Synchronous ovarian epidermoid cyst torsion with appendicitis in a 2.5-year-old girl: Case report.

INTRODUCTION AND IMPORTANCE: Acute appendicitis associated with ovarian epidermoid cyst torsion is extremely rare. To our knowledge, there are about 7 cases that have been reported in English literature, and there was no epidermoid cyst in any of them. CASE PRESENTATION: Herein, we present the case of a 2.5-year-old girl with a history of vomiting, fever, and abdominal pain. She was prepared for the operation following the clinical and radiological assessment. At laparotomy, appendicitis and left ovarian lesion torsion were found. An appendectomy and salpingo-oophorectomy were performed with no complications occurring during surgery or the follow-up period. The results of the histology analysis showed that the appendix was inflamed and that there was an epidermoid cyst with a wide infarction. CLINICAL DISCUSSION: Epidermoid cysts of the ovary are uncommon and often discovered by accident, and histological investigation is required for a definitive diagnosis. In our case, the signs and symptoms before surgery suggested appendicitis. Acute appendicitis in young children is also uncommon. Ovarian lesion torsion associated with acute appendicitis is extremely rare. The treatment is surgery and often requires appendectomy and salpingo-oopherectomy as in our case. CONCLUSION: Such cases should be considered in the differential diagnosis of abdominal pain at any age, and early diagnosis and surgery are always required.

Severe Esophageal Stricture Post Accidental Corrosive Substance Ingestion: A Case Report of Balloon Endoscopic Dilation.

Corrosive substance ingestion is a very serious home accident, mostly common in developing countries. It frequently causes esophageal burns in the acute stage and esophageal stricture, stenosis, and even cancer in the chronic stage. Severe cases of caustic esophagitis may require esophageal replacement. We describe a case of balloon endoscopy dilation in a two-year-old girl with a severe stricture of the esophagus resulting from accidental ingestion of a corrosive substance (strong alkaline liquid) which helped the patient preserve the esophagus and prevent esophageal replacement. We describe the clinical complication and development during the treatment.

A rare lipoma site in a 1-year-old boy.

Lipomas are benign tumors composed of mature adipocytes. A 1-year-old-male baby was admitted to the hospital with a history of an abdominal mass, which had been incidentally detected by a local pediatrician. upon examining the child for a complaint of distention and chronic diarrhea. An ultrasound and computed tomography scan were performed, and findings revealed a fat mass, which was confirmed by laparotomy and microscopic results. At laparotomy, a soft yellow mass was found attached to the mesentery of the jejunum. The mass was enucleated without anastomosis, and the patient was followed up 4 months postoperatively with regular clinical examination and abdominal ultrasonography. This case was examined and reported in this study because lipomas are very rarely present in the mesentery of the intestine, especially at this early age.

Incidental Delayed Diagnosis of Isolated Diffuse Ganglioneuromatosis Caused the Death of a 6-Year-Old Boy: Case Report.

Intestinal diffuse ganglioneuromatosis is a rare, benign, neoplastic condition characterized by disseminated proliferation of neural elements. It has an established association with several systemic disorders including: multiple endocrine neoplasia IIB (MEN IIB) and von Recklinghausen's disease. However, isolated GNs are very rare and sporadic. We report a case of a 6-year-old patient was referred to the emergency department due to a colon perforation during endoscopy. He then underwent sigmoidectomy and the pathologic studies revealed prominent signs of diffuse ganglioneuromatosis. Unfortunately, the patient died the day after because of the late diagnosis and treatment. Such presentation emphasizes the importance of considering diffuse ganglioneuromatosis, among other causes, in patients with intractable GI symptoms despite medical treatment.

A rare case of idiopathic intrauterine intestinal volvulus complicated with intestinal perforation: a case report from Syria.

Fetal intestinal volvulus is rare, but it is a serious condition due to its life-threatening complications. The bowel loop becomes twisted; thus, impaired venous return leads to bowel necrosis. Prenatal volvulus is most secondary to intestinal atresia, arterial supply defect or without any underlying cause, with consideration that cystic fibrosis is the cause of the intestinal obstruction, because of meconium ileus. We report a case of prenatal volvulus complicated with intestinal perforation and meconium peritonitis in the context of meconium ileus.

Mesenteric inflammatory myofibroblastic tumor as a rare cause of small intestinal intussusception.

Inflammatory myofibroblastic tumor (IMT) is an uncommon, usually benign, mesenchymal tumor. IMT affects people of all ages, but it more commonly occurs in children and adolescents. Also, it has the potential to arise in any part of the body, though, it frequently develops in the lungs and mesentery. In this report, we discuss a rare clinical manifestation of mesenteric IMT presented as intussusception of the small intestine in a 7-year-old child.

Celiac disease: a rare cause of 'postoperative' ileoileal intussusception after surgical reduction of ileocolic intussusception in a toddler.

Intussusception (IS) is defined as invagination of part of the bowel into an adjacent section of the intestines and is the second most common cause of small bowel obstruction in children. Postoperative ileoileal intussusception after surgical reduction is a special type of ileoileal intussusception and is considered idiopathic. This research paper examines the case of a female Syrian toddler who had been diagnosed with ileoileal intussusception after surgical reduction. Diagnosis of celiac disease was later histopathologically confirmed. Celiac disease (CD) may be the underlying cause for special types of intussusception that may be considered idiopathic, and further investigations, such as endoscopy, should be considered.

Classic bladder exstrophy and complete rectal prolapse in a 10 year-old child with no previous surgical intervention: what to achieve?

The management of bladder exstrophy (BE) remains one of the most significant challenges encountered by pediatric urologists despite improvements in the operative techniques worldwide. Regardless of surgical technique, timing of primary closure remains a matter of debate. The initial closure may be performed within the first 48-72 hours of life or at ~6-12 weeks of age. Delayed presentation until adolescence is extremely rare. However, due to lack of awareness, and access to healthcare along with poor socioeconomic conditions in developing countries, some patients may not receive treatment during infancy. We present a case of a 10-year-old Syrian male with BE associated with complete rectal prolapse who did not undergo any previous surgical interventions.

Early separation of omphalopagus conjoined twins: a case report from Syria.

Omphalopagus twins are one of many forms of conjoined twins sharing part of the gastrointestinal system and abdominal wall. This type of twins has the best chance of survival if successfully separated. Surgical approaches in these cases are generally preferably elective, but sometimes separation may be urgently needed due to life-threatening complications, such as hemodynamic instability, death of either twin, necrotizing enterocolitis, among many others. We report a case of successfully separated omphalopagus twins at day two of life.

Amyand hernia: scrotal pyocele, associated with perforated vermiform appendix and complicated by testicular ischemia in neonate.

The presence of vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. This research paper examines the case of a 28-day-old Syrian male presented with a history of an infected right-sided hydrocele from the age of 14 days. Upon admission, ultrasonography was reported as a right testicular torsion. Accordingly, emergency surgical exploration was performed, and by exposing the spermatic cord fascia, 7 mL of pus was drained, revealing the cecum and perforated appendix lying beside the right testis, which showed evidence of ischemia and bluish discoloration.

Gastric Duplication Cyst Presenting as Massive Gastrointestinal Bleeding.

Gastric duplication cysts (GDCs) are rare congenital anomalies. Presentation of GDCs varies from an asymptomatic abdominal mass to fulminant or massive gastrointestinal (GI) bleeding. Herein, we describe a case of a GDC in a 10-month-old infant presenting with unexplained massive GI hemorrhage and hematemesis. An abdominal ultrasound was negative, while computerized tomography was, initially, inaccessible. Through a series of repeated esophagogastroduodenoscopies, we documented penetration of the GDC into the gastric cavity that was later confirmed by computerized tomography. The patient was treated successfully with surgical resection.

Legg-Calve-Perthes disease in two generations of male family members: a case report.

Legg-Calve-Perthes disease (LCPD) is a type of avascular necrosis of the femoral head occurring mainly in male children and causing early osteoarthritis. We report 2 generations of 4 male family members with LCPD-like features and mutation of the COL2A1 gene of the 12q13 chromosome. If LCPD occurs in any family member, we recommend genetic analysis and counselling as well as early radiological screening of related children.

Do osteoporosis-related vertebral fractures precede hip fractures?

AIM: To evaluate the relationship between a vertebral fracture and a hip fracture in Saudi Arabians with osteoporosis. METHODS: In this retrospective study, 154 Saudi Arabian patients with osteoporosis-related hip fractures were analyzed for the presence of a vertebral fracture. Radiographs were retrieved from the IPAC (Image Picture Archiving and Computing) System, an imaging retrieval system, and were reviewed independently by two of the authors, Abid Hussain Gullenpet, and Mir Sadat-Ali, and later reviewed jointly. Patients admitted with proximal hip fracture who were ≥ 50 years and had undergone Thoraco-lumber imaging and a dual energy X-ray absorptiometry (DEXA) scan were included in the study. Patients with a history of significant trauma to the spine and those with a malignancy or connective tissue disorder were excluded from the analysis. RESULTS: Out of 154 patients with hip fractures, 78 had a fracture of the femoral neck while 76 had an intertrochanteric hip fracture. Of the 111 patients who were finally included in the study, after applying inclusion and exclusion criteria, 76 patients with an average age of 67.28 ± 12 years had no fractures of the spine. Thirty-five patients with an average age of 76.9 ± 14.5 years (31.53%) had a total of 49 vertebral fractures. Patients with vertebral fractures were significantly older than those without fractures P < 0.001. Overall, 24.7% of these patients had an asymptomatic vertebral fracture. Further analysis showed that 11 males (18.96%) and 24 females (45.28%) had suffered a previous asymptomatic vertebral fracture. Interestingly, all women who participated in this study and who presented with a femoral neck fracture had experienced a prior asymptomatic vertebral fracture. CONCLUSION: We recommend that all elderly patients who go to the radiology department for a chest X-ray also have a DEXA scan and a lateral thoracic spine radiograph.

Bacterial flora on cell phones of health care providers in a teaching institution.

We conducted a cross-sectional study involving culture of cell phones of 288 health care providers (HCP) during a 6-month period. One hundred nine (43.6%) HCP carried infective organisms on their cell phones. It is recommended that cell phones be cleaned regularly.