Journal of Pediatric Surgery Case Reports最新文献

{"title":"Post-traumatic rupture of primary solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas in a male adolescent: a case report","authors":"Paulo Castro ,&nbsp;Heather Hartman ,&nbsp;Yashasvi Shukla ,&nbsp;Michael Moore ,&nbsp;Dennis Drehner ,&nbsp;Harish Lavu","doi":"10.1016/j.epsc.2026.103203","DOIUrl":"10.1016/j.epsc.2026.103203","url":null,"abstract":"<div><h3>Introduction</h3><div>Solid pseudopapillary epithelial neoplasm (SPEN) is a rare pancreatic tumor that typically presents in adult women and is usually asymptomatic.</div></div><div><h3>Case presentation</h3><div>A 12-year-old male presented to the emergency department with worsening abdominal pain one day after suffering mild abdominal trauma during a soccer match. Physical exam showed diffuse abdominal tenderness and guarding. CT abdomen with IV contrast showed a heterogeneous, round structure adjacent to the pancreatic tail with mass effect upon the spleen. MRI abdomen revealed a “claw sign” of pancreatic tissue surrounding the structure, suggesting a an underlying pancreatic mass with capsular rupture measuring 8.3 x 8.1 × 8cm. This finding indicated the need for open distal pancreatectomy. Intraoperatively, safe separation of the splenic vasculature from the mass proved impossible and splenectomy was performed. A drain was left in place. Postoperatively, the patient recovered without complication. At one month follow-up, the patient was seen doing well. A drain amylase did not show evidence of a pancreatic leak and was removed. Histopathology later confirmed the diagnosis of SPEN of the pancreas.</div></div><div><h3>Conclusion</h3><div>Traumatic rupture of SPEN of the pancreas is a rare initial presentation. Distal pancreatectomy shortly after presentation appears to be safe and may require splenectomy if the splenic vasculature appears inseparable from the tumor.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103203"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078693","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}

{"title":"Mediastinal neuroblastoma causing Horner's syndrome in a 7-year-old child: a case report","authors":"Alicija Šavareikaitė ,&nbsp;Paulius Valatka","doi":"10.1016/j.epsc.2026.103195","DOIUrl":"10.1016/j.epsc.2026.103195","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral neuroblastic tumors comprise a spectrum of neoplasms (neuroblastoma, ganglioneuroblastoma, ganglioneuroma) that primarily arise from the sympathoadrenal lineage and can cause variety of symptoms.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Children who develop Horner syndrome of unknown origin must undergo imaging studies to rule out a tumor in the posterior superior mediastinal region.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103195"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078649","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}

{"title":"Fertility preservation via concurrent ovarian tissue cryopreservation during radical resection of pelvic retroperitoneal soft-tissue sarcoma in prepubertal girls: A case series","authors":"Chen Chen ,&nbsp;Xianying Lu ,&nbsp;Ping Zhou ,&nbsp;Chenyue Zhang ,&nbsp;Yulong Mu ,&nbsp;Qun Gao","doi":"10.1016/j.epsc.2026.103185","DOIUrl":"10.1016/j.epsc.2026.103185","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentations</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103185"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038641","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}

{"title":"Dolichocolon causing intestinal obstruction in neonates: a case series","authors":"Melissa Grageda ,&nbsp;Marla Sacks ,&nbsp;Marko Mesić ,&nbsp;Elizabeth Jennifer Lee ,&nbsp;Anthony Barone ,&nbsp;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":"2026-03-01","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}

{"title":"Repair of a chest wall hernia after dirt bike collision: a case report","authors":"Shruthi Srinivas,&nbsp;Kristie Griffin,&nbsp;Kyle Van Arendonk,&nbsp;Sara Mansfield","doi":"10.1016/j.epsc.2026.103189","DOIUrl":"10.1016/j.epsc.2026.103189","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103189"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038599","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}

{"title":"Ileocecal volvulus in an infant with dorsal mesenteric agenesis: A case report","authors":"Alaa Eltayeb ,&nbsp;Abdelrahman S. Elnour ,&nbsp;Rammah Bireama ,&nbsp;Yousif Faisal ,&nbsp;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":"2026-03-01","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}

{"title":"Hypertrophic pyloric stenosis in a neonate: A case report","authors":"Addisu Andargie ,&nbsp;Absalat Serawit Negussie","doi":"10.1016/j.epsc.2026.103190","DOIUrl":"10.1016/j.epsc.2026.103190","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103190"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038639","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}

{"title":"Congenital intramesenteric hernia presenting as small bowel obstruction in children: A case series","authors":"Sachini Arunarathne ,&nbsp;Mathula Hettiarachchi","doi":"10.1016/j.epsc.2026.103204","DOIUrl":"10.1016/j.epsc.2026.103204","url":null,"abstract":"<div><h3>Introduction</h3><div>Intramesenteric hernia is an exceedingly rare congenital internal hernia characterized by herniation of bowel loops between the two layers of the mesentery, forming a true sac.</div></div><div><h3>Cases presentation</h3><div>Case 1: A 1-year-and-6-month-old boy presented with bilious vomiting and abdominal distension for two days. He appeared ill and dehydrated, was afebrile and tachycardic, with normal blood pressure. The abdomen was distended without tenderness or guarding. Plain radiograph and ultrasound demonstrated features of small bowel obstruction. After initial resuscitation with intravenous fluids and antibiotics, surgery was undertaken due to radiological evidence of obstruction. Exploratory laparotomy revealed a sac within the distal ileal mesentery containing viable small bowel loops, which was plicated using absorbable sutures. His postoperative recovery was uneventful. Oral feedings were started on postoperative day 2, and he was discharged on postoperative day 5. Case 2: A 2-year-old girl presented with similar features. She was afebrile and in pain, hemodynamically stable, with a distended, tender abdomen. Ultrasonography demonstrated dilated small bowel loops. Supine abdominal X-ray showed multiple dilated small bowel loops with absent rectal gas. Laparoscopic exploration revealed an intramesenteric pouch containing viable bowel near the distal ileum, which was reduced and plicated through a limited incision. She had an uncomplicated postoperative course. Oral feedings were started on postoperative day 2, and she was discharged on postoperative day 6. At the 3-month follow-up, both children were asymptomatic.</div></div><div><h3>Conclusion</h3><div>Intramesenteric hernia should be considered in the differential diagnosis of pediatric small bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103204"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078650","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}

{"title":"Gallbladder epithelial foregut cyst in a child: case report","authors":"Maria Chiara Cianci,&nbsp;Giovanni Gaglione,&nbsp;Maria Giovanna Grella","doi":"10.1016/j.epsc.2026.103187","DOIUrl":"10.1016/j.epsc.2026.103187","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103187"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038640","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}

{"title":"Isolated gastric perforation in a child following bicycle handlebar injury: A case report","authors":"Bashar Al Jabary ,&nbsp;Loubna Aqqaoui ,&nbsp;Houda Oubejja ,&nbsp;Fouad Ettayebi","doi":"10.1016/j.epsc.2026.103186","DOIUrl":"10.1016/j.epsc.2026.103186","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Gastric perforation must be considered in children who sustain a handlebar injury.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"126 ","pages":"Article 103186"},"PeriodicalIF":0.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038637","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}