行的小肠袢，使用可吸收缝合线缝合。他的术后恢复很顺利。术后第2天开始口服喂养，术后第5天出院。病例2：一名2岁女孩表现出相似的特征。她发热、疼痛，血流动力学稳定，腹部胀痛。超声检查显示小肠袢扩张。仰卧位腹部x线片显示多个扩张的小肠袢并无直肠气体。腹腔镜探查发现回肠远端附近有一个含活肠的肠内袋，通过有限切口将其缩小并折叠。她的术后过程并不复杂。术后第2天开始口服喂养，术后第6天出院。在3个月的随访中，两名儿童均无症状。结论小儿小肠梗阻的鉴别诊断应考虑肠内疝。

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引用次数: 0

Repair of complex acquired tracheoesophageal fistula guided by 3D printing: a case report 3D打印引导下修复复杂获得性气管食管瘘1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-25 DOI: 10.1016/j.epsc.2026.103196

Neal Mukherjee , Michael Bunker , Lia Jacobson , Amar Nijagal , Naveen Swami , Shafkat Anwar

Introduction

3D-printed (3DP) models have been used to for complex surgical simulation and planning in multiple surgical contexts, but never acquired tracheoesophageal fistulas (TEF).

Case presentation

A 10-month-old previously healthy female infant presented with 3 days of persistent fevers and worsening respiratory distress. A 2-cm button battery found in the esophagus on chest x-ray was urgently removed by rigid endoscopy. A remaining plaque-like tracheal lesion was later identified on rigid bronchoscopy as a 2 × 1.5cm TEF. Using the computer-assisted design software Mimics (Materialise v28.06, Leuven, BE) a 1:1 anatomical 3DP replica of the patient's anatomy was constructed using a computed tomography scan and printed using a polyjet resin printer (Stratasys J750, Minneapolis, MN). The model was used to plan the multi-disciplinary repair. The trachea and esophagus were mobilized through a median sternotomy while on cardiopulmonary bypass. The 270-degree esophageal defect was repaired with a partial circumference esophageal anastomosis. The tracheal defect required posterior reconstruction and end-to-end anastomosis. An endotracheal tube was positioned superior to the anastomosis via intraoperative bronchoscopy and a mediastinal chest tube was placed. She was monitored with daily bronchoscopies until extubation on post-operative day 7. A contrast esophagram on day 18 noted no strictures/leaks. The only postoperative complications were mediastinitis treated with antibiotics and left vocal chord hypomobility treated with injection laryngoplasty on post-operative day 23 before discharge home on day 36. She remained grossly asymptomatic through her first year of follow-up with unremarkable 1-year follow-up bronchoscopy.

Conclusion

3D printed models may be helpful in the preoperative planning of complex tracheoesophageal reconstruction.

3d打印（3DP）模型已用于多种手术环境下的复杂手术模拟和计划，但从未用于获得性气管食管瘘（TEF）。病例表现：一名10个月大的健康女婴出现持续发烧3天，呼吸窘迫加重。胸片上发现食管内2厘米纽扣电池，经硬内镜紧急取出。随后在刚性支气管镜下发现残留的斑块样气管病变为2 × 1.5cm TEF。使用计算机辅助设计软件Mimics (Materialise v28.06, Leuven， BE)，使用计算机断层扫描构建患者解剖结构的1:1解剖3d打印副本，并使用多喷射树脂打印机（Stratasys J750, Minneapolis， MN）进行打印。该模型用于规划多学科修复。在体外循环时，通过胸骨正中切开术切除气管和食管。270度食管缺损采用部分围周食管吻合术修复。气管缺损需要后路重建和端对端吻合。术中支气管镜将气管内插管置于吻合口上方，并放置纵隔胸管。她每天接受支气管镜检查，直到术后第7天拔管。第18天食道造影未见狭窄/渗漏。术后唯一并发症为抗生素治疗纵隔炎，术后第23天注射喉成形术治疗左声带活动不全，第36天出院。在第一年的随访中，她基本上没有症状，随访1年的支气管镜检查也不明显。结论3d打印模型可用于复杂气管食管重建的术前规划。

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引用次数: 0

Post-infectious pneumatocele in an infant managed with tube thoracostomy: a case report 婴儿感染后肺气肿管开胸术：1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-25 DOI: 10.1016/j.epsc.2026.103200

Wassie A. Yigzaw , Abay G. Wondimu , Nardos M. Admasu , Leul Adane , Belachew D. Wondemagegnehu

Introduction

Pneumatoceles are thin-walled, gas-filled spaces in the lung parenchyma that most commonly occur after acute pneumonia and are usually transient. Persistent lesions may cause serious complications, including tension pneumatocele, pneumothorax, and superinfection.

Case presentation

A previously healthy 6-month-old male infant presented with fever and shortness of breath of 7 weeks duration. He was treated for severe community-acquired pneumonia with ceftriaxone for 10 days and discharged improved. However, he was admitted again two weeks later with recurrent symptoms. After readmission, ceftriaxone was initiated. Despite 5 days on ceftriaxone, his respiratory distress persisted. Hence antibiotics were changed to cefepime and vancomycin and he was imaged with chest CT with contrast which revealed multiple large pneumatoceles in the left lung. The largest cyst involved the left upper lobe and caused mass effect.

After multidisciplinary review, a diagnosis of post-pneumonia pneumatocele was favored. Under general anesthesia (GA) tube thoracostomy was performed via the left second intercostal space, targeting the largest subpleural cyst. Air evacuation was noted, with transient air bubbling that resolved spontaneously.

The patient showed rapid clinical improvement and follow-up chest X-ray demonstrated complete resolution of the lesions. The chest tube was removed after five days, and the patient was discharged home in stable condition, remaining well at three weeks of follow-up.

Conclusion

Infants who develop symptomatic post-infectious pneumatoceles may benefit from image-guided catheter drainage.

肺泡是肺实质中薄壁充气的间隙，最常见于急性肺炎后，通常是短暂的。持续病变可引起严重并发症，包括张力性气腹膨出、气胸和重复感染。病例表现既往健康的6个月男婴，表现为持续7周的发热和呼吸短促。重症社区获得性肺炎用头孢曲松治疗10天，出院情况好转。然而，两周后，他再次入院，症状复发。再次入院后，开始使用头孢曲松。尽管使用头孢曲松5天，他的呼吸窘迫仍然存在。改用头孢吡肟和万古霉素治疗，胸部CT造影剂显示左肺多发大气肿。最大的囊肿累及左上肺叶，造成肿块效应。多学科回顾后，诊断为肺炎后肺膨出是有利的。全麻下经左第二肋间隙行导管开胸术，针对最大的胸膜下囊肿。注意到空气排出，有短暂的空气冒泡，自发解决。患者表现出快速的临床改善，随后的胸部x线片显示病变完全消退。5天后取出胸管，患者出院，病情稳定，随访3周。结论有症状的感染后气肿患儿可采用图像引导下的导管引流。

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引用次数: 0

Persistent caudal appendix in a child: A case report 儿童尾尾阑尾顽固性1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-24 DOI: 10.1016/j.epsc.2026.103202

Y.E. Houmenou , A.A. Hadonou , M.G. Yassegoungbe , C.S. Metchihoungbe , E.U.E.M. Goudjo , M.A. Fiogbe

Introduction

The caudal appendix, or true tail, is a vestige persisting in the sacrococcygeal region. It may or may not contain bony elements. It should be distinguished from the pseudo-caudal appendix, which is associated with spinal dysraphism.

Case presentation

We report a case of a true tail in a six-week-old female infant with no significant antenatal or family story. She presented with a congenital conical sacral mass measuring 3 cm in length. Clinical examination revealed no associated cutaneous stigmata or neurological deficit. Imaging (lumbosacral X-rays and CT scan) confirmed the absence of vertebral or spinal cord abnormalities. Surgical exploration revealed a suprafascial lesion without musculoskeletal communication, allowing complete monobloc resection. Postoperative outcomes were simple in both the short and medium term., with no neurological deficits and normal motor development.

Conclusion

Patients who have a persistent caudal appendix should undergo imaging studies to rule out a spinal dysraphism.

尾尾，或真尾，是持续存在于骶尾骨区域的残余。它可能含有也可能不含有骨元素。它应该与伪尾尾阑尾相区别，后者与脊柱发育异常有关。我们报告一个六周大的女婴，没有明显的产前或家庭故事的真尾巴病例。她表现为先天性锥形的骶骨肿块，长3厘米。临床检查未发现相关的皮肤红斑或神经功能障碍。影像学（腰骶部x线和CT扫描）证实没有椎体或脊髓异常。手术探查发现筋膜上病变无肌肉骨骼通讯，允许完整的单块切除。术后中短期结果简单。，无神经功能缺损，运动发育正常。结论持续性尾尾阑尾患者应进行影像学检查以排除脊柱发育异常。

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