Journal of Pediatric Surgery Case Reports最新文献_第6页

Intrapancreatic common bile duct duplication presenting with choledocholithiasis in a toddler: a case report 胰内总胆管复制表现为幼儿胆总管结石：1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-11-06 DOI: 10.1016/j.epsc.2025.103143

Audrey Viger , Camille Plourde , Anna Wieckowska , Caroline P. Lemoine

Introduction

Common bile duct (CBD) duplication is an extremely rare congenital anomaly, with most cases reported in adults.Only 14 cases have been reported in children.

Case presentation

A previously healthy 14-month-old girl (8.3 kg) presented with intermittent fevers and diarrhea. There was no history of abdominal pain, jaundice, weight loss, or anorexia. Physical examination was unremarkable. Liver function tests (LFTs) were elevatedelevated (aspartate aminotransferase (AST) 562 U/L, alanine transaminase (ALT) 540 U/L, gamma-glutamyl transferase (GGT) 678 U/L) except for a normal bilirubin. An abdominal ultrasound revealed both dilated intrahepatic and extrahepatic bile ducts. A magnetic resonance cholangiopancreatography (MRCP) demonstrated an intrapancreatic CBD duplication and multiple choledocholithiasis. An endoscopic retrograde cholangiopancreatography (ERCP) was attempted but failed as the endoscope could not pass the child's pylorus. A percutaneous transhepatic cholangiogram confirmed the patient's anatomy and successfully removed the choledocholithiasis. An external-internal biliary drain was placed due to extensive biliary manipulations, and intravenous antibiotics were administered. One week later, definitive surgical management was performed; the patient underwent a laparoscopic CBD resection with a Roux-en-Y hepaticojejunostomy. The postoperative course was unremarkable, and she was discharged on postoperative day 4. One year after surgery, she is doing well with normal LFTs and no recurrence of choledocholithiasis.

Conclusion

Even though they are rare, duplications of the common bile duct should be included in the differential diagnosis of children who develop abdominal pain and have dilatation of the intrahepatic and/or extrahepatic biliary tree.

总胆管（CBD）重复是一种极其罕见的先天性异常，大多数病例报道在成人。仅报告了14例儿童病例。病例表现：先前健康的14个月女童（8.3公斤）出现间歇性发热和腹泻。没有腹痛、黄疸、体重减轻或厌食史。体格检查无明显异常。肝功能测试（LFTs）升高（天冬氨酸转氨酶（AST） 562 U/L，丙氨酸转氨酶（ALT） 540 U/L， γ -谷氨酰转移酶（GGT） 678 U/L），但胆红素正常。腹部超声显示肝内和肝外胆管均扩张。磁共振胆管胰胆管造影（MRCP）显示胰腺内CBD重复和多发性胆总管结石。内镜逆行胰胆管造影（ERCP）被尝试，但失败，因为内镜不能通过孩子的幽门。经皮经肝胆管造影证实了患者的解剖结构，并成功切除了胆总管结石。由于广泛的胆道操作，放置了外部-内部胆道引流管，并静脉注射抗生素。一周后，进行明确的手术治疗；患者接受了腹腔镜CBD切除术和Roux-en-Y肝空肠吻合术。术后病程无明显变化，于术后第4天出院。术后1年，患者肝功能正常，无胆总管结石复发。结论即使是罕见的，在发生腹痛并伴有肝内和/或肝外胆道扩张的儿童中，也应将胆总管重叠纳入鉴别诊断。

{"title":"Intrapancreatic common bile duct duplication presenting with choledocholithiasis in a toddler: a case report","authors":"Audrey Viger , Camille Plourde , Anna Wieckowska , Caroline P. Lemoine","doi":"10.1016/j.epsc.2025.103143","DOIUrl":"10.1016/j.epsc.2025.103143","url":null,"abstract":"<div><h3>Introduction</h3><div>Common bile duct (CBD) duplication is an extremely rare congenital anomaly, with most cases reported in adults.Only 14 cases have been reported in children.</div></div><div><h3>Case presentation</h3><div>A previously healthy 14-month-old girl (8.3 kg) presented with intermittent fevers and diarrhea. There was no history of abdominal pain, jaundice, weight loss, or anorexia. Physical examination was unremarkable. Liver function tests (LFTs) were elevatedelevated (aspartate aminotransferase (AST) 562 U/L, alanine transaminase (ALT) 540 U/L, gamma-glutamyl transferase (GGT) 678 U/L) except for a normal bilirubin. An abdominal ultrasound revealed both dilated intrahepatic and extrahepatic bile ducts. A magnetic resonance cholangiopancreatography (MRCP) demonstrated an intrapancreatic CBD duplication and multiple choledocholithiasis. An endoscopic retrograde cholangiopancreatography (ERCP) was attempted but failed as the endoscope could not pass the child's pylorus. A percutaneous transhepatic cholangiogram confirmed the patient's anatomy and successfully removed the choledocholithiasis. An external-internal biliary drain was placed due to extensive biliary manipulations, and intravenous antibiotics were administered. One week later, definitive surgical management was performed; the patient underwent a laparoscopic CBD resection with a Roux-en-Y hepaticojejunostomy. The postoperative course was unremarkable, and she was discharged on postoperative day 4. One year after surgery, she is doing well with normal LFTs and no recurrence of choledocholithiasis.</div></div><div><h3>Conclusion</h3><div>Even though they are rare, duplications of the common bile duct should be included in the differential diagnosis of children who develop abdominal pain and have dilatation of the intrahepatic and/or extrahepatic biliary tree.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103143"},"PeriodicalIF":0.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526283","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

Nonoperative management of grade III pancreatic injuries in children: a case series 儿童III级胰腺损伤的非手术治疗：一个病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-11-06 DOI: 10.1016/j.epsc.2025.103144

Takeshi Hirabayashi , Tamotsu Kobayashi , Takeshi Saito , Daiki Kasai , Keinosuke Ishido , Kenichi Hakamada

Introduction

Pediatric American Association for the Surgery of Trauma (AAST) Grade III pancreatic injuries—complete transections of the main pancreatic duct (MPD)—are rare, and long-term outcomes following nonoperative management are not well defined.

Case presentations

Three hemodynamically stable children with American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) grade III pancreatic injuries were managed nonoperatively (nil per os, total parenteral nutrition, protease inhibitor therapy, and analgesia.

Case 1 (male, injured at age 10) had early MRCP (day 3) confirming MPD transection; MRCP was repeated at 6 months and 1 year; distal pancreatic atrophy was first detected at 2 years 3 months and remained stable at 7 years 11 months.

Case 2 (female, injured at age 14) had early MRCP (day 5) confirming MPD transection; MRCP was repeated at 6 months and 1 year; distal atrophy was first detected at 1 year 9 months and persisted at 6 years 2months.

Case 3 (male, injured at age 10) had early MRCP (day 7) confirming MPD transection; subsequent MRCPs at 1 month, 8 months, 1 year 10 months, and 2 years 11months were unremarkable, without atrophy.

No patient developed clinically evident endocrine or exocrine insufficiency during follow-up.

Conclusion

Atrophy of the distal pancreas can developed in children who sustained grade-III pancreatic injuries that were managed non-operatively. Long-term pancreatic functional assessment is recommended.

美国儿科创伤外科协会（AAST） III级胰腺损伤——主胰管完全横断（MPD）——是罕见的，非手术治疗后的长期结果尚不明确。3例血流动力学稳定的美国创伤外科协会（AAST）器官损伤量表（OIS） III级胰腺损伤患儿采用非手术治疗（无手术、全肠外营养、蛋白酶抑制剂治疗和镇痛）。病例1（男性，10岁时受伤）早期MRCP（第3天）证实MPD横断；在6个月和1年后重复MRCP；远端胰腺萎缩在2岁3个月时首次发现，并在7岁11个月时保持稳定。病例2（女性，14岁受伤）早期MRCP（第5天）证实MPD横断；在6个月和1年后重复MRCP；远端萎缩在1年9个月时首次发现，并持续到6年2个月。病例3（男性，10岁时受伤）早期MRCP（第7天）证实MPD横断；随后1个月、8个月、1年10个月和2年11个月的mrcp无显著差异，无萎缩。随访期间无患者出现临床上明显的内分泌或外分泌功能不全。结论非手术治疗的iii级胰腺损伤患儿可发生远端胰腺萎缩。建议进行长期胰腺功能评估。

{"title":"Nonoperative management of grade III pancreatic injuries in children: a case series","authors":"Takeshi Hirabayashi , Tamotsu Kobayashi , Takeshi Saito , Daiki Kasai , Keinosuke Ishido , Kenichi Hakamada","doi":"10.1016/j.epsc.2025.103144","DOIUrl":"10.1016/j.epsc.2025.103144","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric American Association for the Surgery of Trauma (AAST) Grade III pancreatic injuries—complete transections of the main pancreatic duct (MPD)—are rare, and long-term outcomes following nonoperative management are not well defined.</div></div><div><h3>Case presentations</h3><div>Three hemodynamically stable children with American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) grade III pancreatic injuries were managed nonoperatively (nil per os, total parenteral nutrition, protease inhibitor therapy, and analgesia.</div><div>Case 1 (male, injured at age 10) had early MRCP (day 3) confirming MPD transection; MRCP was repeated at 6 months and 1 year; distal pancreatic atrophy was first detected at 2 years 3 months and remained stable at 7 years 11 months.</div><div>Case 2 (female, injured at age 14) had early MRCP (day 5) confirming MPD transection; MRCP was repeated at 6 months and 1 year; distal atrophy was first detected at 1 year 9 months and persisted at 6 years 2months.</div><div>Case 3 (male, injured at age 10) had early MRCP (day 7) confirming MPD transection; subsequent MRCPs at 1 month, 8 months, 1 year 10 months, and 2 years 11months were unremarkable, without atrophy.</div><div>No patient developed clinically evident endocrine or exocrine insufficiency during follow-up.</div></div><div><h3>Conclusion</h3><div>Atrophy of the distal pancreas can developed in children who sustained grade-III pancreatic injuries that were managed non-operatively. Long-term pancreatic functional assessment is recommended.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103144"},"PeriodicalIF":0.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474793","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 spleen-sparing distal pancreatectomy in a pediatric patient with a solid pseudopapillary tumor: A case report 机器人保脾远端胰腺切除术治疗小儿实性假乳头状肿瘤1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-11-01 DOI: 10.1016/j.epsc.2025.103135

Autumn Bennitt , Nitin Chilukuri , Michael Leinwand

Introduction

Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm with low metastatic potential that occurs primarily in the pediatric population and is managed by resection via an open or laparoscopic approach.

Case presentation

An 11-year-old female was found to have an incidental distal pancreatic mass on computed tomography (CT) as part of her evaluation following a motor vehicle accident. She complained of vague intermittent abdominal pain but was otherwise asymptomatic. Her abdominal exam was soft, nontender, and without a palpable mass. Magnetic resonance cholangiopancreatography (MRCP) redemonstrated the mass without local invasion. SPECT (Single Photon Emission Computed Tomography)-CT showed lack of radiotracer uptake and thus was not consistent with splenic tissue. She underwent robotic-assisted spleen-sparing distal pancreatectomy using three 8 mm robotic ports across the mid-abdomen and a left lower quadrant 12 mm accessory port. Dissection was performed using the robotic vessel sealer and monopolar electrocautery. The pancreas was transected with a 12 mm endostapler (blue load). Operative time was 5.25 hours, and estimated blood loss was 10 ml. The patient had an uneventful postoperative course and was discharged home on postoperative day 5. Pathology revealed a solid, 3.6 cm × 2.5 cm, well-encapsulated pseudopapillary tumor with a 0.8 mm margin and no lymphovascular or perineural invasion. Our patient has had no evidence of recurrence on imaging over 3 years.

Conclusion

Robotic spleen-preserving distal pancreatectomy appears to be an effective treatment for children with distal pancreatic tumors.

胰腺实性假乳头状肿瘤（SPT）是一种罕见的肿瘤，具有低转移潜力，主要发生在儿童人群中，通过开放或腹腔镜手术切除治疗。病例介绍：一名11岁的女性在一次机动车事故后，在计算机断层扫描（CT）上发现偶然的胰腺远端肿块。她主诉有隐隐约约的间歇性腹痛，但其他方面无症状。腹部检查柔软，无触痛，未见明显肿块。磁共振胰胆管造影（MRCP）显示肿块无局部浸润。SPECT（单光子发射计算机断层扫描）-CT显示缺乏放射性示踪剂摄取，因此与脾组织不一致。她接受了机器人辅助的保脾远端胰腺切除术，使用三个8毫米的机器人端口穿过中腹部和一个12毫米的左下腹辅助端口。采用机器人血管封口器和单极电灼进行解剖。胰腺用12mm内吻合器（蓝色负载）横切。手术时间5.25小时，估计失血量10ml。患者术后过程平稳，术后第5天出院。病理显示实性，3.6 cm × 2.5 cm，包膜良好的假乳头状肿瘤，边界0.8 mm，无淋巴血管或神经周围浸润。我们的病人在3年多的影像上没有复发的迹象。结论机器人保脾远端胰腺切除术是治疗儿童胰腺远端肿瘤的有效方法。

{"title":"Robotic spleen-sparing distal pancreatectomy in a pediatric patient with a solid pseudopapillary tumor: A case report","authors":"Autumn Bennitt , Nitin Chilukuri , Michael Leinwand","doi":"10.1016/j.epsc.2025.103135","DOIUrl":"10.1016/j.epsc.2025.103135","url":null,"abstract":"<div><h3>Introduction</h3><div>Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm with low metastatic potential that occurs primarily in the pediatric population and is managed by resection via an open or laparoscopic approach.</div></div><div><h3>Case presentation</h3><div>An 11-year-old female was found to have an incidental distal pancreatic mass on computed tomography (CT) as part of her evaluation following a motor vehicle accident. She complained of vague intermittent abdominal pain but was otherwise asymptomatic. Her abdominal exam was soft, nontender, and without a palpable mass. Magnetic resonance cholangiopancreatography (MRCP) redemonstrated the mass without local invasion. SPECT (Single Photon Emission Computed Tomography)-CT showed lack of radiotracer uptake and thus was not consistent with splenic tissue. She underwent robotic-assisted spleen-sparing distal pancreatectomy using three 8 mm robotic ports across the mid-abdomen and a left lower quadrant 12 mm accessory port. Dissection was performed using the robotic vessel sealer and monopolar electrocautery. The pancreas was transected with a 12 mm endostapler (blue load). Operative time was 5.25 hours, and estimated blood loss was 10 ml. The patient had an uneventful postoperative course and was discharged home on postoperative day 5. Pathology revealed a solid, 3.6 cm × 2.5 cm, well-encapsulated pseudopapillary tumor with a 0.8 mm margin and no lymphovascular or perineural invasion. Our patient has had no evidence of recurrence on imaging over 3 years.</div></div><div><h3>Conclusion</h3><div>Robotic spleen-preserving distal pancreatectomy appears to be an effective treatment for children with distal pancreatic tumors.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103135"},"PeriodicalIF":0.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474794","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

Raising awareness of the CDH1 mutation for the pediatric surgeon and the use of robotic assisted surgery in pediatric general surgery as demonstrated by a total gastrectomy: a case report 提高儿科外科医生对CDH1突变的认识，并通过全胃切除术证明机器人辅助手术在儿科普通外科中的应用：一份病例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-30 DOI: 10.1016/j.epsc.2025.103141

Melanie Elhafid , Kristopher Milbrandt , Richard Bigsby

Introduction

CDH1 mutation is a rare autosomal dominant mutation. Individuals with this mutation have a lifetime risk of up to 70 % for developing diffuse gastric cancer, often at a young age, and many undergo prophylactic total gastrectomies.

Case presentation

We present the case of a teenage girl with a known CDH1 mutation, identified through family screening. Her family history was significant for diffuse gastric carcinoma, with multiple relatives, including her mother, having previously undergone total gastrectomies due to malignancy. On her first surveillance gastroscopy at age 13, multiple small foci of signet ring cells were discovered despite the absence of clinical symptoms. In collaboration with our adult thoracic surgical team, we conducted a 6-h robotic-assisted total gastrectomy, with Roux-en-Y reconstruction using 4 robotic ports (one of which was an umbilical 10 mm camera port) and one laparoscopic assistant port. Both the esophagojejunal and jejunojejunal anastomoses were create with a robotic stapler. The procedure was successful, and the patient had a favorable postoperative course. The patient resumed gradual enteral feeds post-op day 1 and was discharged home on post-op day 8 tolerating her regular diet. Final pathology confirmed the presence of scattered signet ring cell foci, with negative margins and lymph nodes. The patient continues to do well at one year follow-up, with ongoing nutritional and psychological support. This case is unique as, to the best of our knowledge, it represents one of only a handful of robotic-assisted total gastrectomies reported in pediatric patients worldwide.

Conclusion

Robotic-assisted surgery seems to be a feasible option for teenagers who require a prophylactic total gastrectomy due to a CDH1 mutation.

cdh1突变是一种罕见的常染色体显性突变。携带这种突变的个体一生中患弥漫性胃癌的风险高达70%，通常在年轻时发生，许多人接受预防性全胃切除术。病例介绍我们提出一个十几岁的女孩与已知的CDH1突变，通过家庭筛查确定。患者有弥漫性胃癌家族史，包括其母亲在内的多名亲属曾因恶性肿瘤行全胃切除术。在她13岁时的第一次胃镜检查中，尽管没有临床症状，但发现了多个小的印戒细胞灶。与我们的成人胸外科团队合作，我们进行了6小时的机器人辅助全胃切除术，使用4个机器人端口（其中一个是脐带10毫米相机端口）和一个腹腔镜辅助端口进行Roux-en-Y重建。食管空肠吻合器和空肠吻合器均采用机器人吻合器制作。手术是成功的，病人有一个良好的术后过程。患者术后第1天恢复逐渐的肠内喂养，术后第8天出院，饮食正常。最终病理证实存在分散的印戒细胞灶，伴阴性边缘和淋巴结。在持续的营养和心理支持下，患者在一年的随访中继续表现良好。据我们所知，这个病例是独一无二的，因为它代表了全世界儿科患者中为数不多的机器人辅助全胃切除术之一。结论机器人辅助手术对于因CDH1突变而需要预防性全胃切除术的青少年来说是一种可行的选择。

{"title":"Raising awareness of the CDH1 mutation for the pediatric surgeon and the use of robotic assisted surgery in pediatric general surgery as demonstrated by a total gastrectomy: a case report","authors":"Melanie Elhafid , Kristopher Milbrandt , Richard Bigsby","doi":"10.1016/j.epsc.2025.103141","DOIUrl":"10.1016/j.epsc.2025.103141","url":null,"abstract":"<div><h3>Introduction</h3><div>CDH1 mutation is a rare autosomal dominant mutation. Individuals with this mutation have a lifetime risk of up to 70 % for developing diffuse gastric cancer, often at a young age, and many undergo prophylactic total gastrectomies.</div></div><div><h3>Case presentation</h3><div>We present the case of a teenage girl with a known CDH1 mutation, identified through family screening. Her family history was significant for diffuse gastric carcinoma, with multiple relatives, including her mother, having previously undergone total gastrectomies due to malignancy. On her first surveillance gastroscopy at age 13, multiple small foci of signet ring cells were discovered despite the absence of clinical symptoms. In collaboration with our adult thoracic surgical team, we conducted a 6-h robotic-assisted total gastrectomy, with Roux-en-Y reconstruction using 4 robotic ports (one of which was an umbilical 10 mm camera port) and one laparoscopic assistant port. Both the esophagojejunal and jejunojejunal anastomoses were create with a robotic stapler. The procedure was successful, and the patient had a favorable postoperative course. The patient resumed gradual enteral feeds post-op day 1 and was discharged home on post-op day 8 tolerating her regular diet. Final pathology confirmed the presence of scattered signet ring cell foci, with negative margins and lymph nodes. The patient continues to do well at one year follow-up, with ongoing nutritional and psychological support. This case is unique as, to the best of our knowledge, it represents one of only a handful of robotic-assisted total gastrectomies reported in pediatric patients worldwide.</div></div><div><h3>Conclusion</h3><div>Robotic-assisted surgery seems to be a feasible option for teenagers who require a prophylactic total gastrectomy due to a CDH1 mutation.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103141"},"PeriodicalIF":0.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419384","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

Appendiceal band syndrome in an 8-year-old patient: a case report 8岁儿童阑尾束综合征1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-28 DOI: 10.1016/j.epsc.2025.103140

Zelalem Assefa Semgn , Chibahew Lante kebede , Ayanle Badmah Maigag , Maru Gamma Erge

Introduction

Small bowel obstruction (SBO) secondary to appendiceal band syndrome is an exceptionally rare surgical condition in children.

Case presentation

An 8-year-old boy presented with a 3-day history of progressive abdominal distension, frequent episodes of bilious vomiting, and failure to pass feces and flatus. Physical examination revealed a distended, tender abdomen without a palpable mass. Laboratory investigations showed leukocytosis (WBC 15,000/mm³) with 88 % neutrophils, while hemoglobin and platelet counts were within normal limits. Abdominal radiography demonstrated multiple dilated small bowel loops consistent with mechanical obstruction. After initial resuscitation and nasogastric decompression, an exploratory laparotomy was performed. Intraoperatively, the distal 35 cm of the ileum was found to be constricted by the perforated tip of the appendix, which had formed a fibrous band attaching to the adjacent small bowel mesentery. The involved bowel segment was viable, and an appendectomy alone was sufficient. The postoperative course was uneventful, with satisfactory urine output and early return of bowel function. The patient was discharged home in good condition on the second postoperative day.

Conclusion

Appendiceal band syndrome must be included in the differential diagnosis of children who develop a small bowel obstruction.

摘要继发于阑尾束综合征的小肠梗阻（SBO）在儿童中是一种非常罕见的外科疾病。病例表现：一名8岁男孩，有3天进行性腹胀史，胆汁性呕吐频繁发作，无法排出粪便和放屁。体格检查显示腹部肿胀、柔软，无可触及的肿块。实验室检查显示白细胞增多（白细胞15000 /mm3），中性粒细胞占88%，而血红蛋白和血小板计数在正常范围内。腹部x线显示多个扩张的小肠袢，符合机械阻塞。初步复苏和鼻胃减压后，进行剖腹探查。术中发现回肠远端35 cm处因阑尾末端穿孔而狭窄，阑尾末端形成纤维带，与邻近的小肠肠系膜相连。受累的肠段存活，仅行阑尾切除术就足够了。术后过程顺利，尿量满意，肠功能早期恢复。患者于术后第二天出院，情况良好。结论小儿小肠梗阻必须纳入阑尾束综合征的鉴别诊断。

{"title":"Appendiceal band syndrome in an 8-year-old patient: a case report","authors":"Zelalem Assefa Semgn , Chibahew Lante kebede , Ayanle Badmah Maigag , Maru Gamma Erge","doi":"10.1016/j.epsc.2025.103140","DOIUrl":"10.1016/j.epsc.2025.103140","url":null,"abstract":"<div><h3>Introduction</h3><div>Small bowel obstruction (SBO) secondary to appendiceal band syndrome is an exceptionally rare surgical condition in children.</div></div><div><h3>Case presentation</h3><div>An 8-year-old boy presented with a 3-day history of progressive abdominal distension, frequent episodes of bilious vomiting, and failure to pass feces and flatus. Physical examination revealed a distended, tender abdomen without a palpable mass. Laboratory investigations showed leukocytosis (WBC 15,000/mm<sup>3</sup>) with 88 % neutrophils, while hemoglobin and platelet counts were within normal limits. Abdominal radiography demonstrated multiple dilated small bowel loops consistent with mechanical obstruction. After initial resuscitation and nasogastric decompression, an exploratory laparotomy was performed. Intraoperatively, the distal 35 cm of the ileum was found to be constricted by the perforated tip of the appendix, which had formed a fibrous band attaching to the adjacent small bowel mesentery. The involved bowel segment was viable, and an appendectomy alone was sufficient. The postoperative course was uneventful, with satisfactory urine output and early return of bowel function. The patient was discharged home in good condition on the second postoperative day.</div></div><div><h3>Conclusion</h3><div>Appendiceal band syndrome must be included in the differential diagnosis of children who develop a small bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103140"},"PeriodicalIF":0.2,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419271","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

Early necrotizing enterocolitis in a 2-day-old term neonate: A case report 2天大新生儿早期坏死性小肠结肠炎1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-27 DOI: 10.1016/j.epsc.2025.103139

Samuel Kefiyalew Kelbessa , Sinbona Ararsa Keneni , Abdisa Ejeta Gedefa , Demelash Darota Dojamo

Introduction

Necrotizing enterocolitis (NEC) remains one of the most devastating and poorly understood intestinal diseases in neonates.

Case description

A 30-h-old male neonate was born at a gestational age (GA) of 39 weeks and 3 days, weighing 2800 g, with APGAR scores of 7 and 8 at one and 5 min, respectively. After delivery, the baby began breastfeeding and passed meconium within 16 hours, but developed bilious vomiting, abdominal distension, and dark-red rectal bleeding at 24 hours of age. Palpation of the abdomen elicited a crying response from the infant, and Per rectal exam showed blood on the examining catheter. The white blood cell count was 10.25 × 10^9/L, with a neutrophil percentage of 78.6 %. Abdominal imaging was not conducted due to logistical reasons. Given the clinical presentation, a diagnosis of intestinal malrotation with acute midgut volvulus and potential ischemia was made. The infant underwent laparotomy, revealing necrosis of the transverse and descending colon, which was excised, and the ascending colon was anastomosed to the sigmoid colon. A biopsy of the necrotic colon was consistent with necrotizing enterocolitis, revealing coagulative necrosis and pneumatosis cystoides intestinalis. Postoperatively, the infant had a nasogastric tube for five days, progressed to full feeding over a week, and was discharged on day 14, thriving at eight months post-operation.

Conclusion

Necrotizing enterocolitis must be included in the differential diagnosis of term neonates who develop bilious emesis, abdominal distension, and bloody stool.

坏死性小肠结肠炎（NEC）仍然是新生儿中最具破坏性和知之甚少的肠道疾病之一。病例描述1例30 h大男婴，出生时胎龄39周3天，体重2800 g， 1分钟和5分钟APGAR评分分别为7分和8分。分娩后，婴儿开始母乳喂养并在16小时内排出胎便，但24小时时出现胆汁性呕吐、腹胀和深红色直肠出血。腹部触诊引起婴儿的哭闹反应，直肠检查显示检查导管上有血。白细胞计数10.25 × 10^9/L，中性粒细胞占78.6%。由于后勤原因，未进行腹部影像学检查。结合临床表现，诊断为肠旋转不良伴急性中肠扭转及潜在缺血。婴儿接受剖腹手术，发现横结肠和降结肠坏死，切除，升结肠与乙状结肠吻合。坏死结肠的活检符合坏死性小肠结肠炎，显示凝固性坏死和肠囊性肺肿。术后5天进行鼻胃管插管，1周后完全进食，14天出院，术后8个月身体健康。结论坏死性小肠结肠炎应列入足月新生儿胆汁性呕吐、腹胀、便血的鉴别诊断。

{"title":"Early necrotizing enterocolitis in a 2-day-old term neonate: A case report","authors":"Samuel Kefiyalew Kelbessa , Sinbona Ararsa Keneni , Abdisa Ejeta Gedefa , Demelash Darota Dojamo","doi":"10.1016/j.epsc.2025.103139","DOIUrl":"10.1016/j.epsc.2025.103139","url":null,"abstract":"<div><h3>Introduction</h3><div>Necrotizing enterocolitis (NEC) remains one of the most devastating and poorly understood intestinal diseases in neonates.</div></div><div><h3>Case description</h3><div>A 30-h-old male neonate was born at a gestational age (GA) of 39 weeks and 3 days, weighing 2800 g, with APGAR scores of 7 and 8 at one and 5 min, respectively. After delivery, the baby began breastfeeding and passed meconium within 16 hours, but developed bilious vomiting, abdominal distension, and dark-red rectal bleeding at 24 hours of age. Palpation of the abdomen elicited a crying response from the infant, and Per rectal exam showed blood on the examining catheter. The white blood cell count was 10.25 × 10^9/L, with a neutrophil percentage of 78.6 %. Abdominal imaging was not conducted due to logistical reasons. Given the clinical presentation, a diagnosis of intestinal malrotation with acute midgut volvulus and potential ischemia was made. The infant underwent laparotomy, revealing necrosis of the transverse and descending colon, which was excised, and the ascending colon was anastomosed to the sigmoid colon. A biopsy of the necrotic colon was consistent with necrotizing enterocolitis, revealing coagulative necrosis and pneumatosis cystoides intestinalis. Postoperatively, the infant had a nasogastric tube for five days, progressed to full feeding over a week, and was discharged on day 14, thriving at eight months post-operation.</div></div><div><h3>Conclusion</h3><div>Necrotizing enterocolitis must be included in the differential diagnosis of term neonates who develop bilious emesis, abdominal distension, and bloody stool.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103139"},"PeriodicalIF":0.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419320","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

Letter to the editor in response to: "Laparoscopic gastroduodenal anastomosis (Billroth I) for the management of type-II pyloric atresia in Carmi syndrome: A case report." 致编辑的回复信：“腹腔镜胃十二指肠吻合术（Billroth I）治疗Carmi综合征ii型幽门闭锁1例报告。”

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-25 DOI: 10.1016/j.epsc.2025.103136

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

Non-operative management of a rare late gastrocolic fistula after percutaneous endoscopic gastrostomy in pediatrics 儿科经皮内镜胃造口术后罕见晚期胃结肠瘘的非手术治疗

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-25 DOI: 10.1016/j.epsc.2025.103134

Medhat elsayed , Eiman Yassir Musa Hussain , Sarah Magdy Abdelmohsen , Youmna Medhat , Ibrahim El Kashlan , Mohamed Mostafa Shabab

Introduction

Gastrocolic fistula is a rare but serious complication of percutaneous endoscopic gastrostomy (PEG).

Case presentation

A 13-year-old male with quadriplegic cerebral palsy and a PEG inserted two years prior presented with a one-month history of watery, foul-smelling diarrhea, weight loss, and bilateral lower-limb edema. Laboratory tests revealed anemia and hypoalbuminemia (1.9 g/dL), with otherwise unremarkable sepsis workup. Despite nutritional support and albumin infusions, his condition deteriorated. A contrast study performed via the PEG demonstrated opacification of the colon, confirming a gastrocolic fistula with the gastrostomy tube positioned within the transverse colon. The PEG was removed, and the patient was managed conservatively with total parenteral nutrition for ten days. A repeat contrast study confirmed complete fistula closure, after which nasogastric feeding was resumed. Three weeks later, a new gastrostomy was safely reinserted under laparoscopic guidance, with sustained clinical recovery.

Conclusion

Gastrocolic fistula must be suspected in patients that have a percutaneous endoscopic gastrostomy and develop new-onset diarrhea and malnutrition. Conservative management may lead to spontaneous closure of the fistula.

胃结肠瘘是经皮内镜胃造口术中一种罕见但严重的并发症。病例表现：一名13岁男性，四肢瘫痪性脑瘫，两年前植入了PEG，表现为一个月的水样、恶臭腹泻、体重减轻和双侧下肢水肿。实验室检查显示贫血和低白蛋白血症（1.9 g/dL），其他无明显败血症检查。尽管有营养支持和白蛋白输注，他的病情还是恶化了。通过PEG进行的对比研究显示结肠混浊，证实胃结肠瘘，胃造口管位于横结肠内。将PEG取出，对患者进行全肠外营养十天的保守治疗。重复对比研究证实瘘管完全闭合，之后恢复鼻胃喂养。三周后，在腹腔镜指导下安全地重新植入新的胃造口术，并持续临床恢复。结论经皮内镜胃造口术患者出现新发腹泻和营养不良时，必须怀疑胃结肠瘘。保守治疗可能导致瘘管自行关闭。

{"title":"Non-operative management of a rare late gastrocolic fistula after percutaneous endoscopic gastrostomy in pediatrics","authors":"Medhat elsayed , Eiman Yassir Musa Hussain , Sarah Magdy Abdelmohsen , Youmna Medhat , Ibrahim El Kashlan , Mohamed Mostafa Shabab","doi":"10.1016/j.epsc.2025.103134","DOIUrl":"10.1016/j.epsc.2025.103134","url":null,"abstract":"<div><h3>Introduction</h3><div>Gastrocolic fistula is a rare but serious complication of percutaneous endoscopic gastrostomy (PEG).</div></div><div><h3>Case presentation</h3><div>A 13-year-old male with quadriplegic cerebral palsy and a PEG inserted two years prior presented with a one-month history of watery, foul-smelling diarrhea, weight loss, and bilateral lower-limb edema. Laboratory tests revealed anemia and <strong>hypoalbuminemia (1.9 g/dL)</strong>, with otherwise unremarkable sepsis workup. Despite nutritional support and albumin infusions, his condition deteriorated. A contrast study performed via the PEG demonstrated opacification of the colon, confirming a <strong>gastrocolic fistula with the gastrostomy tube positioned within the transverse colon</strong>. The PEG was removed, and the patient was managed conservatively with total parenteral nutrition for ten days. A repeat contrast study confirmed <strong>complete fistula closure</strong>, after which nasogastric feeding was resumed. Three weeks later, a new gastrostomy was safely reinserted under laparoscopic guidance, with sustained clinical recovery.</div></div><div><h3>Conclusion</h3><div>Gastrocolic fistula must be suspected in patients that have a percutaneous endoscopic gastrostomy and develop new-onset diarrhea and malnutrition. Conservative management may lead to spontaneous closure of the fistula.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103134"},"PeriodicalIF":0.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419383","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

Hepatic rupture in a neonate with hemophilia B: a case report 新生儿血友病B肝破裂1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-24 DOI: 10.1016/j.epsc.2025.103137

Shuai Liu, Ruo-Yi Wang, Chun-Tian Wang

Introduction

Hepatic rupture in neonates is extremely rare and often fatal. Its association with hemophilia B has scarcely been reported.

Case presentation

A male neonate was born via cesarean section at 39 weeks of gestation with a birth weight of 3.6 kg and Apgar scores of 10 and 10. The prenatal course was without complications and there was no family history of bleeding disorders. At 59 hours of life the patient developed with abrupt abdominal distension, which progressed to hemodynamic shock by 61 hours of life. Bloodwork revealed a hemoglobin level of 4.5 g/dL and severe metabolic acidosis (pH 6.57, lactate 27 mmol/L). A bedside ultrasound combined with abdominal paracentesis confirmed hemoperitoneum. Emergency laparotomy was performed at 63 hours of life. We found a 3-cm fissure on the right hepatic lobe, which was surgically repaired. The patient had a postoperative uneventful recovery and was discharged home in stable condition 2 weeks later. Coagulation function assays confirmed factor 9 activity of 2 %, confirming the diagnosis of hemophilia B. At 6-month of follow-up he has had no recurrent bleeding episodes and remains clinically stable on regular factor replacement therapy.

Conclusions

Neonatal hepatic rupture may be the initial manifestation of an underlying bleeding disorder such as hemophilia B. Neonates with spontaneous hepatic rupture should undergo testing to rule out coagulation disorders.

新生儿肝破裂极为罕见，通常是致命的。它与B型血友病的关系几乎没有报道。病例介绍1例男性新生儿在妊娠39周通过剖宫产出生，出生体重3.6 kg， Apgar评分为10和10。产前无并发症，无出血性疾病家族史。患者在出生后59小时出现突发性腹胀，并在出生后61小时发展为血流动力学休克。血检显示血红蛋白水平为4.5 g/dL，严重代谢性酸中毒（pH 6.57，乳酸27 mmol/L）。床边超声联合腹部穿刺术证实腹腔积血。在出生后63小时进行了紧急剖腹手术。我们发现右肝叶有一个3厘米的裂缝，手术修复。患者术后恢复顺利，2周后出院，病情稳定。凝血功能检测证实因子9活性为2%，确诊为b型血友病。随访6个月，患者未出现复发性出血，经常规因子替代治疗后临床稳定。结论新生儿肝破裂可能是潜在出血性疾病如b型血友病的初始表现。新生儿自发性肝破裂应检查排除凝血功能障碍。

{"title":"Hepatic rupture in a neonate with hemophilia B: a case report","authors":"Shuai Liu, Ruo-Yi Wang, Chun-Tian Wang","doi":"10.1016/j.epsc.2025.103137","DOIUrl":"10.1016/j.epsc.2025.103137","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic rupture in neonates is extremely rare and often fatal. Its association with hemophilia B has scarcely been reported.</div></div><div><h3>Case presentation</h3><div>A male neonate was born via cesarean section at 39 weeks of gestation with a birth weight of 3.6 kg and Apgar scores of 10 and 10. The prenatal course was without complications and there was no family history of bleeding disorders. At 59 hours of life the patient developed with abrupt abdominal distension, which progressed to hemodynamic shock by 61 hours of life. Bloodwork revealed a hemoglobin level of 4.5 g/dL and severe metabolic acidosis (pH 6.57, lactate 27 mmol/L). A bedside ultrasound combined with abdominal paracentesis confirmed hemoperitoneum. Emergency laparotomy was performed at 63 hours of life. We found a 3-cm fissure on the right hepatic lobe, which was surgically repaired. The patient had a postoperative uneventful recovery and was discharged home in stable condition 2 weeks later. Coagulation function assays confirmed factor 9 activity of 2 %, confirming the diagnosis of hemophilia B. At 6-month of follow-up he has had no recurrent bleeding episodes and remains clinically stable on regular factor replacement therapy.</div></div><div><h3>Conclusions</h3><div>Neonatal hepatic rupture may be the initial manifestation of an underlying bleeding disorder such as hemophilia B. Neonates with spontaneous hepatic rupture should undergo testing to rule out coagulation disorders.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103137"},"PeriodicalIF":0.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526285","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

Phytobezoar causing small bowel obstruction in a 4-year-old girl: a case report 植牛黄致4岁女童小肠梗阻1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-10-23 DOI: 10.1016/j.epsc.2025.103138

Hailemariam Yohannes Asefa , Mesfin Tesera Wassie , Belete Chaklu Assefa , Berhanu Shetie Sefene , Yonas Fekadu Yilma , Wondwosen Mengist Dereje

Introduction

Bezoar-induced small bowel obstruction is an uncommon condition. Its diagnosis is frequently difficult because of nonspecific symptoms, and surgical exploration remains the definitive treatment to restore bowel function and relieve the obstruction.

Case presentation

A four-year-old girl with Down syndrome was admitted to the malnutrition ward due to failure to thrive since birth. She was diagnosed with severe acute malnutrition and started on appropriate management. On her second day, she developed repeated vomiting of ingested material mixed with grass, followed 12 h later by progressive abdominal distension and inability to pass feces or flatus. Her vital signs showed a pulse of 126 bpm, respiratory rate 26/min, and temperature 37.4 °C. Surgical consultation and abdominal radiography suggested small bowel obstruction. She was taken to the operating room, and exploratory laparotomy revealed a completely obstructing mass 40 cm from the ileocecal valve. An enterotomy was performed, and the bezoar was carefully removed. Other bowel segments were examined to rule out additional bezoars. Postoperatively, she remained stable and was transferred back to the malnutrition ward after two days. She continued nutritional management for two weeks and was discharged with significant improvement. Outpatient Department follow-up at two, four, and eight weeks revealed no new complaints. Her parents were counseled and she was discharged from the hospital.

Conclusion

Bezoars should be included in the differential diagnosis of children who develop a small bowel obstruction.

牛黄引起的小肠梗阻是一种罕见的疾病。由于非特异性症状，其诊断往往很困难，手术探查仍然是恢复肠功能和缓解梗阻的最终治疗方法。病例介绍一名患有唐氏综合症的四岁女孩因出生后发育不良被送进营养不良病房。她被诊断为严重急性营养不良，并开始接受适当的治疗。第2天，患者出现反复呕吐，呕吐物中含有草，12小时后出现进行性腹胀，无法排便或放屁。生命体征：脉搏126 bpm，呼吸频率26/min，体温37.4℃。外科会诊和腹部x线检查提示小肠梗阻。她被送往手术室，剖腹探查发现离回盲瓣40厘米处有一个完全阻塞的肿块。进行肠切开术，并小心地取出牛黄。检查了其他肠段以排除额外的牛黄。术后病情稳定，两天后转回营养不良病房。她继续进行了两周的营养管理，出院时明显好转。门诊随访2周、4周和8周均未发现新的主诉。她的父母接受了劝告，她出院了。结论小儿小肠梗阻的鉴别诊断应纳入牛黄检查。

{"title":"Phytobezoar causing small bowel obstruction in a 4-year-old girl: a case report","authors":"Hailemariam Yohannes Asefa , Mesfin Tesera Wassie , Belete Chaklu Assefa , Berhanu Shetie Sefene , Yonas Fekadu Yilma , Wondwosen Mengist Dereje","doi":"10.1016/j.epsc.2025.103138","DOIUrl":"10.1016/j.epsc.2025.103138","url":null,"abstract":"<div><h3>Introduction</h3><div>Bezoar-induced small bowel obstruction is an uncommon condition. Its diagnosis is frequently difficult because of nonspecific symptoms, and surgical exploration remains the definitive treatment to restore bowel function and relieve the obstruction.</div></div><div><h3>Case presentation</h3><div>A four-year-old girl with Down syndrome was admitted to the malnutrition ward due to failure to thrive since birth. She was diagnosed with severe acute malnutrition and started on appropriate management. On her second day, she developed repeated vomiting of ingested material mixed with grass, followed 12 h later by progressive abdominal distension and inability to pass feces or flatus. Her vital signs showed a pulse of 126 bpm, respiratory rate 26/min, and temperature 37.4 °C. Surgical consultation and abdominal radiography suggested small bowel obstruction. She was taken to the operating room, and exploratory laparotomy revealed a completely obstructing mass 40 cm from the ileocecal valve. An enterotomy was performed, and the bezoar was carefully removed. Other bowel segments were examined to rule out additional bezoars. Postoperatively, she remained stable and was transferred back to the malnutrition ward after two days. She continued nutritional management for two weeks and was discharged with significant improvement. Outpatient Department follow-up at two, four, and eight weeks revealed no new complaints. Her parents were counseled and she was discharged from the hospital.</div></div><div><h3>Conclusion</h3><div>Bezoars should be included in the differential diagnosis of children who develop a small bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103138"},"PeriodicalIF":0.2,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419270","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