Cysts of Gastrointestinal Origin in Children: Varied Presentation / 대한소아소화기영양학회지

PURPOSE: Abdominal cysts of gastrointestinal origin are rare. Their rarity and varied clinical presentations make their pre-operative diagnosis difficult. METHODS: Fourteen patients with histological diagnosis of cysts of gastrointestinal origin admitted between 2009 and 2015 were retrospectively analyzed with respect to age, sex, clinical presentation, diagnostic modality, site and type of cyst, management, outcome and follow-up. RESULTS: The mean age at presentation was 4 years and there were six males and eight females. Abdominal pain was the most common presenting symptom. Five patients had an acute presentation-three had distal ileal mesenteric cysts and two had ileal duplication cyst sharing a common wall with ileum. Six patients presented with chronic abdominal pain and lump—three patients had omental cysts and three had mesenteric cysts—two of these in distal ileum and one in sigmoid colon. Two patients presented with antenatally diagnosed palpable abdominal lump. One had a mesenteric cyst of the ileum and the other had a distal ileal duplication cyst which required excision with resection and anastomosis. One patient had an atypical presentation. He was a known case of sickle cell trait and had presented with vague abdominal pain, recurrent cough and multiple episodes of haemoptysis over a period of one year. At laparotomy, gastric duplication cyst was found which was excised completely. Histopathology confirmed the diagnosis. CONCLUSION: Cysts of gastrointestinal origin are rare and have varied presentation. Surgical excision is the mainstay of treatment. The results and prognosis are good.

Annular Pancreas with a Duodenal Web: a Rare Presentation with Simultaneous Intrinsic and Extrinsic Duodenal Obstruction / 대한췌담도학회지

Congenital duodenal obstruction is a rare cause of neonatal intestinal obstruction caused by various intrinsic and extrinsic congenital lesions. Annular pancreas is one of the causes of extrinsic duodenal obstruction and a duodenal web is one of the causes of intrinsic duodenal obstruction. The simultaneous occurrence of an extrinsic and intrinsic pathology is rare. Only four such cases have been reported in literature. We present a similar case of male neonate with partial duodenal obstruction caused by annular pancreas and an intrinsic duodenal web.

Annular Pancreas with a Duodenal Web: a Rare Presentation with Simultaneous Intrinsic and Extrinsic Duodenal Obstruction / 대한췌담도학회지

Congenital duodenal obstruction is a rare cause of neonatal intestinal obstruction caused by various intrinsic and extrinsic congenital lesions. Annular pancreas is one of the causes of extrinsic duodenal obstruction and a duodenal web is one of the causes of intrinsic duodenal obstruction. The simultaneous occurrence of an extrinsic and intrinsic pathology is rare. Only four such cases have been reported in literature. We present a similar case of male neonate with partial duodenal obstruction caused by annular pancreas and an intrinsic duodenal web.

Post Laparoscopic Cholecystectomy Biloma in a Child Managed by Endoscopic Retrograde Cholangio-Pancreatography and Stenting: A Case Report / 대한소아소화기영양학회지

Laparoscopic cholecystectomy, though an uncommon surgical procedure in paediatric age group is still associated with a higher risk of post-operative bile duct injuries when compared with the open procedure. Small leaks from extra hepatic biliary apparatus usually lead to the formation of a localized sub-hepatic bile collection, also known as biloma. Such leaks are rare complication after laparoscopic cholecystectomy, especially in paediatric age group. Minor bile leaks can usually be managed non-surgically by percutaneous drainage combined with endoscopic retrograde cholangio-pancreatography (ERCP). However, surgical exploration is required in cases not responding to non-operative management. If not managed on time, such injuries can lead to severe hepatic damage. We describe a case of an eight-year-old girl who presented with biloma formation after laparoscopic cholecystectomy who was managed by ERCP.