Laparoscopic management for urachal cyst in a 9-year-old boy

We report a boy with urachal cyst managed laparoscopically. A 9-year-old boy was referred from another hospital with a history of low abdominal pain. We laparoscopically excised the urachal cyst, removing all structures within the umbilicovesical fascia, including the urachus and each medial umbilical ligament, as well as the associated peritoneum from the umbilicus to the bladder dome. Laparoscopic management of urachal disease can be performed safely, with minimal postoperative pain, excellent cosmetic results and early ambulation. We advocate the use of laparoscopic treatment of urachal anomalies in children.     

A fatal case of ruptured infected urachal cyst

A case of a 12 years old school girl is described. She presented nine days after the onset of acute periumbilical abdominal pain which was later accompanied three days prior to admission by purulent discharge from the umbilicus. Radiological investigation revealed a pelvic collection of pus with retroperitoneal extensions. Late presentation made the attempt to save the patient unsuccessful. A review of the literature reveals that extensive intraperitoneal and retroperitoneal extension of abscess resulting from anomaly of the urachus is extremely rare.     

A case of infected urachal cyst--a review of Japanese case reports of urachal cyst

A 24-year-old female with infected urachal cyst is reported. She was admitted to the hospital with complaints of a lower abdominal mass, abdominal pain and cystitis symptom. Brownish pus discharges from her umbilicus were recognized by manual compression of the lower abdominal mass. Cystoscopy revealed a small orifice at the dome of the bladder, and pus discharges from this orifice. A pooling of contrast medium (8 X 2.5 cm) under the umbilicus was detected by a fistelography from the umbilicus, and a low density mass was detected under the abdominal wall between the umbilicus and the dome of bladder on a CT scan. So she was diagnosed as an infected urachal cyst and operated on. The urachal cyst which was adhered to the peritoneum had penetrated both the umbilicus and bladder at the time of operation. Complete removal of the urachal cyst with partial cystectomy was done. We also reviewed the Japanese case reports of urachal cyst.     

Large mesenteric cyst mimicking an ovarian cyst in an 8-year-old: A case report

Introduction and importancePediatric mesenteric cysts, rare and usually benign intra-abdominal tumors, are a difficult preoperative diagnosis due to ambiguous clinical characteristics. The final diagnosis is typically established only during surgery or histological analysis.Case presentationAn 8-year-old female presented with five days of worsening abdominal pain, associated with nausea, vomiting, and fever, as well as vague tenderness in the right quadrants on examination. Computed tomography imaging showed a 10.5 × 8.7 × 7 cm abdominal mass, most suspicious for a cystic mass of ovarian origin. Upon diagnostic laparoscopy, a mesenteric cyst extending to the root of the mesentery was visualized and entirely resected after conversion to an exploratory laparotomy. Histopathological examination of both the cystic fluid and specimen suggest a benign mesenteric cyst.Clinical discussionAlthough mesenteric cysts are noticeably rare, it is important differential to consider in pediatric patients with non-specific symptoms like abdominal pain and distention, intestinal obstruction, or a palpable abdominal mass. Notably, these cysts can be managed successfully by complete surgical resection with an excellent outcome.ConclusionThis report recounts an interesting case of a large mesenteric cyst that mimicked an ovarian cyst in a pre-pubertal girl.     

Subscapularis tendon rupture in an 8-year-old boy: a case report

Since falling off a motorcycle 2 years earlier, an 8-year-old, right-hand-dominant boy reported anterior shoulder pain and weakness. After being evaluated by his family physician and completing a course of physical therapy with no symptomatic improvement, he was seen at our institution. Physical examination was remarkable for diminished strength with internal rotation (4/5). In addition, bellypress and lift-off tests were positive, suggesting a lesion of the subscapularis. Magnetic resonance imaging of the shoulder showed a full-thickness subscapularis tendon tear and a supraspinatus tendon signal that could have represented a partial-thickness tear vs supraspinatus tendinosis. The patient underwent right shoulder diagnostic arthroscopy with debridement of a partial-thickness articular-sided tear of the supraspinatus tendon followed by open repair of the subscapularis tendon rupture. This case illustrates a traumatic subscapularis tendon injury that is rare in this age group. A few other traumatic subscapularis injuries have been reported in children, but they all demonstrated bony avulsion of the lesser tuberosity.     

A case of cerebral salt-wasting syndrome associated with aseptic meningitis in an 8-year-old boy

Cerebral salt-wasting syndrome is a disorder in which excessive natriuresis and subsequent hyponatremic dehydration occur in patients with intracranial diseases. Cerebral salt-wasting syndrome often develops in patients with severe neurosurgical disorders, such as hydrocephalus, cerebral infarction, and tuberculous meningitis. Here, we report on the case of an 8-year-old boy with cerebral salt-wasting syndrome associated with aseptic meningitis. He showed mild developmental retardation and had a history of convulsion. Four days after his admission, cerebral salt-wasting syndrome abruptly started: natriuresis and hyponatremia gradually improved over 10 days. To the best of our knowledge, this is the first report on cerebral salt-wasting syndrome associated with clinically benign aseptic meningitis.     

A case of infected urachal cyst successfully drained by a catheter perforating the bladder

A 42-year-old man complained of lower abdominal pain. Computed tomographic scan and magnetic resonance imaging revealed an infected urachal cyst. A drainage catheter, which had multiple holes over a 10 cm length from the catheter tip, was placed in the urachal cyst. The catheter was inserted from the subumbilicus region and the catheter tip was intended to be situated at the caudal end of the urachal cyst. However, the catheter tip accidentally perforated the bladder and urine flowed out of the bladder through the catheter. Because the urine diluted and washed out the pus in the urachal cyst, the infected urachal cyst was successfully drained. Percutaneous drainage and antibiotics allowed resolution of the inflammatory process. On the twenty-third day after catheter placement, excision of the urachal cyst and partial cystectomy were performed with relative ease and without any complications.     

Intraperitoneal rupture of an infected urachal cyst in an infant. Case report.

Peritonitis due to intraperitoneal rupture of an infected urachal cyst is a life-threatening condition, not previously reported in an infant. We report this condition in an 8-month-old infant. The child underwent complete excision of the urachal remnant and made an uneventful recovery; bacterial culture grew Staphylococcus aureus. Subsequent investigations did not reveal any other renal tract abnormalities.     

Pleomorphic adenoma of the trachea in an 8-year-old boy: a case report

We report a case of pleomorphic adenoma of the trachea in an 8-year-old boy who required emergency surgery for severe respiratory distress. Chest computed tomographic scan and bronchoscopy showed a relatively large mass in distal trachea and right main bronchus and destruction of the lung parenchyma. The patient was subjected to right carinal resection, pneumonectomy, and pericardial patch tracheoplasty for reconstruction of the trachea. Histopathological examination and immunohistochemical staining of tumor specimens were compatible with pleomorphic adenoma. Postoperative follow-up of this patient for a period of 6 months showed satisfactory results with no complications or tumor recurrence. We present not only a very rare benign tracheal tumor in children but also demonstrate successful usage of a free pericardial patch for tracheal reconstruction, although direct anastomosis failed to provide an adequate anastomotic lumen.     

Laryngeal schwannoma in an 8-year-old boy with inspiratory dyspnea

BACKGROUND: Schwannomas of the larynx are rare lesions in the pediatric age group. METHODS: In this article, we report on the neuroimaging features of a schwannoma arising from the left aryepiglottic fold in an 8-year-old boy with a 6-month history of inspiratory dyspnea. RESULTS: Neuroimaging showed a well-defined, avoid mass originating from the left aryepiglottic fold. The lesion was removed endoscopically. CONCLUSION: Complete removal of laryngeal schwannomas is curative, and adjuvant treatment is not required.     

Obstructing ileal duplication cyst infected with Salmonella in a 2-year-old boy: a case report and review of the literature

Alimentary tract duplications (ATDs) are rare congenital anomalies, with an incidence of 1 in 4500 individuals. Patients with these lesions present in a variety of ways, and although histologically benign, ATDs can lead to lethal complications including volvulus, intussusception, or bowel obstruction. Irrespective of anatomical location, the epithelial lining of ATDs contains ectopic acid-secreting mucosa in more than 50% of cases, which can lead to ulceration, bleeding, or transmural erosion and perforation. We report an unusual case of a child who presented with small bowel obstruction caused by an ileal duplication cyst that had become infected with Salmonella. Although reports of infected mesenteric cysts and duodenal duplication cysts have been published, this is the first reported case of an infected ileal duplication cyst. We also present a review of the literature regarding these interesting lesions.     

Staged approach to the urachal cyst with infected omphalitis

Embryonal urachus exists as a cord-like structure between the urinary bladder and the umbilicus. In some cases of urachal cysts at the level of the navel, no special symptoms are detected during childhood, but spontaneous drainage at the navel may occur after adolescence, which is called an infected urachal cyst. Especially in cases accompanied by infected omphalitis, no constant opinion has been established to choose either initially curative resection or staged incision. In this study, we evaluated the characteristics of patients with urachal cysts who underwent the staged approach. Twenty patients (14 men and 6 women) with urachal cysts complicated by infected omphalitis were treated in our hospital. Staged surgery was performed for 18 patients. Neither recurrent omphalitis nor subsequent urachal carcinoma was observed. It is desirable that urachal cyst accompanied by intractable omphalitis should be treated by conservative therapy, conducted image diagnosis, and chosen staged surgery.     

Perforation of choledochal cyst in a 12-year-old boy

Choledochal cyst is a rare congenital malformation that presents in children and young adults and is more frequent in women. Early diagnosis is essential to avoid possible complications. The method of choice for the initial diagnosis is ultrasound. Treatment consists of complete resection of the cyst. We describe a case of perforation of a choledochal cyst in a 12-year-old boy.     

Avascular necrosis following traumatic hip dislocation in an 8-year-old boy

Avascular necrosis of the femoral head as a complication of a hip location that is caused by minor trauma and is promptly reduced is uncommon in young children. The incidence appears to be from 3% to 6% if reduction is performed within the first 4 h [1–3]. However, if it does occur, a significant incidence of degenerative joint disease should be anticipated in the patient's later life. As a possible way of surgical treatment, an intertrochanteric and periacetabular osteotomy should be considered to minimise sequelae. Follow-up must be continued until skeletal maturity is reached.