Journal of Pediatric Surgery Case Reports最新文献_第9页

Vascular malformation of small bowel causing iron deficiency anemia in a child: case report 儿童小肠血管畸形引起缺铁性贫血1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-15 DOI: 10.1016/j.epsc.2025.103106

Chibehew Lante Kebede, Biniyam Gebremedhin Godu, Ephrem Nidaw Kerego, Zelalem assefa semegn, Ayanesh Yihune Sewenet, Wondwosen Alemu

Introduction

Vascular malformations of the small bowel in children are extremely rare and often present with nonspecific symptoms.

Case presentation

A 7-year-old male presented with one year of progressive easy fatigability and a single episode of bright red rectal bleeding. Laboratory evaluation showed microcytic hypochromic anemia with a hemoglobin value of 6.5 g/dL, requiring a transfusion of packed red blood cells. The rectal exam was normal. Imaging studies, including abdominal ultrasound, CT scan, and magnetic resonance angiography, identified a 5× 7 x 3-cm lobulated, low-flow vascular malformation in the small bowel. The patient was taken to the operating room for an exploratory laparotomy, which was done through a midline incision. We found a 5 x 6-cm vascular malformation on a jejunal loop, 40 cm distal to the ligament of Treitz. The malformation appeared to involve the entire circumference of the affected jejunal segment. We resected the jejunal segment that contained the vascular malformation including 1 extra cm of healthy-appearing jejunum on each side, and did an end-to-end anastomosis. The postoperative recovery was uneventful. Enteral feedings were started on the second postoperative day, and he was discharged home on the fourth postoperative day. The histopathological analysis was consistent with a vascular malformation with dilated blood vessels. At one-month follow-up he showed resolution of the anemia and had no recurrence of symptoms.

Conclusion

Vascular malformations can involve the small bowel and be the source of occult or obvious gastrointestinal bleeding. They should be considered in the differential diagnosis of children who develop iron deficiency anemia of unknown etiology.

儿童小肠血管畸形极为罕见，通常表现为非特异性症状。病例介绍：一名7岁男性，表现为一年的进行性易疲劳和一次亮红色直肠出血。实验室评估显示小细胞性低色素贫血，血红蛋白值为6.5 g/dL，需要输血填充红细胞。直肠检查正常。影像学检查，包括腹部超声、CT扫描和磁共振血管造影，在小肠发现一个5× 7 × 3厘米的分叶状、低流量血管畸形。患者被带到手术室进行剖腹探查术，这是通过中线切口完成的。我们在Treitz韧带远端40cm的空肠袢上发现了一个5x6cm的血管畸形。畸形似乎涉及整个周围的影响空肠段。我们切除了含有血管畸形的空肠段，包括每侧多1厘米看起来健康的空肠，并做了端到端吻合。术后恢复顺利。术后第2天开始肠内喂养，第4天出院。组织病理学分析符合血管畸形和血管扩张。在一个月的随访中，他的贫血症状消失，没有复发。结论血管畸形可累及小肠，是隐性或显性消化道出血的根源。在病因不明的儿童缺铁性贫血的鉴别诊断中应考虑这些因素。

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引用次数: 0

Incarcerated umbilical cord hernia: a case report 嵌顿性脐带疝1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-12 DOI: 10.1016/j.epsc.2025.103107

Mohammed Alra'e , Maaweya Jabareen , Wasef Alhroub , Radwan Abukarsh

Introduction

Congenital hernia of the umbilical cord (CHUC) is a rare developmental anomaly that results from the incomplete return of the midgut into the abdominal cavity during fetal development. It is often misdiagnosed as a small omphalocele and may be associated with serious gastrointestinal complications, although such occurrences are infrequently reported in the literature.

Case presentation

A 4-day-old male neonate was brought due to bilious emesis, abdominal distension, and failure to pass meconium since birth. The perinatal history was unremarkable, but detailed ultrasonography had not been performed. Postnatally, the patient had poor sucking and intolerance to breastfeeding. Initial examination revealed an incarcerated umbilical cord hernia. The abdomen was markedly distended with full flanks, shiny erythematous skin, and tenderness with guarding, raising suspicion for a bowel perforation and peritonitis. Reduction of the hernia was not attempted. Radiographic imaging revealed pneumoperitoneum. The patient was taken for an emergency exploratory laparotomy, which was done through a transverse supraumbilical (infraumbilical, please see the figure) incision. We found a congenital hernia of the umbilical cord (CHUC), a segment of ileum incarcerated in the CHUC that had a Meckel's diverticulum, was necrotic and had two sites of perforation. We resected the necrotic segment which was 24 cm long, and did a primary end-to-end anastomosis. Enteral feedings with formula were initiated on postoperative day 5 and fully tolerated by the postoperative day 10. The patient was discharged in stable condition on the 16th day of life.

Conclusion

Umbilical cord hernias are generally benign malformations but can occasionally become incarcerated, causing intestinal obstruction and even intestinal necrosis.

摘要先天性脐带疝（CHUC）是一种罕见的发育异常，是由于胎儿发育期间中肠未完全返回腹腔所致。它经常被误诊为小脐膨出，并可能与严重的胃肠道并发症有关，尽管这种情况在文献中很少报道。病例介绍：一名4天大男婴因胆汁性呕吐、腹胀、出生后未能排出胎便而被送来。围产期病史无明显差异，但未做详细的超声检查。出生后，患者吸吮不良，不耐受母乳喂养。初步检查显示为嵌顿性脐带疝。腹部明显肿胀，腹部饱满，皮肤有光泽，有保护，压痛，怀疑肠穿孔和腹膜炎。没有尝试疝气复位。影像学显示气腹。患者接受紧急剖腹探查术，手术通过脐上（脐下，见图）横切口。我们发现先天性脐疝（CHUC），一段回肠嵌顿在CHUC，有一个梅克尔憩室，是坏死的，有两个穿孔的地方。我们切除了24厘米长的坏死段，并进行了初级端到端吻合。术后第5天开始肠内喂养配方奶，术后第10天完全耐受。患者于出生后第16天出院，病情稳定。结论脐带疝一般为良性畸形，但偶尔会发生嵌顿，引起肠梗阻甚至肠坏死。

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引用次数: 0

Small bowel intussusceptions secondary to Ascaris lumbricoides in a child: a case report 儿童蛔虫继发性小肠肠套叠1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-12 DOI: 10.1016/j.epsc.2025.103108

Hana Abebe Gebreselassie, Zelalem Assefa Semegn, Ephrem Nidaw Kergo, Chibhaew Lante Kebede, Ayanesh Yihune Sewenet

Introduction

Intussusception is one of the most common causes of bowel obstruction in children. Most cases are idiopathic without a pathological lead point, and only about 5 % have an identifiable cause, with Meckel's diverticulum being the most frequent. Ascaris worms are an exceptionally rare lead point in pediatric intussusception.

Case presentation

A 10-year-old girl presented with a one-day history of crampy abdominal pain and frequent episodes of bilious vomiting. On examination, she was in pain, tachycardic (140 bpm), had dry mucous membranes, but was normotensive and afebrile. Abdominal examination was unremarkable except for diffuse pain. Laboratory evaluations were all within normal limits. Abdominal ultrasound showed a 10-cm-long small bowel to small bowel intussusception, 4 cm in diameter, with multiple non-mobile intraluminal objects, suspicious for ascaris lumbricoides. Following fluid resuscitation, the patient was taken to the operating room for an emergency exploratory laparotomy. We eviscerated the bowel and found that the intussusception had already spontaneously reduced. The involved bowel, which was a segment of the jejunum, was erythematous and edematous. The bowel was distended and filled with what seemed to be worms. We did a longitudinal enterotomy and found a conglomerate of ascaris lumbricoides, which we believe served as the pathologic lead point for the intussusception. All the worms were removed and the enterotomy was closed transversely in two layers. The patient had an uneventful postoperative recovery and was discharged home on the 5th postoperative day, on albendazole therapy.

Conclusion

Although rare, Ascaris lumbricoides should be considered in the differential diagnosis of children who develop small bowel-to-small bowel intussusception.

肠套叠是儿童肠梗阻最常见的原因之一。大多数病例是特发性的，没有病理诱因，只有约5%的病例病因明确，其中最常见的是梅克尔憩室。蛔虫是小儿肠套叠的罕见病因。病例介绍一名10岁女孩，有一天腹痛和频繁的胆汁性呕吐史。检查时，患者疼痛，心动过速（140次/分钟），粘膜干燥，但血压正常，不发热。腹部检查除弥漫性疼痛外无明显异常。实验室检查结果均在正常范围内。腹部超声示长约10cm的小肠至小肠肠套叠，直径约4cm，腔内多处不移动物，怀疑蚓蛔虫。液体复苏后，患者被送往手术室进行紧急剖腹探查术。我们切除了肠道，发现肠套叠已经自发减少了。受累的肠是空肠的一部分，有红斑和水肿。肠子膨胀起来，充满了似乎是蠕虫的东西。我们做了纵向肠切开术，发现了一团蛔虫，我们认为这是肠套叠的病理线索。所有的蠕虫被移除，肠切开术横向关闭两层。患者术后恢复顺利，并于术后第5天出院，给予阿苯达唑治疗。结论类蚓蛔虫虽罕见，但在小肠至小肠肠套叠患儿的鉴别诊断中应予以重视。

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引用次数: 0

Corrigendum to “Appendiceal Crohn's disease presenting with urinary symptoms: a case report” [J Pediatr Surg Case Rep 121 (2025) 103083] “以泌尿系统症状为表现的阑尾克罗恩病：一个病例报告”的更正[J儿外科病例报告121 (2025)103083]

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-11 DOI: 10.1016/j.epsc.2025.103105

Monalisa Attif Hassan , Katherine A. Lin , Patricio Gargollo , Michael Stephens , Nathan Hull , Denise B. Klinkner

引用次数: 0

Magnet ingestion in children: a case series 儿童磁铁摄入：一个病例系列

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-08 DOI: 10.1016/j.epsc.2025.103104

Piotr Roman Więckowski, Joanna Matylda Łysak, Roman Dranko, Grzegorz Wąsowski, Aleksandra Marosz, Wiktor Jodkowski

Introduction

Multiple magnet ingestion constitutes an ever-present problem in pediatric surgery. Magnets, attracted to each other, can cause intestinal wall compression, perforation, and eventually, fistulation.

Case presentation

Case 1: A nine-year-old female was admitted after swallowing magnetic beads six days prior. More than 20 magnetic balls were seen on an X-ray. She remained asymptomatic during the three days of observation and passed the magnetic beads spontaneously.

Case 2

A sixteen-month-old female was admitted 6 h after swallowing magnetic objects. An X-ray performed on admission showed four adherent magnetic beads. The patient was observed for seven days, during which she remained asymptomatic. Due to the lack of magnetic bead progression, the patient underwent surgery on the eighth day. Intraoperatively, an enteroenteric fistula was found, and a wedge resection of the intestine was performed. The patient was discharged home a week after surgery.

Case 3

A two-year-old female was admitted to the Pediatric Ward on suspicion of viral gastroenteritis. The patient deteriorated and developed symptoms of shock. An X-ray was performed, revealing ileus and five adherent magnetic beads. The patient underwent surgery. Intraoperatively, an enteroenteric fistula was found, with magnetic beads passing through the mesentery. A wedge resection of the intestine was performed, and the mesenteric perforation was closed. The patient was discharged home a week after surgery.

Conclusion

Children who ingest multiple magnets can have a wide range of clinical presentations. A trial of watchful observation is accepted in asymptomatic patients. Magnets that do not progress should be surgically removed.

在儿科手术中，多次磁铁摄入是一个一直存在的问题。磁铁相互吸引，会导致肠壁受压、穿孔，最终导致瘘管。病例1：一名九岁女童，6天前吞食磁珠入院。在x射线上发现了20多个磁性球。在三天的观察中，她没有任何症状，并自发地通过了磁珠。病例2A 16个月大的女性在吞咽磁性物体6小时后入院。入院时的x光片显示有四个附着的磁珠。患者观察7天，期间无症状。由于没有磁珠进展，患者在第8天接受了手术。术中发现肠肠瘘，并行楔形肠切除术。病人手术后一周出院回家。病例3A是一名两岁女童，因怀疑病毒性肠胃炎入住儿科病房。病人病情恶化并出现休克症状。x光片显示肠梗阻和五个附着的磁珠。病人接受了手术。术中发现肠肠瘘，磁珠穿过肠系膜。楔形切除肠，并关闭肠系膜穿孔。病人手术后一周出院回家。结论儿童误食多块磁铁临床表现多样。在无症状患者中接受观察试验。不能进展的磁铁应通过手术切除。

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引用次数: 0

Complete transection of the small intestine due to blunt abdominal trauma in a 3-year-old child: a case report 3岁儿童钝性腹部创伤致小肠完全横断1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-08 DOI: 10.1016/j.epsc.2025.103103

Yoshitaka Ishiguro , Te-Hsiung Wang , Mari Sonoda , Masato Sato , Shigeru Ohtsuru , Akihiko Hirakawa

Introduction

Complete transection of the small intestine following blunt abdominal trauma in children is extremely rare and poses diagnostic and therapeutic challenges.

Case presentation

A 3-year-old girl presented with abdominal pain, vomiting, and lethargy after suspected non-accidental blunt trauma. On arrival, the patient's vital signs showed tachycardia and fever. Physical examination revealed chest and epigastric ecchymoses, while abdominal ultrasonography revealed free fluid in Morison's pouch. Laboratory tests demonstrated marked transaminase elevation. Contrast-enhanced computed tomography showed free air and fluid in the perihepatic space and splenorenal fossa without evidence of liver injury. A diagnostic laparoscopy confirmed a complete jejunal transection approximately 2 cm distal to the ligament of Treitz with contaminated ascites, prompting conversion to open laparotomy. Approximately 5 cm of the jejunum were resected, followed by primary end-to-end anastomosis. The postoperative course was uneventful, and the patient was transferred to a child protection facility on postoperative day 6. Follow-up at 15 months confirmed normal recovery without complications.

Conclusion

Blunt abdominal trauma in young children can result in severe intestinal injuries that may have a delayed presentation.

儿童钝性腹部创伤后小肠完全横断极为罕见，这给诊断和治疗带来了挑战。一名3岁女孩疑似非意外钝性外伤后出现腹痛、呕吐和嗜睡。到达时，病人的生命体征显示心动过速和发烧。体格检查显示胸部和上腹部有淤血，腹部超声检查显示Morison's袋内有游离液体。实验室检查显示明显的转氨酶升高。增强计算机断层扫描显示肝周间隙和脾肾窝有自由空气和液体，无肝损伤迹象。诊断性腹腔镜检查证实，在Treitz韧带远端约2cm处出现完整的空肠横断，伴有污染的腹水，提示转开腹手术。切除约5cm的空肠，然后进行初级端到端吻合。术后过程顺利，患者于术后第6天转至儿童保护机构。随访15个月，恢复正常，无并发症。结论幼儿钝性腹部创伤可导致严重的肠道损伤，并可延迟表现。

{"title":"Complete transection of the small intestine due to blunt abdominal trauma in a 3-year-old child: a case report","authors":"Yoshitaka Ishiguro , Te-Hsiung Wang , Mari Sonoda , Masato Sato , Shigeru Ohtsuru , Akihiko Hirakawa","doi":"10.1016/j.epsc.2025.103103","DOIUrl":"10.1016/j.epsc.2025.103103","url":null,"abstract":"<div><h3>Introduction</h3><div>Complete transection of the small intestine following blunt abdominal trauma in children is extremely rare and poses diagnostic and therapeutic challenges.</div></div><div><h3>Case presentation</h3><div>A 3-year-old girl presented with abdominal pain, vomiting, and lethargy after suspected non-accidental blunt trauma. On arrival, the patient's vital signs showed tachycardia and fever. Physical examination revealed chest and epigastric ecchymoses, while abdominal ultrasonography revealed free fluid in Morison's pouch. Laboratory tests demonstrated marked transaminase elevation. Contrast-enhanced computed tomography showed free air and fluid in the perihepatic space and splenorenal fossa without evidence of liver injury. A diagnostic laparoscopy confirmed a complete jejunal transection approximately 2 cm distal to the ligament of Treitz with contaminated ascites, prompting conversion to open laparotomy. Approximately 5 cm of the jejunum were resected, followed by primary end-to-end anastomosis. The postoperative course was uneventful, and the patient was transferred to a child protection facility on postoperative day 6. Follow-up at 15 months confirmed normal recovery without complications.</div></div><div><h3>Conclusion</h3><div>Blunt abdominal trauma in young children can result in severe intestinal injuries that may have a delayed presentation.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"121 ","pages":"Article 103103"},"PeriodicalIF":0.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026370","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

Omphalomesenteric duct cyst containing ectopic gastric mucosa in a toddler: a case report 幼儿含胃粘膜异位的脐肠管囊肿1例报告

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-03 DOI: 10.1016/j.epsc.2025.103099

Shital Bhaisare , Jayakumar T K , Harshal Madavi , Kiran Khedkar , Nisha Meshram

Introduction

Omphalomesenteric duct cyst (OMDC) is an uncommon remnant of the omphalomesenteric duct. The occurrence of ectopic gastric mucosa within such cysts is rare and may lead to complications due to acid secretion.

Case presentation

A 2-year-old girl presented to us with persistent serous umbilical discharge since birth, associated with severe periumbilical excoriation. Ultrasonography showed a 1-cm cystic lesion beneath the umbilicus. Umbilical exploration revealed a cyst posterior to the umbilicus in the pre-peritoneal space, communicating with the skin through a fine sinus tract. The cyst was excised completely. Histopathological examination demonstrated ectopic gastric mucosa within the cyst wall. Postoperatively, the child had an uneventful recovery and was discharged home the day after the procedure. She remains asymptomatic and the excoriation of the skin has resolved.

Conclusion

Children presenting with persistent umbilical discharge accompanied by severe skin excoriation should be evaluated for an omphalomesenteric duct cyst containing ectopic gastric mucosa.

摘要肛管囊肿（OMDC）是一种罕见的肛管残余病变。这种囊肿内发生胃粘膜异位是罕见的，并可能因胃酸分泌而导致并发症。病例介绍：一名2岁女童自出生以来持续出现浆液性脐带分泌物，并伴有严重的脐周擦伤。超声示脐下1厘米囊性病变。脐部探查发现一个囊肿位于脐后腹膜前间隙，通过细小的窦道与皮肤相通。囊肿被完全切除了。组织病理学检查显示囊肿壁内胃粘膜异位。术后，患儿顺利康复，并于术后第二天出院回家。她仍无症状，皮肤擦伤已消失。结论儿童持续脐带分泌物并伴有严重的皮肤擦伤，应对伴有胃粘膜异位的脐肠管囊肿进行诊断。

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引用次数: 0

Conservative management of isolated gastric pneumatosis in a full-term neonate: a case report 1例足月新生儿孤立性胃肺病的保守治疗

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-01 DOI: 10.1016/j.epsc.2025.103102

Fatma Thamri , Yasmine Houas , Nada Sghairoun , Nour Ben Alaya , Riadh Jouini

Background

Isolated gastric pneumatosis is an exceptionally rare radiological finding in neonates, with its clinical significance and optimal management in stable, full-term infants remaining poorly defined.

Case presentation

A full-term male newborn was delivered at 38 weeks via spontaneous vaginal delivery from an unmonitored pregnancy. Admitted to the NICU for transient respiratory distress, he developed profuse hematemesis on day three. A nasogastric tube was placed, and gastric lavage revealed bright red blood. The infant was hemodynamically stable but anemic (Hb 13.5 g/dL), with isolated epigastric tenderness. Abdominal radiography showed marked gastric distension, and a subsequent CT scan confirmed intramural gastric pneumatosis without pneumoperitoneum or intestinal involvement, ruling out a lactobezoar. He was managed conservatively with strict NPO status, intravenous omeprazole (1 mg/kg twice daily), and intravenous antibiotics (ampicillin and gentamicin). A follow-up abdominal X-ray 48 hours later confirmed complete resolution of the pneumatosis. Enteral feeding with hydrolyzed formula was successfully reintroduced on the third day post-diagnosis. The patient was discharged on the fourth day, tolerating full feeds, and remained asymptomatic at follow-up.

Conclusion

Isolated gastric pneumatosis in the absence of pneumoperitoneum may be managed conservatively with proton pump inhibitors, diet restriction and empiric antibiotics. Frequent clinical and radiological surveillance is required for the early detection of potential complications.

背景：孤立性胃肺病在新生儿中是一种非常罕见的影像学发现，其临床意义和对稳定足月婴儿的最佳治疗仍不明确。病例介绍：一个足月男婴在妊娠38周时通过阴道自然分娩。因短暂呼吸窘迫住进新生儿重症监护病房，第三天出现大量吐血。放置鼻胃管，洗胃显示鲜红色血液。婴儿血流动力学稳定，但贫血（血红蛋白13.5 g/dL），伴有孤立的上腹部压痛。腹部x线摄影显示明显的胃膨胀，随后的CT扫描证实胃壁内气肺，没有气腹或肠道受累，排除乳粪炎。患者在严格的NPO状态下进行保守治疗，静脉注射奥美拉唑（1 mg/kg，每日2次），静脉注射抗生素（氨苄西林和庆大霉素）。48小时后随访腹部x光片证实肺积症完全消退。在诊断后第3天再次成功引入水解配方肠内喂养。患者于第4天出院，耐受全喂养，随访时无症状。结论无气腹的孤立性胃肺病可采用质子泵抑制剂、饮食限制和经验性抗生素进行保守治疗。频繁的临床和放射监测是早期发现潜在并发症的必要条件。

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引用次数: 0

Bowel obstruction due to an incarcerated Meckel's diverticulum within a minor omphalocele: a case report 小脐膨出内嵌顿性梅克尔憩室致肠梗阻1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-01 DOI: 10.1016/j.epsc.2025.103101

Zineb Benmassaoud , Badr Rouijel , Yacine Zouirech , Mohamed Amine Oukhouya , Hind Cherrabi

Introduction

The coexistence of omphalocele and Meckel's diverticulum (MD) is rare, and even more exceptional when the diverticulum is strangulated within the omphalocele sac. While several reports describe cases involving perforation or fistulization, this specific presentation remains unusual and may be overlooked.

Case presentation

A full-term, two-day-old male newborn was referred for a minor (≈3 cm) omphalocele not detected prenatally. On admission he was hemodynamically stable and afebrile with mild abdominal distension; the anus was patent and a nasogastric tube drained bilious fluid. Laboratory tests were unremarkable. Abdominal ultrasound confirmed a narrow fascial ring (∼1 cm) within a 3 cm omphalocele sac containing a bowel loop; echocardiography showed no cardiac anomalies. After stabilization, surgical exploration of the omphalocele sac identified a 5 cm × 3 cm MD strangulated at its base within the neck of the omphalocele, 25 cm proximal to the ileocecal valve, with significant upstream small-bowel dilatation and no perforation or fistula. Segmental ileal resection including the diverticulum with end-to-end ileo-ileal anastomosis was performed; the abdominal wall defect was closed primarily. Postoperatively, the patient was kept nil per os with nasogastric decompression; feeds were started on day 3 and well tolerated. He was discharged on day 5. Histopathology confirmed MD without ectopic mucosa. At 6-month follow-up, growth and gastrointestinal function were normal.

Conclusion

Newborns with a minor omphalocele can develop a bowel obstruction secondary to incarceration of a Meckel's diverticulum through the omphalocele defect.

脐膨出和梅克尔憩室（MD）共存是罕见的，当憩室在脐膨出囊内绞窄时更为罕见。虽然有一些报道描述了穿孔或瘘管形成的病例，但这种特殊的表现仍然不常见，可能被忽视。一例足月，2天大的男婴因产前未检出的轻微（≈3厘米）脐膨出而被转诊。入院时，患者血流动力学稳定，无发热，伴有轻度腹胀；肛门未闭合，鼻胃管排出胆汁。实验室检查没有异常。腹部超声证实在3厘米的脐膨出囊内有一个狭窄的筋膜环（约1厘米），其中包含肠袢；超声心动图未见心脏异常。稳定后，对脐膨出囊进行手术探查，发现在脐膨出颈内，距回盲瓣近25 cm处，一个5 cm × 3 cm的MD底部绞窄，明显的上游小肠扩张，无穿孔或瘘管。行节段性回肠切除术，包括憩室，端对端回肠吻合术；腹壁缺损初步闭合。术后，患者在鼻胃减压术中保持零呼吸；第3天开始饲喂，耐受良好。他于第五天出院。组织病理学证实为MD，未见粘膜异位。随访6个月，生长和胃肠功能正常。结论新生儿轻度脐膨出可通过脐膨出缺损继发于梅克尔憩室嵌顿性肠梗阻。

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引用次数: 0

Double congenital esophageal bronchus with microgastria: a case report 双先天性食管支气管合并小胃症1例

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Surgery Case Reports

Pub Date : 2025-09-01 DOI: 10.1016/j.epsc.2025.103100

Anna C. Shawyer

Introduction

Congenital esophageal bronchus (CEB) is a rare malformation sometimes associated with microgastria and/or other congenital anomalies. It may present later in life with recurrent pulmonary symptoms.

Case presentation

A term baby was born with an antenatal diagnosis of multiple congenital anomalies including absence of stomach bubble, congenital heart disease and a lumbosacral cystic lesion. Post natal diagnosis confirmed dextrocardia, unbalanced atrioventricular canal defect with hypoplastic right ventricle and pulmonary stenosis, situs inversus totalis, asplenia, and abnormal lumbar and sacral vertebrae with a skin covered lipomyelomeningocele. After birth, an orogastric tube was placed to 15 cm, which on chest x-ray (CXR) stopped at the lower 1/3 of the esophagus. Gas was seen in the abdomen. A contrast study demonstrated microgastria, a gastroesophageal junction (GEJ) within the chest, and a CEB. The CXR was suspicious for a lesion in the lower left lobe (LLL); CT-angiogram confirmed no airway or systemic blood vessels to the LLL. Esophagoscopy revealed an elevated, tight GEJ and 2 distal openings towards the lung. A thoracotomy was performed at 3 weeks of age to close the CEB and resect the LLL; a chest tube was left in situ. Feeds were initiated 1 week after surgery when a contrast study revealed no leak. The baby is tolerating full bolus feeds and at 3 months of age remains in hospital awaiting cardiac surgery.

Conclusion

CEB is a rare anomaly and should be considered when a nasogastric tube cannot be advanced easily, particularly in the setting of multiple congenital anomalies.

先天性食管支气管（CEB）是一种罕见的畸形，有时与小胃和/或其他先天性异常有关。它可能在以后的生活中出现复发性肺部症状。一个足月婴儿出生时，产前诊断为多种先天性异常，包括没有胃泡，先天性心脏病和腰骶囊性病变。产后诊断证实右心，房室管不平衡缺损伴右心室发育不全和肺动脉狭窄，完全性倒位，脾功能不全，腰椎和骶椎异常伴皮肤覆盖的脂肪性脊膜膨出。出生后，将口胃管放置至15cm处，胸部x光片（CXR）显示在食管下1/3处停止。腹部有气体。对比研究显示小胃炎，胸内胃食管交界处（GEJ）和CEB。CXR显示疑似左下叶病变（LLL）；ct血管造影证实没有气管或全身血管到左下肢。食管镜检查显示一个升高的、紧致的GEJ和2个通向肺的远端开口。在3周龄时进行开胸手术以关闭CEB并切除LLL；一根胸管留在原位。术后1周，对比研究显示无渗漏，开始喂养。这名3个月大的婴儿正在接受全剂量的喂养，目前仍在医院等待心脏手术。结论ceb是一种罕见的异常，在鼻胃管不能轻易推进的情况下，特别是在多发性先天性异常的情况下，应予以考虑。

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引用次数: 0