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.
{"title":"Persistent caudal appendix in a child: A case report","authors":"Y.E. Houmenou , A.A. Hadonou , M.G. Yassegoungbe , C.S. Metchihoungbe , E.U.E.M. Goudjo , M.A. Fiogbe","doi":"10.1016/j.epsc.2026.103202","DOIUrl":"10.1016/j.epsc.2026.103202","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Patients who have a persistent caudal appendix should undergo imaging studies to rule out a spinal dysraphism.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103202"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078647","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}
Pub Date : 2026-03-01Epub Date: 2026-01-16DOI: 10.1016/j.epsc.2026.103182
Edamakanti Swetha Soni , Aditya Pratap Singh , Mayur Shyam Soni
Introduction
Enteric duplication cysts are rare congenital malformations, typically sharing a wall and blood supply with adjacent bowel. Isolated variants with independent vascularity and no luminal communication are extremely uncommon, particularly when arising from the colon.
Case presentation
A 3-year-old boy presented with intermittent right-sided abdominal pain for three months. Abdominal ultrasound showed a 4 x 3 × 3 cm cystic lesion in the right hemiabdomen. Contrast-enhanced computed tomography (CECT) showed a 12-cm-long cystic lesion in the right hemiabdomen. The patient was taken to the operating room for an exploratory laparotomy. On exploration, a 12-cm tubular cystic structure was found arising from the anterolateral aspect of the ascending colon, with an independent vascular pedicle and no communication with the native colonic lumen. The lesion was completely excised without the need for a bowel resection. Histopathology confirmed a tubular enteric duplication lined by colonic mucosa and smooth muscle. The postoperative recovery was uneventful, and the child remains asymptomatic at 1 year of follow-up.
Conclusion
Isolated colonic duplication cysts with independent vascularity and no luminal communication are exceedingly rare but can cause chronic abdominal pain in children.
{"title":"Isolated tubular duplication of the ascending colon: A case report","authors":"Edamakanti Swetha Soni , Aditya Pratap Singh , Mayur Shyam Soni","doi":"10.1016/j.epsc.2026.103182","DOIUrl":"10.1016/j.epsc.2026.103182","url":null,"abstract":"<div><h3>Introduction</h3><div>Enteric duplication cysts are rare congenital malformations, typically sharing a wall and blood supply with adjacent bowel. Isolated variants with independent vascularity and no luminal communication are extremely uncommon, particularly when arising from the colon.</div></div><div><h3>Case presentation</h3><div>A 3-year-old boy presented with intermittent right-sided abdominal pain for three months. Abdominal ultrasound showed a 4 x 3 × 3 cm cystic lesion in the right hemiabdomen. Contrast-enhanced computed tomography (CECT) showed a 12-cm-long cystic lesion in the right hemiabdomen. The patient was taken to the operating room for an exploratory laparotomy. On exploration, a 12-cm tubular cystic structure was found arising from the anterolateral aspect of the ascending colon, with an independent vascular pedicle and no communication with the native colonic lumen. The lesion was completely excised without the need for a bowel resection. Histopathology confirmed a tubular enteric duplication lined by colonic mucosa and smooth muscle. The postoperative recovery was uneventful, and the child remains asymptomatic at 1 year of follow-up.</div></div><div><h3>Conclusion</h3><div>Isolated colonic duplication cysts with independent vascularity and no luminal communication are exceedingly rare but can cause chronic abdominal pain in children.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103182"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038643","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}
Pub Date : 2026-03-01Epub Date: 2026-01-25DOI: 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.
{"title":"Post-infectious pneumatocele in an infant managed with tube thoracostomy: a case report","authors":"Wassie A. Yigzaw , Abay G. Wondimu , Nardos M. Admasu , Leul Adane , Belachew D. Wondemagegnehu","doi":"10.1016/j.epsc.2026.103200","DOIUrl":"10.1016/j.epsc.2026.103200","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div><div>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.</div><div>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.</div></div><div><h3>Conclusion</h3><div>Infants who develop symptomatic post-infectious pneumatoceles may benefit from image-guided catheter drainage.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103200"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078535","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}
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.
{"title":"Spontaneous biliary perforation in an infant: A case report","authors":"Shubhangi Kadam, Jayakumar T.K., Kiran Khedkar, Nilesh Nagdeve, Prashant Ramteke","doi":"10.1016/j.epsc.2026.103193","DOIUrl":"10.1016/j.epsc.2026.103193","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous biliary perforation (SBP) is a rare and potentially life-threatening condition in infants, often presenting with acute abdomen and jaundice.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>SBP is a rare event but should be suspected in children who develop acute abdominal distension and jaundice.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103193"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078534","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}
Pub Date : 2026-03-01Epub Date: 2026-01-02DOI: 10.1016/j.epsc.2026.103177
Sean Gannon , Ibraheem Abdelraheem
Introduction
The acute scrotum is a common paediatric emergency presentation most often caused by testicular torsion, epididymo-orchitis, or incarcerated inguinal hernia. We present the rare occurrence of it occurring secondary to perforated appendicitis, further complicated by a post-operative pyocoele requiring surgical intervention.
Case
A 2-year-old male initially presented with Influenza A infection and subsequently developed right-sided scrotal swelling, erythema, and tenderness. Clinical examination revealed right iliac fossa tenderness, and ultrasonography demonstrated perforated appendicitis with associated right-sided epididymo-orchitis, without a scrotal collection. The patient underwent laparoscopic appendectomy and was commenced on intravenous ceftriaxone and metronidazole. Despite initial improvement, scrotal swelling and inflammatory markers persisted. Ultrasonography six days postoperatively identified a right-sided pyocoele, prompting escalation of antibiotic therapy; however, symptoms failed to improve. Repeat imaging three days later demonstrated interval enlargement of the collection. Surgical drainage was performed via a transverse right scrotal incision, and temporary drain placement. Although a patent processus vaginalis was not identified intraoperatively, its involvement was considered likely given the clinical course. The patient improved following drainage but re-presented with recurrent pyrexia, requiring recommencement of intravenous antibiotics and a prolonged course of outpatient broad-spectrum oral therapy with metronidazole and cefalexin, requiring over six weeks of antibiotic therapy in total.
Conclusion
Patients with acute appendicitis and a concomitant acute scrotum should be evaluated for a patent processus vaginalis, as the acute scrotum may be caused by purulent fluid from the abdomen accumulating in the tunica vaginalis. Surgical drainage of the purulent fluid may be required.
{"title":"Acute appendicitis presenting as acute scrotum in a toddler: A case report","authors":"Sean Gannon , Ibraheem Abdelraheem","doi":"10.1016/j.epsc.2026.103177","DOIUrl":"10.1016/j.epsc.2026.103177","url":null,"abstract":"<div><h3>Introduction</h3><div>The acute scrotum is a common paediatric emergency presentation most often caused by testicular torsion, epididymo-orchitis, or incarcerated inguinal hernia. We present the rare occurrence of it occurring secondary to perforated appendicitis, further complicated by a post-operative pyocoele requiring surgical intervention.</div></div><div><h3>Case</h3><div>A 2-year-old male initially presented with Influenza A infection and subsequently developed right-sided scrotal swelling, erythema, and tenderness. Clinical examination revealed right iliac fossa tenderness, and ultrasonography demonstrated perforated appendicitis with associated right-sided epididymo-orchitis, without a scrotal collection. The patient underwent laparoscopic appendectomy and was commenced on intravenous ceftriaxone and metronidazole. Despite initial improvement, scrotal swelling and inflammatory markers persisted. Ultrasonography six days postoperatively identified a right-sided pyocoele, prompting escalation of antibiotic therapy; however, symptoms failed to improve. Repeat imaging three days later demonstrated interval enlargement of the collection. Surgical drainage was performed via a transverse right scrotal incision, and temporary drain placement. Although a patent processus vaginalis was not identified intraoperatively, its involvement was considered likely given the clinical course. The patient improved following drainage but re-presented with recurrent pyrexia, requiring recommencement of intravenous antibiotics and a prolonged course of outpatient broad-spectrum oral therapy with metronidazole and cefalexin, requiring over six weeks of antibiotic therapy in total.</div></div><div><h3>Conclusion</h3><div>Patients with acute appendicitis and a concomitant acute scrotum should be evaluated for a patent processus vaginalis, as the acute scrotum may be caused by purulent fluid from the abdomen accumulating in the tunica vaginalis. Surgical drainage of the purulent fluid may be required.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103177"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979493","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}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 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.
{"title":"Concurrent hepatic and peritoneal hydatid cysts: A case report","authors":"Samuel Gashu Adane , Finot G. Adane , Zemene Eyayu Belete , Dagmawi Geremew","doi":"10.1016/j.epsc.2026.103188","DOIUrl":"10.1016/j.epsc.2026.103188","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Concurrent hydatid cysts should be considered in the differential diagnosis of children who present with multiple cystic lesions within the abdominal cavity.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103188"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038598","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}
Pub Date : 2026-03-01Epub Date: 2026-01-16DOI: 10.1016/j.epsc.2026.103183
Samuel Gashu Adane , Tihitena Negussie , Belachew Dejene , Gobena Mormata , Jejaw Endale , Finot G. Adane
Introduction
Alimentary tract duplications are rare congenital anomalies that usually occur at a single site; however, multisite duplications may arise and present with diverse clinical manifestations.
Case presentation
A one-month-old male neonate, previously healthy, developed tachypnea and grunting during the first week of life. Antenatal follow-up had revealed a fluid-filled structure in the abdomen. He was admitted to a local hospital and treated with antibiotics for two weeks without improvement. On presentation, he exhibited severe respiratory distress. Physical examination revealed a palpable abdominal mass in the left upper quadrant extending to the pelvis. Chest radiographs suggested bilateral lung opacities. Abdominal ultrasonography identified an 11 × 5.6 cm intra-abdominal cyst and a 7 × 5.5 cm right intrapleural cyst. Thoracoabdominal computed tomography confirmed a 5.5 × 5 cm right thoracic cyst and two intra-abdominal cysts measuring 7.5 × 6.5 cm and 5.5 × 5.3 cm.
The patient underwent right posterolateral thoracotomy and laparotomy with excision of the esophageal cyst and enucleation of small bowel duplication cysts. The postoperative course was uneventful. Histopathology confirmed esophageal and small bowel duplication cysts. On follow-up, he remained asymptomatic.
Conclusion
Although alimentary tract duplications typically involve a single site, multisite involvement can occur and should be considered, particularly in patients with varied clinical presentations.
{"title":"Synchronous esophageal and jejunal duplication in an infant: A case report","authors":"Samuel Gashu Adane , Tihitena Negussie , Belachew Dejene , Gobena Mormata , Jejaw Endale , Finot G. Adane","doi":"10.1016/j.epsc.2026.103183","DOIUrl":"10.1016/j.epsc.2026.103183","url":null,"abstract":"<div><h3>Introduction</h3><div>Alimentary tract duplications are rare congenital anomalies that usually occur at a single site; however, multisite duplications may arise and present with diverse clinical manifestations.</div></div><div><h3>Case presentation</h3><div>A one-month-old male neonate, previously healthy, developed tachypnea and grunting during the first week of life. Antenatal follow-up had revealed a fluid-filled structure in the abdomen. He was admitted to a local hospital and treated with antibiotics for two weeks without improvement. On presentation, he exhibited severe respiratory distress. Physical examination revealed a palpable abdominal mass in the left upper quadrant extending to the pelvis. Chest radiographs suggested bilateral lung opacities. Abdominal ultrasonography identified an 11 × 5.6 cm intra-abdominal cyst and a 7 × 5.5 cm right intrapleural cyst. Thoracoabdominal computed tomography confirmed a 5.5 × 5 cm right thoracic cyst and two intra-abdominal cysts measuring 7.5 × 6.5 cm and 5.5 × 5.3 cm.</div><div>The patient underwent right posterolateral thoracotomy and laparotomy with excision of the esophageal cyst and enucleation of small bowel duplication cysts. The postoperative course was uneventful. Histopathology confirmed esophageal and small bowel duplication cysts. On follow-up, he remained asymptomatic.</div></div><div><h3>Conclusion</h3><div>Although alimentary tract duplications typically involve a single site, multisite involvement can occur and should be considered, particularly in patients with varied clinical presentations.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103183"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979491","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}
Pub Date : 2026-03-01Epub Date: 2026-01-26DOI: 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.
{"title":"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","authors":"Mihai Puia-Dumitrescu , Carrie Foster , Emily Watson , Bettina Paek , Martin Walker , Rebecca Stark","doi":"10.1016/j.epsc.2026.103201","DOIUrl":"10.1016/j.epsc.2026.103201","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Fetuses with CDH who develop large pleural effusions may benefit from prenatal thoraco-amniotic shunt placement.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103201"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078646","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}
Pub Date : 2026-03-01Epub Date: 2026-01-06DOI: 10.1016/j.epsc.2026.103178
Somin Jo, Claire Abrajano, Bill Chiu
Introduction
Pilonidal disease (PD) is associated with sex hormones as hair growth and oil production during puberty can exacerbate PD symptoms, and the testosterone therapy received by transgender (TG) patients can potentially lead to PD development. In this case report, we report two TG patients who developed PD after initiating testosterone therapy.
Case presentation
Patient 1, a female-to-male (FTM) transitioned-patient initiated testosterone therapy (50mg every 2 weeks) at 16 years old and developed a pilonidal abscess one month after starting testosterone. He underwent an incision and drainage procedure for the abscess followed by regular manual and laser epilation. He continued the testosterone therapy without interruption and three years after the treatment of pilonidal abscess, he has not noted any PD recurrence.
Patient 2, a FTM transitioned-patient started testosterone therapy (25mg weekly), at 17 years old. One month after starting testosterone, he developed swelling at the gluteal cleft and hair lodged within pilonidal pits, consistent with pilonidal disease. Hair was removed from the pilonidal pits in the clinic, and regular manual and laser epilation were initiated. He did not receive any surgical excision for PD. The testosterone therapy was continued, and at ten months follow up, he has remained symptom-free from PD.
Conclusion
Pilonidal disease can develop after the initiation of testosterone therapy. Standard PD treatment seems to be effective, without the need to interrupt the hormonal therapy.
{"title":"Pilonidal disease development after initiating testosterone therapy – A case Series","authors":"Somin Jo, Claire Abrajano, Bill Chiu","doi":"10.1016/j.epsc.2026.103178","DOIUrl":"10.1016/j.epsc.2026.103178","url":null,"abstract":"<div><h3>Introduction</h3><div>Pilonidal disease (PD) is associated with sex hormones as hair growth and oil production during puberty can exacerbate PD symptoms, and the testosterone therapy received by transgender (TG) patients can potentially lead to PD development. In this case report, we report two TG patients who developed PD after initiating testosterone therapy.</div></div><div><h3>Case presentation</h3><div>Patient 1, a female-to-male (FTM) transitioned-patient initiated testosterone therapy (50mg every 2 weeks) at 16 years old and developed a pilonidal abscess one month after starting testosterone. He underwent an incision and drainage procedure for the abscess followed by regular manual and laser epilation. He continued the testosterone therapy without interruption and three years after the treatment of pilonidal abscess, he has not noted any PD recurrence.</div><div>Patient 2, a FTM transitioned-patient started testosterone therapy (25mg weekly), at 17 years old. One month after starting testosterone, he developed swelling at the gluteal cleft and hair lodged within pilonidal pits, consistent with pilonidal disease. Hair was removed from the pilonidal pits in the clinic, and regular manual and laser epilation were initiated. He did not receive any surgical excision for PD. The testosterone therapy was continued, and at ten months follow up, he has remained symptom-free from PD.</div></div><div><h3>Conclusion</h3><div>Pilonidal disease can develop after the initiation of testosterone therapy. Standard PD treatment seems to be effective, without the need to interrupt the hormonal therapy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103178"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940879","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}
Pub Date : 2026-03-01Epub Date: 2026-01-24DOI: 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.
{"title":"Missed proximal jejunal web during repair of jejunal atresia: a case report","authors":"Sara L. Lee, Heung Bae Kim, Arin L. Madenci","doi":"10.1016/j.epsc.2026.103197","DOIUrl":"10.1016/j.epsc.2026.103197","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusions</h3><div>All efforts should be made to rule out proximal partial obstructions during the repair of small bowel atresias.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103197"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078533","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}
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