Journal of Pediatric Surgery Case Reports最新文献

Atypical presentation of occult congenital diaphragmatic hernia as intermittent obstructive symptoms: A case report

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-19 DOI: 10.1016/j.epsc.2025.103018

Connor V. Haynes , Carly T. Thaxton , Matthew P. Shaughnessy , David H. Stitelman

Introduction

Congenital diaphragmatic hernias (CDH) diagnosed beyond one month of life are rare and designated late-onset. Late-onset CDH can present with a variety of clinical manifestations including respiratory and gastrointestinal symptoms, which may be acute onset or long-standing chronic issues.

Case presentation

A 32-month-old boy with a five-month history of obstructive bowel symptoms was brought to the emergency department due to acute respiratory distress and abdominal pain. He was born at 41w1d with no prenatal suspicion of congenital anomalies. At the age of 27 months, the previously healthy patient with normal stooling patterns presented with a picture of bowel obstruction and was subsequently admitted three times over the next five months, with a maximum stay of eight days, due to ongoing obstructive symptoms. Multiple abdominal and chest radiographs during this period did not reveal an obvious structural etiology. Upon his respiratory distress presentation, repeat radiography revealed bowel loops in the left hemithorax with rightward mediastinal shift. Laparoscopy and thoracoscopy demonstrated a posterior left diaphragmatic hernia with omentum adherent to lung. Laparotomy was performed for reduction and suture repair of the diaphragm. Omentum fixed to the splenic flexure of the colon resulted in a fibrotic band of scar tissue and bowel caliber change. These bands were lysed. The post-operative course was uneventful, and the patient has maintained normal bowel movements without abdominal pain for three months.

Conclusion

Late-onset congenital diaphragmatic hernia must be included in the differential diagnosis of children who present with new-onset acute intestinal obstruction.

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引用次数: 0

Fourth branchial cleft cyst presenting as a mediastinal mass in a neonate: a case report

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-18 DOI: 10.1016/j.epsc.2025.103017

Marisa E. Schwab , Karthik Balakrishnan , Stephanie D. Chao

Introduction

Fourth branchial cleft anomalies are a rare congenital condition with varying presentations. Pediatricians and pediatric subspecialists must be familiar with this entity.

Case presentation

A 4-day old term female presented with increased work of breathing. Exam was notable for intermittent subcostal retractions. X-ray showed a mediastinal shadow. Chest CT showed a large mass extending from the neck into the mediastinum. Interventional radiology placed a pigtail into the mass via the left neck. This drained milky cloudy fluid for seven weeks. After transfer to a quaternary children's hospital, an MRI showed a persistent large thick-walled cyst tracking into the neck.

Laryngoscopy, bronchoscopy and esophagoscopy initially didn't show anomalies. Methylene blue dye was injected into the drain and seen to exit from a left pyriform sinus tract. This was confirmed with on-table fluoroscopy.

Two days later, she underwent injection of sclerosing agents and contrast via the drain under fluoroscopy. The sinus tract was cauterized and suture ligated using laryngoscopy. Laryngoscopy a few days later revealed no patent sinus tract. Sclerosant was again injected. Ultrasound after one month showed a slightly decreased mediastinal mass. Ultrasound three months later was significantly decreased size. At 7-month follow-up, the patient remains asymptomatic, feeding and growing well.

Conclusion

Fourth branchial anomalies are rare but must be considered in a pediatric patient of any age presenting with a neck or mediastinal mass.

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引用次数: 0

Management of a failed esophageal atresia repair in an infant asylee: a case report

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-17 DOI: 10.1016/j.epsc.2025.103012

Tina Huang, John Spencer Laue, Zaria Murrell

Introduction

Anastomotic leaks are not uncommon after the surgical repair of esophageal atresia (EA) and can cause significant morbidity. Inadequate medical infrastructure and supplies in Central American countries can be associated with poor outcomes. Access to care in resource-rich countries may be considered for patients from low-income countries who have surgical complications and have exhausted all local resources.

Case presentation

A female newborn born in Mexico with type-C esophageal atresia underwent primary esophago-esophagostomy two days after birth, near the Mexican Guatemalan border. One week later, an anastomotic leak was noticed, and the local surgeons proceeded with a repeat thoracotomy and re-do anastomosis. The patient was maintained without nutrition because parenteral nutrition was not available. Three weeks later, a recurrent leak was noticed after feedings were introduced. The local surgeons proceeded with a thoracotomy, distal esophageal closure, gastrostomy tube placement, and spit fistula. Having exhausted all local resources, the local surgeon advised the family to seek medical asylum in the U.S. She arrived at the U.S. at the age of 8 months and was first seen at another hospital due to dislodgement of the gastrostomy tube, which was replaced for a button. She was subsequently referred to our hospital. We did a thorough evaluation by rigid bronchoscopy and contrast studies and confirmed the feasibility of an esophageal anastomosis. We communicated extensively through a video platform with the local surgeon from Mexico to discuss the details of all prior procedures in preparation for the anastomosis. We proceeded with a fourth thoracotomy, spit fistula take-down and esophageal anastomosis. She developed a small leak that resolved spontaneously by postoperative day 22. She was supported by jejunal feedings through a GJ tube since postoperative day 1. She was discharged on postoperative day 28 on oral feedings plus GJ supplemental feedings.

Conclusion

Direct communication between surgeons across international borders can help in the surgical planning of patients who develop complications and come to the U.S. needing further care.

{"title":"Management of a failed esophageal atresia repair in an infant asylee: a case report","authors":"Tina Huang, John Spencer Laue, Zaria Murrell","doi":"10.1016/j.epsc.2025.103012","DOIUrl":"10.1016/j.epsc.2025.103012","url":null,"abstract":"<div><h3>Introduction</h3><div>Anastomotic leaks are not uncommon after the surgical repair of esophageal atresia (EA) and can cause significant morbidity. Inadequate medical infrastructure and supplies in Central American countries can be associated with poor outcomes. Access to care in resource-rich countries may be considered for patients from low-income countries who have surgical complications and have exhausted all local resources.</div></div><div><h3>Case presentation</h3><div>A female newborn born in Mexico with type-C esophageal atresia underwent primary esophago-esophagostomy two days after birth, near the Mexican Guatemalan border. One week later, an anastomotic leak was noticed, and the local surgeons proceeded with a repeat thoracotomy and re-do anastomosis. The patient was maintained without nutrition because parenteral nutrition was not available. Three weeks later, a recurrent leak was noticed after feedings were introduced. The local surgeons proceeded with a thoracotomy, distal esophageal closure, gastrostomy tube placement, and spit fistula. Having exhausted all local resources, the local surgeon advised the family to seek medical asylum in the U.S. She arrived at the U.S. at the age of 8 months and was first seen at another hospital due to dislodgement of the gastrostomy tube, which was replaced for a button. She was subsequently referred to our hospital. We did a thorough evaluation by rigid bronchoscopy and contrast studies and confirmed the feasibility of an esophageal anastomosis. We communicated extensively through a video platform with the local surgeon from Mexico to discuss the details of all prior procedures in preparation for the anastomosis. We proceeded with a fourth thoracotomy, spit fistula take-down and esophageal anastomosis. She developed a small leak that resolved spontaneously by postoperative day 22. She was supported by jejunal feedings through a GJ tube since postoperative day 1. She was discharged on postoperative day 28 on oral feedings plus GJ supplemental feedings.</div></div><div><h3>Conclusion</h3><div>Direct communication between surgeons across international borders can help in the surgical planning of patients who develop complications and come to the U.S. needing further care.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103012"},"PeriodicalIF":0.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pacemaker migration into the peritoneal cavity in children: a case series

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-17 DOI: 10.1016/j.epsc.2025.103016

Nicole H. Chicoine , Patrick J. Javid , David H. Rothstein , Samuel E. Rice-Townsend , Kimberly J. Riehle , Terrence U. Chun , Sarah L.M. Greenberg

Introduction

Cardiac pacemakers can have a variety of complications, one of which is migration into the peritoneal cavity. This complication, which can have variable clinical manifestations, has rarely been reported in pediatric patients.

Case presentations

Patient 1 was an 8-year-old female who had a pacemaker placed at the age of 1 year due to periodic asystole. She presented with rectal extrusion of a pacemaker lead. Computerized tomography (CT) scan confirmed the migration of the pacemaker generator and the lead to the area of the rectum. The devices were successfully removed transrectally. Patient 2 was a 19-year-old male with complete AV block who had a dual chamber pacemaker placed at the age of 7 years. Migration was detected at the age of 17 years on a routine abdomen/chest x-ray, and was confirmed on a CT. Laparoscopic retrieval was done at the age of 19 years. Patient 3 was a 1-year-old male with congenital heart disease requiring pacemaker placement at the age of 3 months. During a transvenous lead replacement at the age of 15 months, intraperitoneal migration was incidentally noticed at the time of the abdominal wall incision. The device was removed and replaced through the same incision. Patient 4 was a former 27 weeker male who had a pacemaker placed at the age of 5 months. At the age of 7 months, an abdominal x-ray done for unrelated reasons suggested possible pacemaker migration. Given that the patient was asymptomatic, and that the pacemaker was functioning properly, the pacemaker was left in place at that time and removed much later when the patient was 3 years old.

Conclusion

Migration of abdominal wall pacemakers in pediatric patients may present with or without symptoms. In select asymptomatic cases with preserved device function, delayed or elective surgical intervention may be considered.

{"title":"Pacemaker migration into the peritoneal cavity in children: a case series","authors":"Nicole H. Chicoine , Patrick J. Javid , David H. Rothstein , Samuel E. Rice-Townsend , Kimberly J. Riehle , Terrence U. Chun , Sarah L.M. Greenberg","doi":"10.1016/j.epsc.2025.103016","DOIUrl":"10.1016/j.epsc.2025.103016","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac pacemakers can have a variety of complications, one of which is migration into the peritoneal cavity. This complication, which can have variable clinical manifestations, has rarely been reported in pediatric patients.</div></div><div><h3>Case presentations</h3><div>Patient 1 was an 8-year-old female who had a pacemaker placed at the age of 1 year due to periodic asystole. She presented with rectal extrusion of a pacemaker lead. Computerized tomography (CT) scan confirmed the migration of the pacemaker generator and the lead to the area of the rectum. The devices were successfully removed transrectally. Patient 2 was a 19-year-old male with complete AV block who had a dual chamber pacemaker placed at the age of 7 years. Migration was detected at the age of 17 years on a routine abdomen/chest x-ray, and was confirmed on a CT. Laparoscopic retrieval was done at the age of 19 years. Patient 3 was a 1-year-old male with congenital heart disease requiring pacemaker placement at the age of 3 months. During a transvenous lead replacement at the age of 15 months, intraperitoneal migration was incidentally noticed at the time of the abdominal wall incision. The device was removed and replaced through the same incision. Patient 4 was a former 27 weeker male who had a pacemaker placed at the age of 5 months. At the age of 7 months, an abdominal x-ray done for unrelated reasons suggested possible pacemaker migration. Given that the patient was asymptomatic, and that the pacemaker was functioning properly, the pacemaker was left in place at that time and removed much later when the patient was 3 years old.</div></div><div><h3>Conclusion</h3><div>Migration of abdominal wall pacemakers in pediatric patients may present with or without symptoms. In select asymptomatic cases with preserved device function, delayed or elective surgical intervention may be considered.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"118 ","pages":"Article 103016"},"PeriodicalIF":0.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Distal vaginal agenesis reconstruction with interval buccal graft vaginoplasty followed by anastomosis to the upper vagina: A case report

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-12 DOI: 10.1016/j.epsc.2025.103011

Taryn Wassmer , Viktoriya Tulchinskaya , Aimee Morrison , Aaron Garrison , Lesley Breech

Introduction

Pull-through vaginoplasty, commonly performed for management of distal vaginal agenesis, risks post-operative stenosis if the proximal vagina is > 3 cm from the introitus. An alternative may be staged reconstruction using buccal graft vaginoplasty followed by interval anastomosis to native vagina.

Case presentation

A 12-year-old pubertal female with history of multiple laryngopharyngeal congenital anomalies presented with acute on chronic back pain. Spinal MRI incidentally identified hematometrocolpos measuring 7.3 × 8 × 15.6 cm with inflammation of atretic native upper vagina leading to a diagnosis of distal vaginal atresia. The distal aspect of the native upper vagina was found to be over 6 cm from the introitus. Given this distance, she was not deemed to be an ideal candidate for native pull-through vaginoplasty. IR-guided drainage of hematometrocolpos was performed for symptomatic relief. Hormonal suppression was used to allow sufficient time for resolution of vaginal wall inflammation bridging to staged surgical procedures. A buccal graft neovagina was created first, followed by routine postoperative dilation to allow for optimal development of the lower buccal graft. After 8 months, laparoscopic mobilization of Müllerian structures with transvaginal anastomosis to the interposition buccal graft neovagina was completed. 5 months postoperatively a stricture was identified that was injected with triamcinolone and bupivacaine. The final total vaginal length approached 9 cm without evidence of strictures or stenosis.

Conclusion

This novel staged surgical approach allows graft maturity and optimizes time utilization and healing, and may be an alternative for patients at risk of complications from native pull-through vaginoplasty.

{"title":"Distal vaginal agenesis reconstruction with interval buccal graft vaginoplasty followed by anastomosis to the upper vagina: A case report","authors":"Taryn Wassmer , Viktoriya Tulchinskaya , Aimee Morrison , Aaron Garrison , Lesley Breech","doi":"10.1016/j.epsc.2025.103011","DOIUrl":"10.1016/j.epsc.2025.103011","url":null,"abstract":"<div><h3>Introduction</h3><div>Pull-through vaginoplasty, commonly performed for management of distal vaginal agenesis, risks post-operative stenosis if the proximal vagina is > 3 cm from the introitus. An alternative may be staged reconstruction using buccal graft vaginoplasty followed by interval anastomosis to native vagina.</div></div><div><h3>Case presentation</h3><div>A 12-year-old pubertal female with history of multiple laryngopharyngeal congenital anomalies presented with acute on chronic back pain. Spinal MRI incidentally identified hematometrocolpos measuring 7.3 × 8 × 15.6 cm with inflammation of atretic native upper vagina leading to a diagnosis of distal vaginal atresia. The distal aspect of the native upper vagina was found to be over 6 cm from the introitus. Given this distance, she was not deemed to be an ideal candidate for native pull-through vaginoplasty. IR-guided drainage of hematometrocolpos was performed for symptomatic relief. Hormonal suppression was used to allow sufficient time for resolution of vaginal wall inflammation bridging to staged surgical procedures. A buccal graft neovagina was created first, followed by routine postoperative dilation to allow for optimal development of the lower buccal graft. After 8 months, laparoscopic mobilization of Müllerian structures with transvaginal anastomosis to the interposition buccal graft neovagina was completed. 5 months postoperatively a stricture was identified that was injected with triamcinolone and bupivacaine. The final total vaginal length approached 9 cm without evidence of strictures or stenosis.</div></div><div><h3>Conclusion</h3><div>This novel staged surgical approach allows graft maturity and optimizes time utilization and healing, and may be an alternative for patients at risk of complications from native pull-through vaginoplasty.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103011"},"PeriodicalIF":0.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant splenic mesothelial cyst in a child: A case report 一名儿童的巨大脾间皮细胞囊肿：病例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-10 DOI: 10.1016/j.epsc.2025.103010

Saad Andaloussi , Omar Dalero , Abdelkrim Haita , Jinane Kharmoum , Zakarya Alami Hassani , Aziz Elmadi

Introduction

Splenic mesothelial cysts are rare, accounting for a small fraction of primary non-parasitic splenic cysts. They often present as incidental findings but can become symptomatic when they reach a significant size.

Case presentation

An 8-year-old girl presented with a 30-day history of progressive left upper quadrant abdominal pain. Physical exam revealed a firm, tender mass in the left upper quadrant. Laboratory tests including complete white count and inflammatory markers were all within normal limits. Hydatid serology was normal. Abdominal ultrasonography (US) revealed splenomegaly with a large hypoechoic cystic lesion arising from the spleen without Doppler flow. Contrast-enhanced computed tomography scan of the abdomen and pelvis confirmed the splenomegaly and a large unilocular cystic lesion measuring 15 × 10 × 14 cm, occupying nearly the entire splenic parenchyma, displacing adjacent organs. No internal enhancement, solid components, or calcifications were observed. Preoperative vaccinations were administered. Due to the size of the cyst and the persistence of pain, the patient was taken to the operating room for a laparoscopic exploration. We found minimal residual splenic tissue around the large cyst, so we proceeded with a total splenectomy after aspirating the cyst. The histopathology analysis was consistent with a mesothelial cyst. The postoperative course was uneventful. The patient was enrolled in a structured vaccination program and remains asymptomatic with no complications at two years of follow-up.

Conclusion

For symptomatic giant splenic cysts involving the splenic hilum, laparoscopic total splenectomy remains a safe and effective option when spleen-preserving alternatives are anatomically unfeasible.

{"title":"Giant splenic mesothelial cyst in a child: A case report","authors":"Saad Andaloussi , Omar Dalero , Abdelkrim Haita , Jinane Kharmoum , Zakarya Alami Hassani , Aziz Elmadi","doi":"10.1016/j.epsc.2025.103010","DOIUrl":"10.1016/j.epsc.2025.103010","url":null,"abstract":"<div><h3>Introduction</h3><div>Splenic mesothelial cysts are rare, accounting for a small fraction of primary non-parasitic splenic cysts. They often present as incidental findings but can become symptomatic when they reach a significant size.</div></div><div><h3>Case presentation</h3><div>An 8-year-old girl presented with a 30-day history of progressive left upper quadrant abdominal pain. Physical exam revealed a firm, tender mass in the left upper quadrant. Laboratory tests including complete white count and inflammatory markers were all within normal limits. Hydatid serology was normal. Abdominal ultrasonography (US) revealed splenomegaly with a large hypoechoic cystic lesion arising from the spleen without Doppler flow. Contrast-enhanced computed tomography scan of the abdomen and pelvis confirmed the splenomegaly and a large unilocular cystic lesion measuring 15 × 10 × 14 cm, occupying nearly the entire splenic parenchyma, displacing adjacent organs. No internal enhancement, solid components, or calcifications were observed. Preoperative vaccinations were administered. Due to the size of the cyst and the persistence of pain, the patient was taken to the operating room for a laparoscopic exploration. We found minimal residual splenic tissue around the large cyst, so we proceeded with a total splenectomy after aspirating the cyst. The histopathology analysis was consistent with a mesothelial cyst. The postoperative course was uneventful. The patient was enrolled in a structured vaccination program and remains asymptomatic with no complications at two years of follow-up.</div></div><div><h3>Conclusion</h3><div>For symptomatic giant splenic cysts involving the splenic hilum, laparoscopic total splenectomy remains a safe and effective option when spleen-preserving alternatives are anatomically unfeasible.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103010"},"PeriodicalIF":0.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barrett's metaplasia complicating gastro-oesophageal reflux disease in a 3-year-old child: A case report

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-10 DOI: 10.1016/j.epsc.2025.103009

Ipsita Sarkar , Astor Rodrigues , Merrill McHoney

Introduction

Gastro-oesophageal reflux disease (GORD) can cause significant complications in children. Barrett's oesophagus (BO) is an uncommon and late-presenting complication that is rare in children but has significant life-long implications.

Case presentation

A 3-year-old boy presented with faltering growth, weight loss, and episodes of haematochezia and melaena. His past medical history included primary gastrostomy at 10 months for incoordinate swallowing, and gastro-oesophageal reflux disease managed with omeprazole (1mg/kg once daily). On admission, his haemoglobin was 85 g/L. Oesophagogastroduodenoscopy (OGD) revealed severe oesophagitis with a tight, impassable stricture 15 cm from the incisors. Contrast swallow confirmed the stricture and biopsy showed mild spongiosis above it. Four weeks later, a single balloon dilation was performed using a CRE PRO™ Balloon Dilatation Catheter, dilating the stricture to 8 mm. A nasojejunal (NJ) tube was inserted due to his emaciated state. Biopsy of the distal oesophagus showed metaplasia consistent with BO. Post dilation, he was admitted for a two-week period of NJ tube feeding, after which he underwent laparoscopic Nissen fundoplication with hiatal hernia repair and new Stamm gastrostomy. Postoperatively, he transitioned to gastrostomy feeding and following a transient dumping syndrome he gained significant weight. At 6-month follow-up, repeat OGD and biopsy showed resolution of his stenosis and metaplasia. The patient was tolerating bolus feeding through his gastrostomy, with continued weight improvement. At his 18-month review, he remained well and was scheduled for ongoing endoscopic surveillance.

Conclusion

Gastro-oesophageal reflux disease, even when managed with anti-acid medication, can lead to Barrett's oesophagus in children as young as 3 years of age.

{"title":"Barrett's metaplasia complicating gastro-oesophageal reflux disease in a 3-year-old child: A case report","authors":"Ipsita Sarkar , Astor Rodrigues , Merrill McHoney","doi":"10.1016/j.epsc.2025.103009","DOIUrl":"10.1016/j.epsc.2025.103009","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastro-oesophageal reflux disease (GORD) can cause significant complications in children. Barrett's oesophagus (BO) is an uncommon and late-presenting complication that is rare in children but has significant life-long implications.</div></div><div><h3>Case presentation</h3><div>A 3-year-old boy presented with faltering growth, weight loss, and episodes of haematochezia and melaena. His past medical history included primary gastrostomy at 10 months for incoordinate swallowing, and gastro-oesophageal reflux disease managed with omeprazole (1mg/kg once daily). On admission, his haemoglobin was 85 g/L. Oesophagogastroduodenoscopy (OGD) revealed severe oesophagitis with a tight, impassable stricture 15 cm from the incisors. Contrast swallow confirmed the stricture and biopsy showed mild spongiosis above it. Four weeks later, a single balloon dilation was performed using a CRE PRO™ Balloon Dilatation Catheter, dilating the stricture to 8 mm. A nasojejunal (NJ) tube was inserted due to his emaciated state. Biopsy of the distal oesophagus showed metaplasia consistent with BO. Post dilation, he was admitted for a two-week period of NJ tube feeding, after which he underwent laparoscopic Nissen fundoplication with hiatal hernia repair and new Stamm gastrostomy. Postoperatively, he transitioned to gastrostomy feeding and following a transient dumping syndrome he gained significant weight. At 6-month follow-up, repeat OGD and biopsy showed resolution of his stenosis and metaplasia. The patient was tolerating bolus feeding through his gastrostomy, with continued weight improvement. At his 18-month review, he remained well and was scheduled for ongoing endoscopic surveillance.</div></div><div><h3>Conclusion</h3><div>Gastro-oesophageal reflux disease, even when managed with anti-acid medication, can lead to Barrett's oesophagus in children as young as 3 years of age.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103009"},"PeriodicalIF":0.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Volvulus of the ascending and transverse colon in a 4-year-old child: a case report 一名 4 岁儿童的升结肠和横结肠溃疡：病例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-09 DOI: 10.1016/j.epsc.2025.103008

Eya Lamloum, Yosra Ben Ahmed, Mariem Marzouki, Intissar Chibani, Faouzi Nouira, Said Jlidi

Introduction

The incidence of colonic volvulus in the pediatric population is unknown, with literature limited to case reports and small case series. Volvulus of the transverse colon is very rare and only a few cases have been documented so far.

Case presentation

A 4-year-old boy with no medical or surgical history who was brought to the emergency department due to acute abdominal pain and vomiting. Physical exam revealed a distended and tender abdomen, mostly in the epigastrium and right side. Basic blood tests were not revealing. A plain abdominal x-ray was done and appeared normal. A subsequent computed tomography (CT) scan showed a largely distended colon and a whirl sign in the mesocolon, suspicious for a colonic volvulus. He was taken to the operating room for an emergency laparotomy during which we found that the ascending and the transverse colon had volvulized 360° in an anticlockwise direction. The volvulized colon had no signs of ischemia. We detorsed the colon and confirmed that the perfusion was completely normal. The patient had an uneventful initial recovery. However, 48 hours after the operation he developed acute abdominal pain, which prompted us to take him back to the operating room for a re-laparotomy. We found that the segment of colon that had initially volvulized, despite not being ischemic at the time of the first operation, was now severely ischemic. We decided to do a resection of the ischemic segment and followed with an end-to-end anastomosis. The patient had an uneventful recovery and was discharged home on the fourth postoperative day. The pathology of the resected segment was unremarkable. At six months of follow-up, he remains in good health.

Conclusion

Transverse colonic volvulus, though rare in children, should be considered in children who develop acute abdominal pain and vomiting, even in the absence of abnormal findings on the plain abdominal films. Close postoperative monitoring is crucial for detecting potential early complications.

{"title":"Volvulus of the ascending and transverse colon in a 4-year-old child: a case report","authors":"Eya Lamloum, Yosra Ben Ahmed, Mariem Marzouki, Intissar Chibani, Faouzi Nouira, Said Jlidi","doi":"10.1016/j.epsc.2025.103008","DOIUrl":"10.1016/j.epsc.2025.103008","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of colonic volvulus in the pediatric population is unknown, with literature limited to case reports and small case series. Volvulus of the transverse colon is very rare and only a few cases have been documented so far.</div></div><div><h3>Case presentation</h3><div>A 4-year-old boy with no medical or surgical history who was brought to the emergency department due to acute abdominal pain and vomiting. Physical exam revealed a distended and tender abdomen, mostly in the epigastrium and right side. Basic blood tests were not revealing. A plain abdominal x-ray was done and appeared normal. A subsequent computed tomography (CT) scan showed a largely distended colon and a whirl sign in the mesocolon, suspicious for a colonic volvulus. He was taken to the operating room for an emergency laparotomy during which we found that the ascending and the transverse colon had volvulized 360° in an anticlockwise direction. The volvulized colon had no signs of ischemia. We detorsed the colon and confirmed that the perfusion was completely normal. The patient had an uneventful initial recovery. However, 48 hours after the operation he developed acute abdominal pain, which prompted us to take him back to the operating room for a re-laparotomy. We found that the segment of colon that had initially volvulized, despite not being ischemic at the time of the first operation, was now severely ischemic. We decided to do a resection of the ischemic segment and followed with an end-to-end anastomosis. The patient had an uneventful recovery and was discharged home on the fourth postoperative day. The pathology of the resected segment was unremarkable. At six months of follow-up, he remains in good health.</div></div><div><h3>Conclusion</h3><div>Transverse colonic volvulus, though rare in children, should be considered in children who develop acute abdominal pain and vomiting, even in the absence of abnormal findings on the plain abdominal films. Close postoperative monitoring is crucial for detecting potential early complications.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103008"},"PeriodicalIF":0.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800530","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}

引用次数: 0

Alternative treatment for refractory Jacquet dermatitis after Hirschsprung disease surgery: A case report

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-09 DOI: 10.1016/j.epsc.2025.103004

Sinan Kılıç , Ahmet Güven , Sakine Işık

Introduction

Jacquet's erosive diaper dermatitis (JDD) is a severe form of diaper dermatitis, characterized by papuloerythematous erosions with crater-like borders in the genital and perianal regions.

Case presentation

A 2-year-old male patient was diagnosed with Hirschsprung disease (HD) during the neonatal period. A transition zone was detected in the rectosigmoid region on a contrast enema. Full-thickness rectal biopsy confirmed aganglionosis, and a colostomy was created from the transverse colon. At 18 months of age, the patient underwent the Swenson procedure, and the colostomy was closed during the same session. Following the operation, spontaneous stool passage was achieved. Approximately six months after surgery, ulcerative lesions characteristic of Jacquet dermatitis developed in the perianal region. Despite six months of treatment with moisturizers, regenerative, epithelializing, and barrier therapies (e.g., zinc oxide, madecassoside, shea butter, glycerin, oatmeal, hyaluronic acid), the lesions did not improve. However, after initiating treatment with pure Aloe Vera gel, including a 10 % diluted natural extract applied four times daily, plus a dairy-free diet for three weeks, a rapid clinical response was observed, with visible improvement within the same period.

Conclusion

The combination of Aloe Vera-based ointment plus dairy-free diet seems to be an effective management strategy for children with post pull-through Jacquet's dermatitis.

{"title":"Alternative treatment for refractory Jacquet dermatitis after Hirschsprung disease surgery: A case report","authors":"Sinan Kılıç , Ahmet Güven , Sakine Işık","doi":"10.1016/j.epsc.2025.103004","DOIUrl":"10.1016/j.epsc.2025.103004","url":null,"abstract":"<div><h3>Introduction</h3><div>Jacquet's erosive diaper dermatitis (JDD) is a severe form of diaper dermatitis, characterized by papuloerythematous erosions with crater-like borders in the genital and perianal regions.</div></div><div><h3>Case presentation</h3><div>A 2-year-old male patient was diagnosed with Hirschsprung disease (HD) during the neonatal period. A transition zone was detected in the rectosigmoid region on a contrast enema. Full-thickness rectal biopsy confirmed aganglionosis, and a colostomy was created from the transverse colon. At 18 months of age, the patient underwent the Swenson procedure, and the colostomy was closed during the same session. Following the operation, spontaneous stool passage was achieved. Approximately six months after surgery, ulcerative lesions characteristic of Jacquet dermatitis developed in the perianal region. Despite six months of treatment with moisturizers, regenerative, epithelializing, and barrier therapies (e.g., zinc oxide, madecassoside, shea butter, glycerin, oatmeal, hyaluronic acid), the lesions did not improve. However, after initiating treatment with pure Aloe Vera gel, including a 10 % diluted natural extract applied four times daily, plus a dairy-free diet for three weeks, a rapid clinical response was observed, with visible improvement within the same period.</div></div><div><h3>Conclusion</h3><div>The combination of Aloe Vera-based ointment plus dairy-free diet seems to be an effective management strategy for children with post pull-through Jacquet's dermatitis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103004"},"PeriodicalIF":0.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800531","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}

引用次数: 0

Hand-made silo for the management of gastroschisis in a limited-resource setting: a case series

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-04-07 DOI: 10.1016/j.epsc.2025.103005

Shweta Patil, Nahil Najeeb, Shreyas Dudhani, Amit Kumar Sinha, Rashi, Digamber Chaubey

Introduction

Gastroschisis is a rare congenital abdominal wall defect whose management in resource-limited settings poses significant challenges of hypothermia, severe fluid loss resulting in shock, infections, intestinal necrosis, and intestinal obstruction. Commercially available preformed silo bags are often unaffordable and/or inaccessible.

Case presentations

We used self-made silo bags in four patients with gastroschisis. Case 1 was a 39-week male with a 4-cm defect, who achieved complete reduction of the eviscerated bowel by day of life 6, followed by successful abdominal closure. The silo became dislodged once during the reduction process, but it was replaced easily. His growth continues to be appropriate at six months of follow-up. Case 2 was a 40-week male with a 4 cm defect, who achieved full reduction of the eviscerated bowel by day of life 7. He continues to grow well at 2 months of follow up. Case 3 was a 38-week female with a large (9 cm) defect and extensive herniation, who had suffered hypothermia and fluid loss before arrival. the hand-made silo was placed without difficulties. Before the herniated bowel could be completely reduced, the family left against medical advice and the patient was lost to follow up. Case 4 was a 40-week male with a 5 cm defect. Like the previous patient, before the herniated bowel could be completely reduced, the family left against medical advice, and he was lost to follow up.

Conclusion

In resource-limited environments, self-made silo bags offer a practical and cost-effective solution for managing gastroschisis.

{"title":"Hand-made silo for the management of gastroschisis in a limited-resource setting: a case series","authors":"Shweta Patil, Nahil Najeeb, Shreyas Dudhani, Amit Kumar Sinha, Rashi, Digamber Chaubey","doi":"10.1016/j.epsc.2025.103005","DOIUrl":"10.1016/j.epsc.2025.103005","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastroschisis is a rare congenital abdominal wall defect whose management in resource-limited settings poses significant challenges of hypothermia, severe fluid loss resulting in shock, infections, intestinal necrosis, and intestinal obstruction. Commercially available preformed silo bags are often unaffordable and/or inaccessible.</div></div><div><h3>Case presentations</h3><div>We used self-made silo bags in four patients with gastroschisis. Case 1 was a 39-week male with a 4-cm defect, who achieved complete reduction of the eviscerated bowel by day of life 6, followed by successful abdominal closure. The silo became dislodged once during the reduction process, but it was replaced easily. His growth continues to be appropriate at six months of follow-up. Case 2 was a 40-week male with a 4 cm defect, who achieved full reduction of the eviscerated bowel by day of life 7. He continues to grow well at 2 months of follow up. Case 3 was a 38-week female with a large (9 cm) defect and extensive herniation, who had suffered hypothermia and fluid loss before arrival. the hand-made silo was placed without difficulties. Before the herniated bowel could be completely reduced, the family left against medical advice and the patient was lost to follow up<strong>.</strong> Case 4 was a 40-week male with a 5 cm defect. Like the previous patient, before the herniated bowel could be completely reduced, the family left against medical advice, and he was lost to follow up.</div></div><div><h3>Conclusion</h3><div>In resource-limited environments, self-made silo bags offer a practical and cost-effective solution for managing gastroschisis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"117 ","pages":"Article 103005"},"PeriodicalIF":0.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800533","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}

引用次数: 0