Journal of Pediatric Surgery Case Reports最新文献_第3页

Ovarian mucinous adenoma with a malignant component in an adolescent: a case report 青春期卵巢粘液腺瘤伴恶性成分：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.2026.103184

John Paul Bustamante , Shaban Gheith , Mohammad Fadaie , Brandon Velazquez , Jill Menell , Colin Bethel

Introduction

Primary ovarian mucinous adenocarcinoma in the adolescent population is extremely rare, with limited cases reported in the literature.

Case presentation

A 14-year-old female presented with a two-week history of progressive abdominal pain, distension, bloating, early satiety, and fatigue. Physical examination revealed a significantly distended abdomen with diffuse tenderness. Contrast-enhanced CT imaging demonstrated a large multiloculated cystic adnexal mass measuring 36 × 32 × 21 cm, with displacement of bowel loops. Laboratory evaluation showed normal tumor markers except for a mildly elevated CA-125 of 47 U/mL (reference range: <35 U/mL). The patient initially underwent diagnostic laparoscopy, which was converted to open laparotomy due to the tumor's size and complexity. Replacing the left ovary, a unilateral, encapsulated mucinous tumor was entirely excised along with the associated incorporated left ovary and fallopian tube, with preservation of the uterus and contralateral adnexa. Histopathology demonstrated mucinous cystadenoma (70 %), borderline tumor (25 %), and a focal invasive mucinous adenocarcinoma component (<5 %), without lymphovascular or infiltrative invasion. The postoperative course was uneventful, and the patient was discharged on postoperative day 2. Upon follow up, she continued to have elevated CA-125 of 56 U/mL, and underwent staging laparoscopy, noted to be negative for any metastatic disease, repeat CA-125 normalized 13 U/mL. Long term planned follow up with routine ultrasounds and CA-125 levels.

Conclusion

Mucinous ovarian tumors can have borderline and malignant components and therefore require a thorough histopathologic analysis.

原发性卵巢粘液腺癌在青少年人群中极为罕见，文献中报道的病例有限。病例介绍一名14岁女性，有两周进行性腹痛、腹胀、早期饱腹感和疲劳病史。体格检查显示腹部明显膨胀并伴有弥漫性压痛。CT增强成像显示一个大的多室囊性附件肿块，尺寸为36 × 32 × 21 cm，伴肠袢移位。实验室检查显示肿瘤标志物正常，CA-125轻度升高47 U/mL（参考范围：35 U/mL）。患者最初接受了诊断性腹腔镜检查，由于肿瘤的大小和复杂性，转为开腹手术。替换左卵巢，切除单侧包膜黏液性肿瘤，同时切除合并的左卵巢和输卵管，保留子宫和对侧附件。组织病理学表现为粘液囊腺瘤（70%）、交界性肿瘤（25%）和局灶性浸润性粘液腺癌成分（5%），无淋巴血管或浸润性浸润。术后过程顺利，患者于术后第2天出院。在随访中，她的CA-125继续升高至56 U/mL，并进行了分期腹腔镜检查，注意到任何转移性疾病均为阴性，重复CA-125正常化13 U/mL。长期计划随访常规超声检查和CA-125水平。结论卵巢黏液性肿瘤可有交界性和恶性成分，因此需要进行彻底的组织病理学分析。

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引用次数: 0

Gallbladder epithelial foregut cyst in a child: case report 儿童胆囊上皮性前肠囊肿1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.epsc.2026.103187

Maria Chiara Cianci, Giovanni Gaglione, Maria Giovanna Grella

Introduction

Ciliated foregut cysts (CFCs) of the gallbladder are benign and extremely rare congenital anomalies, particularly in the pediatric population. They present with nonspecific symptoms that hinder preoperative suspicion, so histopathological examination is crucial for proper diagnosis.

Case presentation

A 6-year-old girl presented to the emergency department with recurrent episodes of abdominal pain and vomiting. Abdominal ultrasound revealed a cystic lesion adjacent to the gallbladder, and magnetic resonance cholangiography showed a cystic diverticular dilation arising along the cystic duct, positioned at the upper aspect of the gallbladder infundibulum without luminal communication. Based on these findings, the patient underwent laparoscopic excision of the cystic lesion combined with cholecystectomy. The procedure was completed without complications. Histopathological evaluation demonstrated a ciliated foregut cyst of the gallbladder, confirming the congenital nature of the anomaly. Postoperative recovery was uneventful, and at five months of follow-up she remains asymptomatic with normal laboratory results and no radiological abnormalities.

Conclusion

Epithelial foregut cysts can occasionally develop near the gallbladder, be misdiagnosed as cystic biliary lesions, and can be a source of recurring abdominal pain in children.

胆囊纤毛前肠囊肿（cfc）是一种良性且极其罕见的先天性异常，尤其在儿科人群中。他们表现出非特异性症状，妨碍术前怀疑，因此组织病理学检查是正确诊断的关键。病例介绍：一名6岁女童因腹痛和呕吐反复发作而就诊于急诊科。腹部超声示胆囊旁囊性病变，磁共振胆管造影示沿胆囊管出现囊性憩室扩张，位于胆囊漏斗上部，无腔内相通。基于这些发现，患者接受了腹腔镜下胆囊病变切除联合胆囊切除术。手术顺利完成，无并发症。组织病理学检查显示为胆囊纤毛前肠囊肿，证实此异常为先天性。术后恢复顺利，随访5个月，患者无症状，实验室检查结果正常，无影像学异常。结论上皮性前肠囊肿偶有发生于胆囊附近，易误诊为胆囊性胆道病变，是儿童反复腹痛的原因之一。

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引用次数: 0

Isolated gastric perforation in a child following bicycle handlebar injury: A case report 儿童自行车车把损伤后孤立性胃穿孔1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-18 DOI: 10.1016/j.epsc.2026.103186

Bashar Al Jabary , Loubna Aqqaoui , Houda Oubejja , Fouad Ettayebi

Introduction

Handlebar injuries are a significant cause of blunt abdominal trauma in children, ranging from minor contusions to severe organ damage. Gastric perforation following such trauma is rare but potentially life-threatening.

Case presentation

A 10-year-old boy presented with acute abdominal pain after a bicycle handlebar injury that occurred shortly after food intake. Physical examination revealed generalized abdominal tenderness and a circular abrasion over the right paraumbilical region. Laboratory investigations showed leukocytosis with normal pancreatic enzyme levels. Contrast-enhanced abdominal CT demonstrated pneumoperitoneum and a clearly visualized full-thickness defect in the anterior gastric wall, with no associated solid organ injuries. Emergency exploratory laparotomy confirmed an isolated gastric perforation, which was repaired using a two-layer primary closure. The postoperative course was uneventful. A nasogastric tube was maintained for 48 hours. Oral feedings were initiated on postoperative day five without doing a contrast study. The patient was discharged on postoperative day seven.

Conclusion

Gastric perforation must be considered in children who sustain a handlebar injury.

车把损伤是儿童钝性腹部创伤的重要原因，从轻微挫伤到严重的器官损伤。这种创伤后的胃穿孔很少见，但可能危及生命。病例介绍：一名10岁男孩在进食后不久因自行车车把受伤而出现急性腹痛。体格检查发现全身腹部压痛和右脐旁区圆形擦伤。实验室检查显示白细胞增多，胰酶水平正常。增强腹部CT显示气腹和胃壁全层缺损清晰可见，无相关实体器官损伤。急诊剖腹探查证实为孤立性胃穿孔，采用两层初级缝合术修复。术后过程平淡无奇。鼻胃管维持48小时。术后第5天开始口服喂养，未做对比研究。患者于术后第7天出院。结论儿童车把损伤应考虑胃穿孔。

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引用次数: 0

Isolated tubular duplication of the ascending colon: A case report 孤立的升结肠管状重复：1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-16 DOI: 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.

肠重复囊肿是一种罕见的先天性畸形，通常与邻近的肠道共用一个肠壁和血液供应。具有独立血管和无管腔通信的孤立变异极为罕见，特别是当发生在结肠时。病例介绍一名3岁男孩，以间歇性右侧腹痛3个月为主诉。腹部超声示右半腹部4 × 3 × 3 cm囊性病变。对比增强计算机断层扫描（CECT）显示右半腹部有一个12厘米长的囊性病变。病人被带到手术室进行剖腹探查术。探查时，发现升结肠前外侧有一个12厘米的管状囊状结构，有独立的血管蒂，与原结肠管腔不相通。病变完全切除，无需肠切除术。组织病理学证实肠管状复制，内衬结肠黏膜和平滑肌。术后恢复顺利，随访1年，患儿仍无症状。结论孤立性结肠重复囊肿具有独立的血管，无腔内相通，但可引起儿童慢性腹痛。

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引用次数: 0

Synchronous esophageal and jejunal duplication in an infant: A case report 婴儿食管和空肠同步重复1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-16 DOI: 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.

消化道重复是一种罕见的先天性异常，通常发生在单个部位；然而，可能出现多位点重复，并表现出不同的临床表现。病例介绍1个月大的男婴，既往健康，在出生第一周出现呼吸急促和咕噜声。产前随访显示腹部有一个充满液体的结构。他被送往当地一家医院，接受了两周的抗生素治疗，但没有好转。报告时，他表现出严重的呼吸窘迫。体格检查显示左侧上腹部可触及肿块，延伸至骨盆。胸片提示双侧肺混浊。腹部超声示11 × 5.6 cm腹腔内囊肿和7 × 5.5 cm右侧胸膜内囊肿。胸腹ct证实右胸囊肿为5.5 × 5 cm，腹内囊肿为7.5 × 6.5 cm和5.5 × 5.3 cm。患者行右后外侧开胸开腹手术，切除食管囊肿，切除小肠重复囊肿。术后过程平淡无奇。组织病理学证实为食道和小肠重复囊肿。在随访中，他仍无症状。结论虽然消化道重复病变通常累及一个部位，但也可能累及多个部位，尤其是临床表现各异的患者。

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引用次数: 0

Dolichocolon causing intestinal obstruction in neonates: a case series 新生儿胆总管引起肠梗阻：一个病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-13 DOI: 10.1016/j.epsc.2026.103181

Melissa Grageda , Marla Sacks , Marko Mesić , Elizabeth Jennifer Lee , Anthony Barone , Francisca Velcek

Introduction

Dolichocolon is a rare congenital colonic redundancy with unknown pediatric prevalence, which can present as neonatal intestinal obstruction.

Case presentations

.

Case 1

A 2-week old, term male infant presented with abdominal distention and bilious vomiting. Upper gastrointestinal series ruled out malrotation. He improved with conservative management, but returned at 5 weeks of age with 2 weeks duration of obstipation, abdominal distention, vomiting and dehydration. Imaging studies showed dilated bowel loops, markedly redundant sigmoid colon consistent with dolichocolon. At exploration, dilated redundant sigmoid colon was resected with primary anastomosis.

Case 2

A premature female infant presented with intermittent feeding difficulties since birth, progressive abdominal distention, dilated bowel loops on imaging, and was treated conservatively. Contrast enema at 6 weeks of age demonstrated a redundant sigmoid colon, consistent with dolichocolon. Progressive abdominal distention and dilated bowel loops raised concerns for intermittent obstruction from volvulus. At exploration, dilated redundant sigmoid colon was resected with primary anastomosis.

Case 3

A preterm female infant presented during the first week of life with feeding difficulties, intermittent abdominal distention, obstipation and nonbilious vomiting. Imaging demonstrated distended loops of bowel and redundant sigmoid colon. Dilated redundant sigmoid colon was resected at 3 weeks of age, with satisfactory post-operative course.

All patients were thriving well on long term follow-up at 6, 5 and 4 years, respectively.

Conclusion

While rare, dolichocolon must be included in the differential diagnosis of neonates who develop intermittent intestinal obstruction.

摘要胆道结肠是一种罕见的先天性结肠赘肉，儿童患病率不详，可表现为新生儿肠梗阻。例演示。病例1A 2周大，足月男婴表现为腹胀和胆汁性呕吐。上消化道检查排除了旋转不良。经保守治疗后病情好转，但在5周龄时复发，持续2周的顽固性腹痛、腹胀、呕吐和脱水。影像学检查显示肠袢扩张，乙状结肠明显多余，与小结肠一致。探查时，经一期吻合切除扩张的乙状结肠。病例2A早产女婴自出生以来出现间歇性喂养困难，进行性腹胀，影像学显示肠袢扩张，保守治疗。6周龄的对比灌肠显示乙状结肠多余，与小结肠一致。进行性腹胀和肠袢扩张引起对肠扭转引起的间歇性梗阻的关注。探查时，经一期吻合切除扩张的乙状结肠。病例3A早产女婴在出生第一周出现喂养困难、间歇性腹胀、顽阻和非胆汁性呕吐。影像学显示肠袢扩张和乙状结肠多余。3周龄时切除扩张的乙状结肠，术后病程满意。在6年、5年和4年的长期随访中，所有患者都表现良好。结论新生儿间歇性肠梗阻虽罕见，但应纳入鉴别诊断。

{"title":"Dolichocolon causing intestinal obstruction in neonates: a case series","authors":"Melissa Grageda , Marla Sacks , Marko Mesić , Elizabeth Jennifer Lee , Anthony Barone , Francisca Velcek","doi":"10.1016/j.epsc.2026.103181","DOIUrl":"10.1016/j.epsc.2026.103181","url":null,"abstract":"<div><h3>Introduction</h3><div>Dolichocolon is a rare congenital colonic redundancy with unknown pediatric prevalence, which can present as neonatal intestinal obstruction.</div></div><div><h3>Case presentations</h3><div>.</div></div><div><h3>Case 1</h3><div>A 2-week old, term male infant presented with abdominal distention and bilious vomiting. Upper gastrointestinal series ruled out malrotation. He improved with conservative management, but returned at 5 weeks of age with 2 weeks duration of obstipation, abdominal distention, vomiting and dehydration. Imaging studies showed dilated bowel loops, markedly redundant sigmoid colon consistent with dolichocolon. At exploration, dilated redundant sigmoid colon was resected with primary anastomosis.</div></div><div><h3>Case 2</h3><div>A premature female infant presented with intermittent feeding difficulties since birth, progressive abdominal distention, dilated bowel loops on imaging, and was treated conservatively. Contrast enema at 6 weeks of age demonstrated a redundant sigmoid colon, consistent with dolichocolon. Progressive abdominal distention and dilated bowel loops raised concerns for intermittent obstruction from volvulus. At exploration, dilated redundant sigmoid colon was resected with primary anastomosis.</div></div><div><h3>Case 3</h3><div>A preterm female infant presented during the first week of life with feeding difficulties, intermittent abdominal distention, obstipation and nonbilious vomiting. Imaging demonstrated distended loops of bowel and redundant sigmoid colon. Dilated redundant sigmoid colon was resected at 3 weeks of age, with satisfactory post-operative course.</div><div>All patients were thriving well on long term follow-up at 6, 5 and 4 years, respectively.</div></div><div><h3>Conclusion</h3><div>While rare, dolichocolon must be included in the differential diagnosis of neonates who develop intermittent intestinal obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103181"},"PeriodicalIF":0.2,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038638","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

Robotic-assisted thoracoscopy in the treatment of pleuropulmonary blastoma: A case report 机器人辅助胸腔镜治疗胸膜肺母细胞瘤1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-13 DOI: 10.1016/j.epsc.2026.103180

Pooya Ganjali , Douglas Tamura , Stephanie Jones

Introduction

Robotic-assisted thoracic surgery in the management of pleuropulmonary blastoma (PPB) remains extremely rare.

Case presentation

A 12-year-old female with a known heterozygous DICER-1 mutation developed mild chest pain. She had a history of multifocal follicular thyroid carcinoma and a history of a small cystic lesion in the upper lobe of the left lung, measuring 3.0 × 4 × 4 cm. The cyst had been stable in size for several years. At the time of presentation, she underwent a chest computerized tomography (CT) that showed that the cyst had increased in size to 14 × 8 × 8.6 cm and had new calcifications. We took her to the operating room for an exploratory thoracoscopy. We initially drained the cyst with a thoracoscopic needle. Once the cyst was decompressed, we added 2 ports, docked the DaVinci ® robotic device, and did a robotic-assisted wedge resection on the upper lobe. The specimen was placed in a bag before removing it from the chest. The pathology analysis confirmed the diagnosis of PPB Type II and confirmed clear margins. We left a chest tube, which was removed 36 hours later. Post-operative imaging showed no residual tumor. The oncology service recommended no additional surgical resection. She was enrolled in a therapeutic trial and is currently receiving adjuvant chemotherapy and radiotherapy.

Conclusion

Robotic-assisted thoracoscopy may be a safe and effective approach for the management of type II PPB.

机器人辅助胸外科手术治疗胸膜肺母细胞瘤（PPB）仍然非常罕见。病例介绍：一名已知DICER-1杂合突变的12岁女性出现轻度胸痛。患者有多灶性滤泡性甲状腺癌病史，左肺上叶有小囊性病变，大小为3.0 × 4 × 4 cm。囊肿的大小已经稳定了好几年。在出现病例时，她接受了胸部计算机断层扫描（CT），显示囊肿的大小增加到14 × 8 × 8.6 cm，并有新的钙化。我们带她去手术室做胸腔镜探查。我们最初用胸腔镜针引流囊肿。一旦囊肿被减压，我们增加2个端口，对接达芬奇®机器人装置，并在上肺叶进行机器人辅助楔形切除术。标本在从胸腔取出之前被放在一个袋子里。病理分析证实PPB II型的诊断和明确的边缘。我们留下了胸管，36小时后取出了。术后影像学未见肿瘤残留。肿瘤学服务不建议额外的手术切除。她参加了一项治疗试验，目前正在接受辅助化疗和放疗。结论机器人辅助胸腔镜是治疗II型PPB的一种安全有效的方法。

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引用次数: 0

Recurrent solid pseudopapillary neoplasm of the pancreas with hepatic and lymphatic metastasis in a teenager: A case report 胰腺实性假乳头状肿瘤复发并肝及淋巴转移一例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-07 DOI: 10.1016/j.epsc.2026.103179

Hoa Nguyen Viet , Ngoc Nguyen Bich , Phuong Tran Ha , Trang Dang Thi Huyen , Tuan Vu Hong , Phuc Chu Minh

Introduction

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare neoplasm with low malignant potential, predominantly affecting young women. Despite its generally favorable prognosis following complete resection, recurrence or metastasis may occur years later.

Case presentation

A 15-year-old female who had undergone enucleation of a large pancreatic head SPN at the age of 6 years was admitted to the hospital due to persistent abdominal pain. She had been followed at a local hospital but the follow up was interrupted due to COVID-19 restrictions. She underwent a magnetic resonance that showed a recurrence of the SPN, with a hepatic. The diagnosis was confirmed with a core needle biopsy. We took her to the operating room and did a pancreaticoduodenectomy (Whipple procedure) with portal vein reconstruction, hepatic wedge resection, and extensive lymphadenectomy. Pathological analysis confirmed recurrent SPN with hepatic metastasis and found SPN infiltration in 3 out of 29 peripancreatic lymph nodes. The patient tolerated the procedure well. She developed a low-flow pancreatic fistula that was managed conservatively and resolved spontaneously. Oral feedings were started after the resolution of pancreatic fistula on postoperative day 7. She was discharged 13 days after the operation. At 4 years of follow up she remains asymptomatic and free of recurrence.

Conclusion

Simple enucleation may not be an acceptable approach for the management of large SPN of the pancreatic head, since as seen in our patient, it may be associated with recurrences.

胰腺实性假乳头状肿瘤（SPN）是一种低恶性潜能的罕见肿瘤，主要发生在年轻女性。尽管完全切除后预后良好，但多年后可能发生复发或转移。病例介绍：一名15岁女性，6岁时行大胰头SPN去核术，因持续腹痛入院。她在当地一家医院接受了随访，但由于COVID-19的限制，随访中断了。她接受了磁共振检查，显示SPN复发，并伴有肝纤维化。诊断被证实与核心针活检。我们带她到手术室，做了胰十二指肠切除术（惠普尔手术），重建门静脉，肝楔切除术和广泛的淋巴结切除术。病理分析证实复发性SPN伴肝转移，29个胰周淋巴结中3个发现SPN浸润。病人对手术的耐受性很好。患者出现低流量胰瘘，经保守治疗后自行痊愈。术后第7天胰瘘消除后开始口服喂养。术后13天出院。随访4年，患者无症状，无复发。结论单纯去核可能不是治疗胰头大SPN的一种可接受的方法，因为正如本例患者所见，它可能与复发有关。

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引用次数: 0

Pilonidal disease development after initiating testosterone therapy – A case Series 开始睾酮治疗后毛毛疾病的发展-一个病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-06 DOI: 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.

毛囊性疾病（PD）与性激素有关，因为青春期毛发生长和油脂分泌会加重PD症状，变性（TG）患者接受的睾酮治疗可能会导致PD的发展。在本病例报告中，我们报告了两例TG患者在开始睾酮治疗后发展为PD。病例介绍：患者1，一名女向男（FTM）过渡的患者，16岁时开始睾酮治疗（每2周50mg），开始睾酮治疗一个月后出现毛毛脓肿。他接受了脓肿的切开和引流手术，然后定期手工和激光脱毛。他继续睾酮治疗，没有中断，三年后治疗毛毛脓肿，他没有注意到任何PD复发。患者2，FTM过渡患者，17岁开始睾酮治疗（每周25mg）。在开始使用睾酮一个月后，他出现臀裂肿胀，毛卡在毛毛窝里，与毛毛病相符。在临床上，从毛毛窝中去除毛发，并开始定期手工和激光脱毛。他没有接受任何PD手术切除。睾酮治疗继续进行，在10个月的随访中，他仍然没有PD的症状。结论睾酮治疗开始后可发生毛鞘疾病。标准的PD治疗似乎是有效的，不需要中断激素治疗。

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引用次数: 0

Robert's uterus with ipsilateral renal agenesis presenting as pelvic inflammatory disease in a teenager: A case report 罗伯特的子宫与同侧肾发育不全表现为盆腔炎的青少年：1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2026-01-03 DOI: 10.1016/j.epsc.2026.103173

Akkamahadevi C. Hiremath, Harshita Ramamurthy , T.D. Nandeesha, R. Padmasri

Introduction

Robert's uterus, with ipsilateral renal agenesis, is an exceptionally rare Mullerian duct anomaly (MDA). It usually presents with cyclical pain, but presentation as pelvic inflammatory disease in an adolescent is extremely uncommon.

Case presentation

We report a rare case of Robert's uterus with ipsilateral renal agenesis in a 13-year-old girl, eight months post-menarche, who presented with 15 days of abdominal pain, copious purulent vaginal discharge, and fever. Ultrasonography suggested a septate/bicornuate uterus with a large, irregular pelvic collection. MRI demonstrated an asymmetric uterine septum forming a non-communicating left hemi-cavity and left renal agenesis. As an emergency procedure under anesthesia, 100 ml of hematinic purulent material was drained from the pouch of Douglas. After clinical stabilization for one week, hystero-laparoscopy was performed. Hysteroscopy revealed a normal vagina, single cervix, and right hemi uterus with right tubal ostia, whereas laparoscopy revealed a broad fundus, a dilated left tube and flimsy adhesions, findings suggestive of Robert's uterus. Laparoscopic-guided hysteroscopic unification metroplasty was successfully done by incising the asymmetric septum using a bipolar Collins knife. A no. 8 Foley catheter was left in situ for one week to prevent adhesions. She recovered uneventfully and, at 9-month follow-up, experiences regular moderate menstrual cycles without dysmenorrhea or pain.

Conclusion

Robert's uterus is a rare Mullerian malformation that should be considered in the differential diagnosis of females presenting with features of pelvic inflammatory disease. Ipsilateral renal agenesis should be evaluated in patients diagnosed with Robert's uterus.

罗伯特子宫伴同侧肾发育不全，是一种非常罕见的苗勒管异常（MDA）。它通常表现为周期性疼痛，但在青少年中表现为盆腔炎是非常罕见的。我们报告一例罕见的罗伯特子宫合并同侧肾发育不全的13岁女孩，初潮后8个月，表现为腹痛15天，大量脓性阴道分泌物和发烧。超声提示子宫分隔/双角状，骨盆大而不规则。MRI显示不对称的子宫间隔形成不相通的左半腔和左肾发育不全。作为麻醉下的紧急手术，从道格拉斯眼袋中抽出100毫升血液病脓性物质。临床稳定一周后，行子宫腹腔镜检查。宫腔镜检查显示正常阴道、单子宫颈、右半子宫及右侧输卵管口，而腹腔镜检查显示眼底宽阔、左侧输卵管扩张和脆弱的粘连，提示罗伯特子宫。腹腔镜引导下宫腔镜统一成形术采用双极柯林斯刀切开不对称鼻中隔成功完成。一个没有。Foley导尿管留置1周，防止粘连。在9个月的随访中，患者恢复正常，月经周期正常，无痛经或疼痛。结论罗伯特子宫是一种罕见的缪勒氏畸形，在女性盆腔炎性疾病的鉴别诊断中应予以重视。诊断为罗伯特子宫的患者应评估同侧肾发育不全。

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引用次数: 0