Journal of Pediatric Surgery Case Reports最新文献_第2页

Missed proximal jejunal web during repair of jejunal atresia: a case report 空肠闭锁修补术中空肠近端网缺失1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-24 DOI: 10.1016/j.epsc.2026.103197

Sara L. Lee, Heung Bae Kim, Arin L. Madenci

Introduction

Jejunoileal atresia repair commonly involves interrogation of the bowel distal for additional atresias, although rare, the practice of proximal bowel interrogation for an additional proximal atresia should be considered.

Case presentation

The patient was a female neonate born at 34 weeks who had prenatal imaging with evidence of proximal intestinal atresia. Post-natal abdominal plain film redemonstrated a proximal obstruction with gasless distal intestine. On the third day of life, she underwent exploratory laparotomy where two jejunal atresias were found and Heineke-Mikulicz type closure was performed with a 4:1 mismatch. Her postoperative course was prolonged due to feeding intolerance and multiple feeding attempts were initiated while on parenteral nutrition. On postoperative day 37, an upper GI series showed a normal duodenal-jejunal junction, dilated hyperperistaltic duodenum and proximal jejunum with contrast propagating beyond the caliber of change and reaching the cecum at 5–6.5 hours. She ultimately underwent re-operation on postoperative day 65 due to persistent partial obstructive symptoms with the presumed functional obstruction due to anastomotic size mismatch. During her second operation, she was found to have a new transition point at a jejunoileal web proximal to the site of the previously obstructive, resected jejunoileal atresias. Enteroplasty of this new proximal jejunal web was performed. She recovered expectantly until discharge with full feeds and no complications at short term follow-up.

Conclusions

All efforts should be made to rule out proximal partial obstructions during the repair of small bowel atresias.

空肠回肠闭锁修复通常涉及肠远端闭锁的询问，尽管罕见，但应考虑肠近端询问的做法，以增加近端闭锁。病例介绍：患者是一名34周出生的女性新生儿，产前影像学显示近端肠闭锁。产后腹部平片显示近端梗阻，远端肠无气。在出生的第三天，她进行了剖腹探查，发现两个空肠闭锁，并以4:1不匹配的Heineke-Mikulicz型闭合。由于进食不耐受，术后疗程延长，并在肠外营养时多次尝试进食。术后第37天，上消化道显示正常的十二指肠-空肠连接，扩张的高蠕动十二指肠和空肠近端，造影剂在改变的口径之外传播，并在5-6.5小时到达盲肠。由于持续的部分梗阻症状，推测吻合口大小不匹配导致功能性梗阻，患者最终在术后第65天再次接受手术。在她的第二次手术中，她发现在先前梗阻性切除空肠回肠闭锁的近端空肠回肠网有一个新的过渡点。对这一新的近端空肠网进行肠成形术。患者恢复正常，出院时进食充足，短期随访无并发症。结论在小肠闭锁修补术中应尽量排除近端部分梗阻。

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引用次数: 0

Mediastinal neuroblastoma causing Horner's syndrome in a 7-year-old child: a case report 纵隔神经母细胞瘤引起7岁儿童霍纳综合征1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-24 DOI: 10.1016/j.epsc.2026.103195

Alicija Šavareikaitė , Paulius Valatka

Introduction

Peripheral neuroblastic tumors comprise a spectrum of neoplasms (neuroblastoma, ganglioneuroblastoma, ganglioneuroma) that primarily arise from the sympathoadrenal lineage and can cause variety of symptoms.

Case presentation

A 7-year-old patient with no significant past medical history presented to the emergency room. On clinical examination, right-eye miosis and ptosis were observed, along with conjunctival hyperemia, redness, and neck muscle rigidity. Auscultation demonstrated pathological breath sounds consistent with an acute upper respiratory tract infection. An anterior chest X-ray revealed a clearly defined, oval mass with calcifications at the apex of the right lung and paravertebral regions. Subsequent imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), identified a mass in the upper posterior mediastinum measuring approximately 39× 25 × 27 mm, suggestive of a neurogenic origin. Enlarged lymph nodes were also observed, while laboratory findings showed no significant abnormalities. A whole-body two-dimensional metaiodobenzylguanidine (MIBG) scintigraphy demonstrated scintigraphic evidence of an adrenergic-origin tumor in the right upper mediastinum. The solitary mass measured 40 × 27 × 26 mm and was partially calcified. No pathological findings were detected in the lungs, and there was no evidence of osseous metastasis. Based on the radiological findings, a preliminary diagnosis of paraspinal ganglioneuroma with associated Horner syndrome was made. Thoracoscopic surgery was performed, resulting in the complete excision of a tumor measuring approximately 5 cm in diameter, along with mediastinal lymph node dissection. The postoperative recovery was uneventful, with the wounds healing by primary intention and no complications occurring. Histopathological examination of the resected specimen, revealed a differentiated neuroblastoma with lymph node metastasis. Additional treatment, including adjuvant therapy was not selected for the patient. Horner syndrome resolved after the surgical treatment. At the one-year follow-up, routine chest MRI revealed new foci in the posterior superior mediastinum. Whole-body MIBG scintigraphy confirmed recurrence, and a subsequent surgical intervention was planned.

Conclusion

Children who develop Horner syndrome of unknown origin must undergo imaging studies to rule out a tumor in the posterior superior mediastinal region.

外周神经母细胞肿瘤包括一系列肿瘤（神经母细胞瘤、神经节神经母细胞瘤、神经节神经瘤），主要起源于交感神经肾上腺系，可引起多种症状。病例介绍：一名无明显既往病史的7岁患者被送往急诊室。临床表现为右眼缩小、上睑下垂，结膜充血、红肿、颈肌僵直。听诊显示病理性呼吸音符合急性上呼吸道感染。胸部x线片显示右肺顶端和椎旁有清晰的椭圆形肿块伴钙化。随后的影像学检查，包括计算机断层扫描（CT）和磁共振成像（MRI），在后纵隔上部发现一个约39× 25 × 27 mm的肿块，提示神经源性起源。淋巴结肿大，实验室检查未见明显异常。全身二维metaiodobenzylguanidine （MIBG）显像显示右上纵隔肾上腺素能源性肿瘤。孤立肿块大小为40 × 27 × 26 mm，部分钙化。肺部未见病理改变，亦无骨转移的证据。根据影像学表现，初步诊断为椎管旁神经节神经瘤伴霍纳综合征。进行胸腔镜手术，切除了直径约5cm的肿瘤，同时进行了纵隔淋巴结清扫。术后恢复顺利，创面自然愈合，无并发症发生。切除标本的组织病理学检查显示为分化的神经母细胞瘤伴淋巴结转移。没有为患者选择额外的治疗，包括辅助治疗。手术治疗后，霍纳综合征消失。在一年的随访中，常规胸部MRI显示后上纵隔有新的病灶。全身MIBG显像证实复发，并计划随后的手术干预。结论发生不明原因霍纳综合征的儿童必须接受影像学检查，以排除后上纵隔区肿瘤。

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引用次数: 0

Currarino syndrome with presacral neuroblastoma: A case report Currarino综合征合并骶前神经母细胞瘤1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-22 DOI: 10.1016/j.epsc.2026.103192

Rami Darawsheh , Neal Mukherjee , Ernesto J. Rojas , Alberto Jarrin Lopez , Olajire Idowu , Sunghoon Kim

Introduction

Currarino syndrome is a rare congenital disorder defined by the triad of sacral anomaly, presacral mass, and anorectal malformation. Presacral masses in Currarino syndrome are typically benign developmental lesions; however, the occurrence of a presacral neuroblastoma in a patient with the complete Currarino triad has not been reported.

Case presentation

A male newborn delivered at 37 weeks of gestation after a pregnancy complicated by maternal alcohol and marijuana use was found to have an imperforate anus, bilious emesis, and abdominal distension requiring orogastric decompression and diverting colostomy. Further evaluation revealed microcephaly, a tethered spinal cord, a left multicystic dysplastic kidney, severe hypospadias with a penoscrotal fistula draining meconium, and a sacral anomaly. At five months of age, a spinal MRI identified a 2 × 1.7 × 2 cm presacral mass. A screening ultrasound (US) obtained five months earlier during a VACTERL evaluation did not identify a presacral mass, likely reflecting US's limited sensitivity for presacral lesions. Surgical excision of the mass via sacral coccygectomy and anorectoplasty revealed a poorly differentiated neuroblastoma with favorable histopathologic features and negative margins. Staging studies showed no residual or metastatic disease. No oncologic therapy was initiated. Exome sequencing did not identify pathogenic MNX1 or other clinically significant germline variants. At three years of follow-up, the patient demonstrated normal growth without tumor recurrence.

Conclusion

This case demonstrates that presacral masses in Currarino syndrome, traditionally considered benign developmental lesions, can present with a neuroblastoma. Neuroblastoma should be included in the differential diagnosis for presacral lesions in Currarino syndrome.

摘要currarino综合征是一种罕见的先天性疾病，以骶骨异常、骶前肿块和肛肠畸形为特征。Currarino综合征的骶前肿块是典型的良性发育性病变；然而，出现骶前神经母细胞瘤的患者完全Currarino三联征尚未见报道。病例介绍1例妊娠37周分娩的男性新生儿，因母亲饮酒和吸食大麻而导致肛门闭锁、胆汁性呕吐和腹胀，需要行口胃减压术和转移结肠造口术。进一步的检查显示小头畸形，脊髓栓系，左多囊肾发育不良，严重的尿道下裂伴阴道瘘排出胎粪，以及骶骨异常。5个月大时，脊柱MRI发现一个2 × 1.7 × 2 cm的骶前肿块。5个月前在VACTERL评估中获得的筛查超声（US）未发现骶前肿块，可能反映了US对骶前病变的有限敏感性。通过骶骨尾骨切除术和肛肠成形术切除肿块显示为低分化神经母细胞瘤，具有良好的组织病理学特征和阴性边缘。分期研究显示无残留或转移性疾病。未开始肿瘤治疗。外显子组测序未发现致病性MNX1或其他具有临床意义的种系变异。随访3年，患者生长正常，无肿瘤复发。结论本病例表明，Currarino综合征的骶前肿块，传统上被认为是良性的发育性病变，可以表现为神经母细胞瘤。神经母细胞瘤应列入Currarino综合征骶前病变的鉴别诊断。

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引用次数: 0

Wandering spleen in a Cornelia De Lange young woman: a case report 科妮莉亚·德·兰格年轻女性游离脾1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-21 DOI: 10.1016/j.epsc.2026.103194

Francesca Nascimben , Agnese Capalbo , Valeria Nocera , Maria Barbara Leone , Rossella Angotti , Francesco Molinaro

Introduction

this is the first reported case of splenic volvulus (SV) due to Wandering Spleen (WS) in a patient with Cornelia de Lange syndrome (CdLs). The aim of this paper is to share our experience regarding the diagnostic and therapeutic management of this rare condition.

Case presentation

an 18-year-old young woman affected by CdLS (NIPBL mutation), previously treated for ileal volvulus due to intestinal malrotation, was referred to our institution with vomiting, diarrhea and suspected abdominal pain. Urgent abdominal ultrasound and computed tomography (CT) revealed splenic volvulus. She underwent emergency laparotomy which confirmed splenic voluvlus associated with a wandering spleen; the splenic hilum was derotated and splenopexy was performed through the placement of a tailored polypropylene surgical mesh. The postoperative course was regular: analgesics were administered for 5 days and antibiotic therapy for 7 days; she was discharged on postoperative day 7 in good general condition after abdominal ultrasound examination. Follow up was uneventfull: postoperative ultrasounds performed 1 and 6 months after surgery showed a spleen of normal volume and morphology with preserved vascular pattern.

Conclusion

splenic volvulus should be always included in the differential diagnosis of abdominal pain in patients with CdLs in whom diagnosis and management may be complicated by neurological impairment, low compliance and non-specific symptoms.

这是首例报道的由游离脾（WS）引起的Cornelia de Lange综合征（CdLs）患者脾扭转（SV）。本文的目的是分享我们对这种罕见疾病的诊断和治疗管理的经验。病例介绍一名18岁的年轻女性，患有CdLS （NIPBL突变），先前因肠道旋转不良而接受回肠扭转治疗，因呕吐，腹泻和疑似腹痛而转诊至我院。紧急腹部超音波及电脑断层扫描显示脾扭转。她接受了紧急剖腹手术，证实脾体积与脾游离有关；脾门旋转，脾固定术通过放置特制的聚丙烯手术网片进行。术后疗程常规：镇痛药5 d，抗生素治疗7 d；术后第7天，经腹部超声检查，全身情况良好出院。随访顺利：术后1个月和6个月的超声检查显示脾脏体积和形态正常，血管形态保留。结论在诊断和处理伴有神经功能障碍、依从性低和非特异性症状的cdl患者腹痛时，应将脾扭转纳入鉴别诊断。

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引用次数: 0

Ileocecal volvulus in an infant with dorsal mesenteric agenesis: A case report 婴儿肠系膜背侧发育不全致回盲扭转1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-21 DOI: 10.1016/j.epsc.2026.103191

Alaa Eltayeb , Abdelrahman S. Elnour , Rammah Bireama , Yousif Faisal , Faisal Nugud

Introduction

Intestinal volvulus due to agenesis of the dorsal mesentery is an exceptionally rare cause of intestinal obstruction in infants, with few cases reported in the literature.

Case presentation

A 3-month-old female presented with a 2-day history of abdominal pain, persistent vomiting, progressive abdominal distension, and constipation. She appeared ill and dehydrated, with marked tachycardia and fever. Examination revealed a distended, tender abdomen with absent bowel sounds and an empty rectum. Laboratory tests showed anemia and leukocytosis. Abdominal radiograph demonstrated dilated small bowel loops with multiple air–fluid levels and no distal gas. After resuscitation with intravenous fluids, insertion of a nasogastric tube and urethral catheter, initiation of broad-spectrum antibiotics, and transfusion of packed red blood cells, she underwent urgent exploratory laparotomy. Intraoperatively, the entire small intestine lacked its mesentery and was supplied solely by a single large marginal artery. An ileocecal volvulus with a freely mobile cecum was identified. Detorsion was performed, the bowel was viable, and the mesenteric defect was closed by approximating the peritoneal edges along the marginal vessel. Recovery was uneventful, with oral feeding resumed on postoperative day five and discharge on day seven. At six-month follow-up, the child demonstrated normal growth, feeding tolerance, and no recurrent symptoms.

Conclusion

Dorsal mesenteric agenesis with volvulus must be considered in the differential diagnosis of infants who develop acute intestinal obstruction.

摘要由于肠系膜背侧发育不全引起的肠扭转是婴儿肠梗阻的一种罕见原因，文献报道的病例很少。病例表现：一名3个月大的女性，腹痛、持续呕吐、进行性腹胀和便秘2天。她看起来不舒服，脱水，有明显的心动过速和发烧。检查发现腹部胀痛，无肠音，直肠空。实验室检查显示贫血和白细胞增多。腹部x线片显示小肠袢扩张，有多个气液面，远端无气体。在静脉输液、插入鼻胃管和尿道导管、开始使用广谱抗生素和输注填充红细胞后，她接受了紧急剖腹探查术。术中，整个小肠缺乏肠系膜，仅由一条大的边缘动脉供应。发现回盲扭转伴盲肠自由移动。进行了扭转，肠存活，肠系膜缺损沿边缘血管接近腹膜边缘闭合。恢复顺利，术后第5天恢复口服喂养，第7天出院。在六个月的随访中，儿童表现出正常的生长，喂养耐受性，无复发症状。结论婴幼儿急性肠梗阻的鉴别诊断应考虑肠系膜背侧发育不全伴肠扭转。

{"title":"Ileocecal volvulus in an infant with dorsal mesenteric agenesis: A case report","authors":"Alaa Eltayeb , Abdelrahman S. Elnour , Rammah Bireama , Yousif Faisal , Faisal Nugud","doi":"10.1016/j.epsc.2026.103191","DOIUrl":"10.1016/j.epsc.2026.103191","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal volvulus due to agenesis of the dorsal mesentery is an exceptionally rare cause of intestinal obstruction in infants, with few cases reported in the literature.</div></div><div><h3>Case presentation</h3><div>A 3-month-old female presented with a 2-day history of abdominal pain, persistent vomiting, progressive abdominal distension, and constipation. She appeared ill and dehydrated, with marked tachycardia and fever. Examination revealed a distended, tender abdomen with absent bowel sounds and an empty rectum. Laboratory tests showed anemia and leukocytosis. Abdominal radiograph demonstrated dilated small bowel loops with multiple air–fluid levels and no distal gas. After resuscitation with intravenous fluids, insertion of a nasogastric tube and urethral catheter, initiation of broad-spectrum antibiotics, and transfusion of packed red blood cells, she underwent urgent exploratory laparotomy. Intraoperatively, the entire small intestine lacked its mesentery and was supplied solely by a single large marginal artery. An ileocecal volvulus with a freely mobile cecum was identified. Detorsion was performed, the bowel was viable, and the mesenteric defect was closed by approximating the peritoneal edges along the marginal vessel. Recovery was uneventful, with oral feeding resumed on postoperative day five and discharge on day seven. At six-month follow-up, the child demonstrated normal growth, feeding tolerance, and no recurrent symptoms.</div></div><div><h3>Conclusion</h3><div>Dorsal mesenteric agenesis with volvulus must be considered in the differential diagnosis of infants who develop acute intestinal obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103191"},"PeriodicalIF":0.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038642","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

Fertility preservation via concurrent ovarian tissue cryopreservation during radical resection of pelvic retroperitoneal soft-tissue sarcoma in prepubertal girls: A case series 在青春期前女孩盆腔腹膜后软组织肉瘤根治术中通过同时卵巢组织冷冻保存保存生育能力：一个病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-20 DOI: 10.1016/j.epsc.2026.103185

Chen Chen , Xianying Lu , Ping Zhou , Chenyue Zhang , Yulong Mu , Qun Gao

Introduction

Pelvic retroperitoneal soft-tissue sarcoma (STS) is extremely rare in prepubertal girls, and concurrent ovarian tissue cryopreservation (OTC) during radical resection, performed to preserve fertility before initiating highly gonadotoxic anticancer therapy without delaying overall treatment, has been scarcely reported.

Case presentations

Case 1 was a 6-year-old girl with embryonal rhabdomyosarcoma (Stage III; T2bNxM0G3) undergoing concurrent OTC during radical resection after 2 cycles of neoadjuvant chemotherapy. Total operative time was 301 minutes, with 16 minutes dedicated to OTC. Histopathology confirmed no malignant cells in the ovarian tissue. After postoperative chemotherapy and radiotherapy (34.22 Gy), she remains disease-free at 33 months of follow-up. Case 2 was a 7-year-old girl with undifferentiated small round cell sarcoma (Stage III; T1bNxM0G4) who underwent OTC during radical surgery (total time: 408 minutes; OTC: 20 minutes) following neoadjuvant chemotherapy. No tumor cells were found in the ovarian cortex. She completed adjuvant therapy (55.80 Gy radiotherapy) and showed no recurrence at 36 months of follow up. Case 3 was a 10-year-old girl diagnosed with embryonal rhabdomyosarcoma (Stage III; T2bNxM0G3) who underwent concurrent OTC (10 minutes) within a 255-min radical resection after 4 cycles of neoadjuvant chemotherapy. The ovarian tissue was tumor-free. Following adjuvant chemotherapy, radiotherapy (50.4 Gy), and stem cell transplantation, no recurrence was observed at 17 months of follow-up.

Conclusion

OTC combined with radical tumor resection reduces the need for second surgery and preserves ovarian fertility and endocrine function before the development of gonadotoxicity. This approach appears to be safe and feasible for pelvic retroperitoneal STS.

盆腔腹膜后软组织肉瘤（STS）在青春期前女孩中极为罕见，在根治性切除期间同时进行卵巢组织冷冻保存（OTC），在开始高促性腺毒素抗癌治疗之前保持生育能力，而不延迟整体治疗，很少有报道。病例1是一名6岁女孩，患有胚胎性横纹肌肉瘤（III期；T2bNxM0G3），在2个周期的新辅助化疗后，在根治性切除期间同时进行OTC。总手术时间为301分钟，其中16分钟用于OTC。组织病理学证实卵巢组织未见恶性细胞。术后化疗放疗34.22 Gy，随访33个月无病变。病例2是一名7岁女孩，患有未分化小圆细胞肉瘤（III期；T1bNxM0G4），在新辅助化疗后根治性手术（总时间：408分钟；OTC: 20分钟）。卵巢皮层未见肿瘤细胞。患者完成辅助治疗（55.80 Gy放疗），随访36个月无复发。病例3是一名10岁女孩，诊断为胚胎性横纹肌肉瘤（III期；T2bNxM0G3），在4个周期的新辅助化疗后，在255分钟的根治性切除术中同时进行OTC（10分钟）。卵巢组织无肿瘤。经辅助化疗、放疗（50.4 Gy）和干细胞移植，随访17个月无复发。结论otc联合肿瘤根治性切除可减少二次手术的需要，在发生促性腺毒性前保留卵巢的生育能力和内分泌功能。这种方法对于盆腔腹膜后STS是安全可行的。

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引用次数: 0

Spontaneous biliary perforation in an infant: A case report 婴儿自发性胆道穿孔1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.epsc.2026.103193

Shubhangi Kadam, Jayakumar T.K., Kiran Khedkar, Nilesh Nagdeve, Prashant Ramteke

Background

Spontaneous biliary perforation (SBP) is a rare and potentially life-threatening condition in infants, often presenting with acute abdomen and jaundice.

Case presentation

A 6-month-old baby girl presented to us with sudden onset abdominal distension, non-bilious vomiting, and non-passage of stools. Physical examination revealed no clinically evident jaundice, distended abdomen and tenderness. Laboratory investigations showed leukocytosis and elevated bilirubin. Ultrasound study showed mild ascites with bowel edema. We performed an exploratory laparotomy and found biliary peritonitis caused by perforations at the gallbladder neck and common bile duct distal to the cystic duct, without any biliary dilatation. The patient underwent cholecystectomy and hepaticoduodenostomy. Postoperative recovery was uneventful, with normalization of liver function and no recurrence during a twelve month follow-up period.

Conclusion

SBP is a rare event but should be suspected in children who develop acute abdominal distension and jaundice.

背景：自发性胆道穿孔（SBP）是一种罕见且可能危及生命的婴儿疾病，通常表现为急性腹部和黄疸。一个6个月大的女婴因突发性腹胀、非胆汁性呕吐和不排便而就诊。体格检查未见明显黄疸、腹胀及压痛。实验室检查显示白细胞增多和胆红素升高。超声检查显示轻度腹水伴肠水肿。我们进行了剖腹探查，发现胆道性腹膜炎是由胆囊颈和胆囊管远端的胆总管穿孔引起的，没有任何胆道扩张。病人接受了胆囊切除术和肝十二指肠切开术。术后恢复顺利，12个月随访期间肝功能恢复正常，无复发。结论收缩压是一种罕见的事件，但在发生急性腹胀和黄疸的儿童中应予以怀疑。

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引用次数: 0

Concurrent hepatic and peritoneal hydatid cysts: A case report 并发肝及腹膜包虫囊肿1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.epsc.2026.103188

Samuel Gashu Adane , Finot G. Adane , Zemene Eyayu Belete , Dagmawi Geremew

Introduction

Hydatid disease, or echinococcosis, is a parasitic infection caused by the tapeworm Echinococcus. The simultaneous involvement of hydatid disease in two or more organs is very rare, and the presentation can be nonspecific.

Case presentation

A 4-year-old, previously healthy female who presented with a one-month history of progressive, dull-aching pain in the right upper abdomen and suprapubic region, associated with lower abdominal swelling, loss of appetite, and nausea. She came from a rural area with a family history of cattle rearing. On examination, she was comfortable, with normal vital signs and anthropometric measurements. Abdominal examination revealed hepatomegaly and an ill-defined suprapubic mass. Imaging with ultrasound and contrast-enhanced CT revealed a unilocular, thick-walled liver cyst (7.5 × 6.5 cm) involving segments 6 and 7, and a separate large peritoneal cyst (8.5 × 5.5 cm) in the pelvis. Serology for hydatid disease was unavailable, and the diagnosis was made based on imaging. She received albendazole for one week and subsequently underwent elective surgery. The liver cyst was managed via a right subcostal incision with partial pericystectomy and drainage, while the pelvic cyst was excised through a midline suprapubic incision, with the cavity filled using omentum. Both procedures were completed without rupture or significant spillage. Postoperatively, she remained well and was discharged on the sixth day with oral albendazole. Follow-up at 1, 3, and 6 months revealed no complications.

Conclusion

Concurrent hydatid cysts should be considered in the differential diagnosis of children who present with multiple cystic lesions within the abdominal cavity.

棘球绦虫病是一种由绦虫棘球绦虫引起的寄生虫感染。同时累及两个或多个器官的包虫病是非常罕见的，其表现可以是非特异性的。病例表现：一名4岁健康女性，表现为右上腹部和耻骨上区域进行性、钝痛性疼痛一个月，伴有下腹部肿胀、食欲不振和恶心。她来自农村地区，有养牛的家族史。检查时，患者身体状况良好，生命体征和人体测量值正常。腹部检查显示肝脏肿大及耻骨上肿块。超声和增强CT成像显示一单眼厚壁肝囊肿（7.5 × 6.5 cm），累及第6节和第7节，骨盆内另一大腹膜囊肿（8.5 × 5.5 cm）。没有包虫病的血清学，诊断是基于影像学。她接受阿苯达唑治疗一周，随后接受择期手术。肝囊肿经右肋下切口行部分包膜切除引流，盆腔囊肿经耻骨上中线切口切除，并用大网膜填充腔。这两个过程都没有破裂或明显的溢出。术后病情良好，于第6天口服阿苯达唑出院。随访1、3、6个月均未发现并发症。结论小儿腹腔内多发囊性病变应考虑并发包虫病的鉴别诊断。

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引用次数: 0

Repair of a chest wall hernia after dirt bike collision: a case report 摩托车碰撞后胸壁疝修补1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.epsc.2026.103189

Shruthi Srinivas, Kristie Griffin, Kyle Van Arendonk, Sara Mansfield

Introduction

Traumatic chest wall herniation involving lung is a rare phenomenon, especially in pediatric patients. We present a unique thoracoscopic approach to management with excellent functional and cosmetic results.

Case presentation

A 15-year-old male sustained a traumatic disruption of the right third costochondral junction after a dirt bike accident. The right upper lobe herniated through this defect. Thoracoscopy revealed a 10cm × 5cm anterior chest wall defect with adherent parenchyma. The lung was reduced using a combination of blunt dissection and external pressure. A non-anatomic wedge resection of the injured lung was performed to prevent postoperative air leak. The right third rib demonstrated a clear fracture and malalignment so it was reapproximated with an 18-hole resorbable rib plate with small stab incisions. A Vicryl mesh patch was used to overlap the margins of the defect and fixated circumferentially with an absorbable tacker to restore chest wall integrity. We then performed cryoablation of the surrounding ribs, nerve blocks, and application of pleural sealant. A chest tube was placed, and the lung was directly reinflated. The patient did well and was discharged home on postoperative day one. At his follow up one and two months later, he had complete clinical and radiographic healing with return to baseline activity.

Conclusion

Lung herniation following chest wall trauma is rare. Thoracoscopic repair with absorbable materials in an adolescent is possible and should allow for continued chest wall growth.

外伤性胸壁疝累及肺部是一种罕见的现象，尤其在儿童患者中。我们提出了一种独特的胸腔镜治疗方法，具有良好的功能和美容效果。病例介绍：一名15岁男性在一次越野自行车事故后，右侧第三肋软骨连接处创伤性断裂。右上肺叶通过这个缺损突出。胸腔镜检查显示前胸壁缺损10cm × 5cm，伴附着实质。采用钝性剥离和外压联合复位肺。为防止术后漏气，对损伤肺行非解剖性楔形切除。右侧第三根肋骨明显骨折且排列不整，因此用带有小刺伤的18孔可吸收肋骨板重新缝合。使用Vicryl网状补片重叠缺损边缘，并用可吸收的粘钉环周固定以恢复胸壁完整性。然后我们对周围肋骨进行冷冻消融，神经阻滞，并应用胸膜密封剂。植入胸管，直接对肺进行再充气。患者恢复良好，术后第一天出院回家。在1个月和2个月后的随访中，他完成了临床和放射学治疗，恢复了基线活动。结论胸壁外伤后肺疝发生率较低。在青少年胸腔镜下使用可吸收材料进行修复是可能的，并且应该考虑到胸壁的持续生长。

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引用次数: 0

Hypertrophic pyloric stenosis in a neonate: A case report 新生儿肥厚性幽门狭窄1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.epsc.2026.103190

Addisu Andargie , Absalat Serawit Negussie

Introduction

Hypertrophic pyloric stenosis (HPS) typically presents between the third and eighth weeks of life. Presentation in the immediate neonatal period is rare and clinically challenging.

Case presentation

A male neonate was born at 39 weeks and 3 days of gestation via spontaneous vaginal delivery with a birth weight of 2720 g. The pregnancy and delivery were uneventful. On the second day of life, the newborn developed non-bilious, non-projectile vomiting and feeding intolerance. Physical examination was unremarkable, and laboratory studies, including serum electrolytes, were within normal limits. Abdominal ultrasonography demonstrated an elongated and thickened pyloric canal with a “cervical-sign” configuration, measuring 13.4 mm in length and 3.1 mm in wall thickness, consistent with hypertrophic pyloric stenosis. The neonate underwent open Ramstedt Pyloromyotomy. The postoperative course was uneventful.

Conclusion

Hypertrophic pyloric stenosis can present in the first days of life and should be considered in early neonates who develop non-bilious vomiting or feeding intolerance.

肥厚性幽门狭窄（HPS）通常出现在生命的第三和第八周之间。在新生儿初期的表现是罕见的，临床上具有挑战性。病例介绍1例男性新生儿在妊娠39周零3天自然阴道分娩，出生体重2720克。怀孕和分娩都平安无事。在出生的第二天，新生儿出现非胆汁、非抛射性呕吐和喂养不耐受。体格检查无异常，实验室检查，包括血清电解质，都在正常范围内。腹部超声显示幽门管延长增厚，呈“宫颈征”状，长13.4 mm，壁厚3.1 mm，符合肥厚性幽门狭窄。新生儿行开放式Ramstedt幽门肌切开术。术后过程平淡无奇。结论肥厚性幽门狭窄可在出生后第一天出现，早期新生儿出现非胆汁性呕吐或喂养不耐受应予以考虑。

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