Journal of Pediatric Surgery Case Reports最新文献

{"title":"Syndromic and non-syndromic Hirschsprung disease with sensorineural hearing loss: A case series","authors":"Fareeda Galley ,&nbsp;Ebenezer Akomea-Agyin ,&nbsp;Robert Sagoe ,&nbsp;Anthony Davor ,&nbsp;Regina Darko-Asante","doi":"10.1016/j.epsc.2025.103125","DOIUrl":"10.1016/j.epsc.2025.103125","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurocristopathies (NCPs) arise from abnormalities in the formation and migration of neural crest cells (NCCs) during fetal development. These lead to clinical manifestations in various body parts where NCCs contribute to development. They include the failure of NCCs to migrate completely into the distal colon, leading to Hirschsprung disease; failure to contribute to inner ear formation, resulting in sensorineural hearing loss; and failure to contribute to pigmentation of various parts, including the iris. These abnormalities can present in combinations found in both syndromic and non-syndromic children.</div></div><div><h3>Cases presentation</h3><div>We report on two cases that exhibit different combinations of the clinical manifestations of NCPs. The first is a 2-year-old female delivered at term with delayed passage of meconium but presented at 3 months of life with constipation and abdominal distention. She was managed with rectal washouts, and a rectal biopsy confirmed Hirschsprung disease. She had a trans-endorectal pull-through done at 2 years for a short segment Hirschsprung disease. The mother later reported some developmental delays, which led to the identification of the child's inability to respond to her name or startle to loud noise. An ear assessment revealed bilateral sensorineural hearing loss, believed to be congenital in origin. This was managed with a left-sided cochlear implant, and the child is currently undergoing rehabilitation and has yet to develop her speech. The second is an 18-month-old male believed to be the first reported case of Waardenburg-Shah in Ghana. The child was delivered at term with normal passage of meconium but developed constipation after introduction of family feeds at 6 months and was managed at home by parents with herbal enemas till 16 months of age, when enemas could not relieve constipation. The mother presented the child to the hospital on account of chronic constipation and inability to gain weight. Examination revealed a malnourished child with blue colored iris, abdominal distention, and digital rectal examination of an empty rectum with a gush of feces after removing the finger. Rectal washouts were done, and a rectal biopsy confirmed Hirschsprung disease. A hearing assessment revealed bilateral sensorineural hearing impairment, which was managed with hearing aids. The child is still undergoing nutritional rehabilitation towards definitive surgery.</div></div><div><h3>Conclusion</h3><div>Patients with Hirschsprung disease should undergo early hearing assessment to rule out Hirschsprung-associated sensorineural hearing loss. The combination of Hirschsprung disease and sensorineural hearing loss may or may not be syndromic.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103125"},"PeriodicalIF":0.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365554","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":"Acute appendicitis caused by Enterobius vermicularis in an 8-year-old child: a case report","authors":"Autumn Bertch ,&nbsp;Kimber Boyko ,&nbsp;Irina Stout","doi":"10.1016/j.epsc.2025.103130","DOIUrl":"10.1016/j.epsc.2025.103130","url":null,"abstract":"<div><h3>Background</h3><div><em>Enterobius</em> vermicularis is a common pediatric parasite, and appendicitis is a frequent surgical emergency in children; however, it is uncommon for <em>E. vermicularis</em> infection to be the underlying cause.</div></div><div><h3>Case presentation</h3><div>An 8-year-old girl presented with fever, vomiting, and right lower quadrant abdominal pain. Laboratory evaluation demonstrated leukocytosis (WBC 19.3 × 10⁹/L) with neutrophilia (14.4 × 10⁹/L) and eosinophilia (1.0 × 10⁹/L). Contrast-enhanced CT revealed a dilated, fluid-filled appendix with mucosal thickening and a distal appendicolith, consistent with acute appendicitis. She underwent uncomplicated laparoscopic appendectomy and was discharged the following day, tolerating a regular diet. Histopathology confirmed acute appendicitis with E. vermicularis organisms present. She was prescribed pyrantel pamoate oral suspension 50 mg/mL, 4.8 mL by mouth as a single dose, with a repeat dose scheduled two weeks later, and all household contacts were advised to undergo treatment. Notably, she had a history of recurrent conjunctivitis and vulvovaginitis, prompting referral to ophthalmology to evaluate for rare extraintestinal involvement.</div></div><div><h3>Conclusion</h3><div>Parasitic infection of the appendix should be suspected in pediatric patients with acute appendicitis and eosinophilia to ensure complete treatment with anti-parasitic therapy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103130"},"PeriodicalIF":0.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365553","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":"Ultrasound-guided retrieval of a retain guidewire in the femoral region of a 4-year-old male with anasarca: a case report","authors":"Saswati Behera ,&nbsp;Raksha Ranjan ,&nbsp;Navdeep Singh Dhoat ,&nbsp;Gopal Krishan Jalwal ,&nbsp;Charmi Patidar ,&nbsp;Sourabh Meena","doi":"10.1016/j.epsc.2025.103132","DOIUrl":"10.1016/j.epsc.2025.103132","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous central venous catheters (CVCs) are essential for children with difficult intravenous access but carry a risk of complications. Guidewire-related incidents, such as fracture or retention, are rare but serious. These challenges are exacerbated in patients with severe generalized anasarca, where physiological changes can complicate even standard procedures.</div></div><div><h3>Case scenario</h3><div>A 4-year-old male with nephrotic syndrome and severe anasarca on mechanical ventilation required a central venous access. During an ultrasound guided attempt via the right femoral vein, the J-shaped guidewire met with some resistance, after which it was withdrawn with some force. Due to severe anasarca, bedside ultrasonography (USG) failed to localize the retained segment thus making it impossible to explore. The child was sick and intubated. Upon gradual decrease in anasarca, as the bedside X-ray confirmed a knotted, retained piece in the thigh, two more attempts of bedside USG guided exploration under sedation was tried but failed. Two days later, cellulitis developed at the site. The child was taken to the operating room, where an ultrasound-guided needle was used to mark the exact location of the foreign body. This guided surgical incision and dissection, leading to the successful retrieval of the knotted guidewire.</div></div><div><h3>Conclusion</h3><div>Ultrasound guidance seems to be an effective way to localize retained fragments of guidewires located in the soft tissue of the thigh in children.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103132"},"PeriodicalIF":0.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365552","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":"Posterior sagittal anorectoplasty for a recto-urethral fistula on a 14-year-old boy: a case report","authors":"Fekadu Mengesha WoldeAmanuel,&nbsp;Ephrem Nidaw Kergo,&nbsp;Hana Abebe Gebreselassie,&nbsp;Zelalem Assefa Semegn","doi":"10.1016/j.epsc.2025.103124","DOIUrl":"10.1016/j.epsc.2025.103124","url":null,"abstract":"<div><h3>Introduction</h3><div>Anorectal malformations (ARMs) are typically diagnosed and managed during infancy. Delayed treatment in adolescents is exceptionally rare.</div></div><div><h3>Case presentation</h3><div>A 14-year-old boy from a rural area was seen at our pediatric surgery unit with a sigmoid colostomy placed during the neonatal period. He had been lost to follow-up since the neonatal discharge. On examination, he was well-nourished and weighed 46 kg. He had no anal opening, but his gluteal muscles were well developed, the intergluteal cleft was prominent, and an anal dimple was present. A distal colostogram demonstrated a mildly dilated rectum terminating just below the sacrum, and a rectobulbar urethral fistula. His sacral ratio was 0.78. He was taken to the operating room for an elective posterior sagittal anorectoplasty (PSARP). Electrocautery mapping of the sphincter complex guided a midline posterior sagittal incision from the sacrum to the anal dimple. We ligated and repaired the rectobulbar urethral fistula with interrupted 4-0 reabsorbable braided sutures. The rectum was mobilized, tapered to fit tension-free within the sphincter complex, and the neoanus was positioned centrally. The colo-cutaneous anastomosis was fashioned with sixteen interrupted 3-0 reabsorbable braided sutures. The postoperative course was uneventful. Anal dilations began on postoperative day 14 and continued for three months, achieving an adequate anal caliber. The colostomy was closed safely in the fourth postoperative month. He is currently fully continent.</div></div><div><h3>Conclusion</h3><div>Posterior sagittal anorectoplasty seems to be an effective approach for the repair of anorectal malformations in teenagers who had not had the repair done during infancy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103124"},"PeriodicalIF":0.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419272","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":"Precocious puberty in a 20-month-old girl secondary to an ovarian juvenile granulosa cell tumor: a case report","authors":"Syrine Laribi ,&nbsp;Myriam Ben Fredj ,&nbsp;Sabrine Ben Youssef ,&nbsp;Afef Toumi ,&nbsp;Sawsen Chakroun ,&nbsp;Lassaad Sahnoun","doi":"10.1016/j.epsc.2025.103133","DOIUrl":"10.1016/j.epsc.2025.103133","url":null,"abstract":"<div><h3>Background</h3><div>Juvenile granulosa cell tumors (JGCTs) are extremely rare ovarian neoplasms, accounting for a small fraction of pediatric ovarian tumors. Their hormonal activity often manifests as precocious puberty, which may be the first sign of the disease.</div></div><div><h3>Case presentation</h3><div>We report the case of a 20-month-old girl presenting with persistent vaginal bleeding for one month. She was born at term by cesarean section after an uncomplicated pregnancy, with an unremarkable medical history. Her mother reported breast development starting six months earlier. On examination, the patient appeared in good general condition, with Tanner stage II breast and pubic hair development and no clitoromegaly. Abdominopelvic ultrasonography revealed a large mixed solid–cystic right ovarian mass measuring 68 × 60 mm with intralesional fluid and uterine enlargement. Pelvic MRI confirmed an 80-mm right ovarian mass with both solid and cystic components and no locoregional invasion or abnormal vascular flow. Laboratory tests showed elevated estradiol (68 pg/mL; normal &lt;62 pg/mL), lactate dehydrogenase (269 U/L; normal &lt;200 U/L), and inhibin B (985 pg/mL; normal &lt;200 pg/mL), with normal human chorionic gonadotropin, progesterone, and alpha-fetoprotein levels. The patient underwent right salpingo-oophorectomy to ensure complete excision and to avoid potential tumor cell spillage or future complications., and histopathological examination confirmed a juvenile granulosa cell tumor. Postoperative follow-up over five months showed complete resolution of symptoms and no recurrence.</div></div><div><h3>Conclusion</h3><div>Ovarian juvenile granulosa cell tumors must be promptly ruled out in females who present precocious puberty.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103133"},"PeriodicalIF":0.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324641","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":"Juvenile granulosa cell tumor in a teenager: a case report","authors":"Ian Cummings-Ruiz ,&nbsp;Nicole A. Martínez-Martínez ,&nbsp;Kenneth Avilés-Fernández ,&nbsp;Yaiel Rodríguez-Avilés ,&nbsp;Victor Ortiz-Justiniano","doi":"10.1016/j.epsc.2025.103131","DOIUrl":"10.1016/j.epsc.2025.103131","url":null,"abstract":"<div><h3>Introduction</h3><div>Juvenile granulosa cell tumors (JGCTs) are rare ovarian sex cord–stromal neoplasms that primarily affect young females and are often detected early due to hyperestrogenic manifestations.</div></div><div><h3>Case presentation</h3><div>A 17-year-old female with a history of seizures and hypothyroidism presented with a 5-month history of intermittent abdominal pain, nausea, anorexia, and constant lower-back discomfort associated with progressive abdominal distention. Physical examination revealed marked abdominal distention with striae. Laboratory studies demonstrated elevated lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), as well as beta-human chorionic gonadotropin (β-hCG). An abdominopelvic computed tomography (CT) scan revealed a 35.7 × 26 × 19.1 cm predominantly cystic adnexal mass with eccentric solid components and no evidence of ascites or lymphadenopathy. Tumor markers, including alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA), were negative. Surgical exploration via periumbilical incision revealed a large cystic mass arising from the left adnexa. Controlled decompression with a Veress needle allowed safe mobilization of the tumor, yielding 4.8 L of cystic fluid that was sent for cytological evaluation. The mass was then excised from the abdominal cavity, and a left salpingo-oophorectomy was performed. Pathology confirmed a JGCT with an intact capsule, classified as stage IA according to the Federation of Gynecology and Obstetrics (FIGO) criteria. Postoperatively, the patient recovered well and remained asymptomatic, with no recurrence during a 3-year follow-up period.</div></div><div><h3>Conclusion</h3><div>JGCT should be considered as a differential diagnosis of large ovarian tumors in adolescents, even in the absence of hormonal manifestations.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103131"},"PeriodicalIF":0.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323968","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":"Large congenital lymphatic venous malformation in a twin pregnancy: A case report","authors":"Azalia Avila ,&nbsp;Nina Kosciuszek ,&nbsp;Christine M. Finck ,&nbsp;DonnaMaria E. Cortezzo","doi":"10.1016/j.epsc.2025.103126","DOIUrl":"10.1016/j.epsc.2025.103126","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital lymphatic venous malformations (LVMs) are rare, slow-flow vascular anomalies with highly variable presentations. While most pose no considerable risk to the pregnant individual or fetus, larger complex lesions, particularly in monochorionic-diamniotic twin pregnancies, are uncommon and present unique diagnostic and management challenges.</div></div><div><h3>Case presentation</h3><div>A 27-year-old gravida 4, para 2 pregnant individual presented at 23 0/7 weeks' gestation with a monochorionic-diamniotic twin pregnancy. Ultrasound and fetal magnetic resonance imaging (MRI) revealed a large T2 hyperintense cystic mass extending from the chest wall into the neck, axilla, and arm of twin B, consistent with a LVM. Multidisciplinary evaluation guided prenatal surveillance. At 31 2/7 weeks’ gestation, evolving hydrops and severe maternal pre-eclampsia necessitated cesarean delivery. Twin B required intubation for airway compression and remained hemodynamically stable. MRI confirmed a complex and extensive LVM with an extensive venous component. After multidisciplinary discussion, she was treated with rapamycin and later underwent limited resection, drainage and vacuum assisted closure of the left neck lesion, leading to resolution of the lesion with subsequent extubation by day of life (DOL) 43. She subsequently underwent limited aspiration, drainage, and vacuum assisted closure of the left chest wall. She demonstrated clinical improvement with early initiation of supportive therapies.</div></div><div><h3>Conclusion</h3><div>Large fetal lymphovascular malformations require close monitoring and imaging surveillance throughout gestation due to the risk of potential lesion progression and hydrops fetalis.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103126"},"PeriodicalIF":0.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323967","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":"Gastrojejunostomy and Ladd's procedure for the management of obstructive preduodenal portal vein and intestinal malrotation in an adolescent: A case report","authors":"Vitalis C. Osuji,&nbsp;Michael Tirabassi","doi":"10.1016/j.epsc.2025.103121","DOIUrl":"10.1016/j.epsc.2025.103121","url":null,"abstract":"<div><h3>Introduction</h3><div>A potential cause of bowel obstruction in the setting of intestinal malrotation is preduodenal portal vein (PDPV). It is a rare congenital anomaly that can be associated with duodenal atresia, duodenal web, or annular pancreas.</div></div><div><h3>Case presentation</h3><div>A 14-year-old female with a long history of failure to thrive presented to the hospital with abdominal pain. She described the pain as intermittent, responsive to pain medication, with radiation to the back. Her mother provided a history of approximately 10–15lbs of unintentional weight loss in 3–4 months, and intermittent symptoms that had been ongoing for over one year. She underwent a computed tomography (CT) of the abdomen/pelvis with intravenous contrast and was found to have intestinal malrotation with splenosis, inverse relationship of the superior mesenteric artery and superior mesenteric vein, the appendix in the left lower quadrant, and uterine didelphys. She underwent an upper gastrointestinal (UGI) study with small bowel follow-through that confirmed the malrotation, without bowel obstruction or volvulus. Due to persistent symptoms, she was taken to the operating room for an exploratory laparoscopy. We found that she had a PDPV, which was likely the cause of her symptoms. The PDPV was very close to the pylorus. After careful dissection, we were unable to obtain adequate duodenal length proximal to the PDPV to do a duodeno-duodenostomy. Therefore, we decided to proceed with gastrojejunostomy, followed by a Ladd's procedure. She had an uncomplicated recovery and was discharged home on postoperative day 10. Nine months after the operation, she remains asymptomatic.</div></div><div><h3>Conclusion</h3><div>PDPV can present as the primary cause of duodenal obstruction. A gastrojejunostomy appears to be an effective treatment for cases in which a duodeno-duodenostomy is not doable.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103121"},"PeriodicalIF":0.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270087","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":"Acute abdominal pain due to torsion and gangrene of a Meckel's diverticulum: a case report","authors":"Ashagre Gebremichael Ganta ,&nbsp;Amanu Gashaw","doi":"10.1016/j.epsc.2025.103120","DOIUrl":"10.1016/j.epsc.2025.103120","url":null,"abstract":"<div><h3>Introduction</h3><div>Meckel's diverticulum is a common congenital anomaly that can lead to serious complications. Axial torsion is a rare event that can result in vascular compromise, ischemia, and gangrene. Its clinical presentation is non-specific and can be indistinguishable from other causes of a surgical acute abdomen.</div></div><div><h3>Case presentation</h3><div>A 4-year-old male presented to the emergency department with a four-day history of progressive abdominal pain that had become constant, severe, and diffuse. His symptoms were accompanied by bilious vomiting, high-grade fever (up to 39.8 °C), profound lethargy, and anorexia. On examination, he was tachycardic, febrile, and exhibited a toxic clinical appearance. His abdomen was significantly distended, with profound tenderness, involuntary guarding, rigidity, and rebound tenderness indicative of generalized peritonitis; bowel sounds were absent. Laboratory investigations revealed leukocytosis of 40.0 × 10⁹/L with neutrophilia, and a markedly elevated CRP of 105 mg/L. Abdominal x-ray demonstrated non-specific air-fluid levels, and large volume of complex free fluid was seen on a bedside ultrasonography. Following vigorous fluid resuscitation and broad-spectrum intravenous antibiotics, the patient underwent an urgent exploratory laparotomy. Intraoperatively, the appendix appeared normal. We found a gangrenous Meckel's diverticulum located 55 cm proximal to the ileocecal valve, which had undergone a 540-degree axial torsion around its narrow pedicle, resulting in ischemia without perforation. A segmental small bowel resection with primary anastomosis was performed. Histopathology confirmed transmural hemorrhagic infarction and coagulative necrosis. The postoperative course was uneventful, with return of bowel function on the second postoperative day. The patient was discharged home on postoperative day 10.</div></div><div><h3>Conclusion</h3><div>Torsion of a Meckel's diverticulum should be included in the differential diagnosis of children who develop acute abdominal pain.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103120"},"PeriodicalIF":0.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325494","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":"Sacrococcygeal epidermal inclusion cyst in a child: A case report","authors":"Saswati Behera ,&nbsp;Satvik Dharmaik ,&nbsp;Santosh Behera ,&nbsp;Ankit Rai ,&nbsp;Gargi Kapatia ,&nbsp;Ashish Kumar","doi":"10.1016/j.epsc.2025.103118","DOIUrl":"10.1016/j.epsc.2025.103118","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidermal inclusion cysts (EIC) are common benign lesions, but their occurrence in the sacrococcygeal area, particularly in the pediatric population, is an exceedingly rare event. Due to their location, they must be differentiated from other more serious retrorectal tumors.</div></div><div><h3>Case presentation</h3><div>A 10-year-old male child presented with a congenital, firm, non-fluctuant swelling over his sacrococcygeal region that had been slowly increasing in size since birth. There was no associated urine or fecal incontinence or any history of trauma. On examination, the swelling was firm to touch, non-fluctuant, mobile and located in the midline of the natal cleft just superior to the anus. There was no associated erythema, overlying skin changes, draining sinus, or pain upon handling. Per rectal examination revealed no palpable mass. Ultrasonography (USG) showed a cystic homogenous well-defined mass of 3x2.5 × 3 centimetres without any spinal communication or bony deformity. Magnetic resonance imaging (MRI) confirmed the USG findings. The patient underwent complete surgical excision of the mass under general anesthesia in jack knife prone position. Histopathological examination confirmed the diagnosis of an epidermal inclusion cyst, showing a cyst lined by stratified squamous epithelium and containing keratin flakes, with no evidence of malignancy. The patient had an uncomplicated recovery with no postoperative neurological deficits. He is doing well and under regular follow up.</div></div><div><h3>Conclusion</h3><div>Epidermal inclusion cyst must be considered in the differential diagnosis of children who present with sacrococcygeal lesions. Complete surgical resection is the treatment of choice.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"122 ","pages":"Article 103118"},"PeriodicalIF":0.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325493","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}