Intestinal obstruction due to giant liver cyst: A case report.

BACKGROUND: Congenital hepatic cysts are relatively rare but are now diagnosed earlier and more frequently with a routine prenatal ultrasound. Solitary liver cysts are divided into simple and solitary intrahepatic biliary cysts, depending on the biliary connection. While some solitary liver cysts are symptomatic in childhood, even in newborns, they are often found incidentally in adults. CASE SUMMARY: A 3-mo-old female infant was admitted to Mogadishu Somali Training and Research Hospital with recurrent vomiting, respiratory problems, and abdominal bloating complaints. On examination, the abdomen was greatly distended and extremely tight. She had repeated vomiting for 3 d, no stool output, and decreased urine. The abdominal ultrasonography detected a solitary cystic lesion measuring 10 cm × 10 cm × 14 cm, extending from the liver or right kidney to the pelvis. In the magnetic resonance imaging examination of the patient, a solitary cystic structure of 10 cm × 10 cm × 14 cm in the right abdomen was observed, extending to the pelvis and possibly originating from the liver. The patient was operated via fenestration after her fluid and electrolytes improved. Oral nutrition was initiated on the 2nd postoperative day, and the drain was removed on the 5th postoperative day. The patient visited the outpatient clinic control 1 mo later with no clinical complaints. CONCLUSION: Congenital liver cysts are usually followed without complications. They rarely reach gigantic dimensions and may cause respiratory distress, intestinal obstruction and recurrent vomiting. Surgery can provide quite successful outcomes in the treatment of giant sized simple liver cysts.

A strangulated umbilical hernia with perforated Meckel diverticulum: Case report.

INTRODUCTION AND IMPORTANCE: Meckel's diverticulum (MD) is one of the most common gastrointestinal anomalies and affects 2-3 % of the population. Strangulated umbilical hernia with a perforated Meckel diverticulum is an extremely rare event. CASE PRESENTATION: We reported here a case of one year old boy of a strangulated umbilical hernia with perforated MD that operated at the Mogadishu hospital. A wedge resection of the MD and anastomosis was performed. CLINICAL DISCUSSION: MD is one of the most common gastrointestinal anomalies and affects 2-3 % of the population. About 60 % of cases come to medical attention before the age of ten, with the remainder of patients presenting in adolescence and adulthood. It is more difficult to diagnose in males, especially in adulthood. CONCLUSION: Being aware of the likelihood that there could be a perforated Meckel's diverticulum in a sac of strangulated umbilical hernia has notable importance and may lead to innovative treatment and postoperative rehabilitation modalities.

Spontaneous rupture of umbilical hernia with evisceration of small bowel in an infant: A case report.

INTRODUCTION: Umbilical hernia is a condition that frequently affects children, with the majority resolving spontaneously. The appearance of redness, ulceration, or a sudden increase in the size of the umbilical hernia is indicative of a threatening rupture and suggests the requirement for surgical intervention. We hereby present a case of spontaneous umbilical hernia rupture with bowel evisceration. A PRESENTATION OF THE CASE: a 6-month-old infant was admitted to the hospital due to rupture of the umbilical hernia and intestinal evisceration. Following an assessment, a primary resuscitative approach was applied, including wet dressing of the bowel. A segment of the small bowel loop had a compromised blood supply at the time of the operation, so resection with a hand-sewn anastomosis was performed. No other abnormality was identified intraoperatively, and the abdomen was closed. The baby was discharged after a remarkable recovery. CLINICAL DISCUSSION: Umbilical hernia in infants is a common condition and may present with serious complications in less common occurrences, including rupture and intestine evisceration, as in our case. By publishing this case, we hope to raise the awareness of physicians regarding the early detection of such complications and urgent consultation with pediatric surgeons. CONCLUSION: It is important for both the parents and the clinicians to be aware of these red flags and to seek immediate consultation from a pediatric surgeon for timely intervention. This will help to lessen the severity of the complications that could otherwise put the infant at a higher risk for morbidity.

Infantile Bowel Obstruction in a Patient with Situs Inversus Totalis and Polysplenia: A Case Report.

The infantile intestinal obstruction associated with situs inversus totalis and polysplenia is extremely rare, with only a few cases reported in the literature. Furthermore, the management of this association is complicated. We report a case of a 2-month-old boy with intestinal obstruction due to malrotation and volvulus with thin translucent omentum sac encasing the small intestine associated with situs inversus totalis, polysplenia, and pulmonary hypertension. To the best of our knowledge, this is the first case of situs inversus totalis with polysplenia, pulmonary hypertension, and intestinal obstruction due to malrotation and volvulus with thin translucent omentum sac encasing the small intestine.

Retrospective evaluation of inpatients admitted to a tertiary hospital in Somalia for Pediatric surgery.

Objective: The aim is to reflect on the epidemiology of the patient population at a tertiary hospital for pediatric surgery, diagnostic pattern, and mortality in Somalia retrospectively. Methods: In this study, 163 patient who were hospitalized to Pediatric Surgery Clinic of Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital in 2018 were included. Data regarding age, gender, diagnosis, surgical condition, mortality rate and cause of the death were recorded from the patient charts and the institutional digital database. Results: Of 163 patients 47 were female (28.8%) and 116 were male (71.2%). The mean age of the patients was 6.4 ± 4.8 years. The main diagnoses were congenital malformation (34.4%), acute abdomen (25.8%), traumatic injury (23.3%), infection (9.8%) and neoplasm (6.1%). Mortality rate was 9.8% and the leading cause of death was sepsis by 87.5%. Perforated appendicitis, intestinal obstruction and intussusception were creating the 68.7% of the diseases that result in death. Conclusions: Our results show that two-thirds of the surgical deaths could be prevented with timely presentation. We think that the health policymakers in Somalia should focus on how to improve the access to surgical care, patient transfer, timely presentation, and training of pediatric surgeons and to overcome the poor surgical outcomes.

A case of empyema necessitans in an adolescent with mycobacterium tuberculosis.

Introduction and importance: An empyema is a buildup of pus in the pleural space and is most commonly associated with pneumonia. Streptococcus pneumonia is the most common cause of pneumonia, although staphylococcus aureus is common in developing countries. empyema necsitans is An extravasation of purulent material outside the pleural space involving the chest wall. Case presentation: Here we present a 15-year-old girl presented with swelling on the right thorax wall. I was told that the swelling had been there for 1 year with moderate discomfort upon lifting objects, with no other complaints. Her medical history was unremarkable until the mass appeared. There was no history of fever, cough, or weight loss, and there was no family history of tuberculosis. Clinical discussion: Empyema necessitatis can be quite harmful. It has the potential to cause bone and soft tissue erosion. This may be asymptomatic at first and proceed at a slow and steady pace. Tuberculous EN can be treated with both surgical and medical treatments. This case applies to both surgical intervention and medical treatment with antituberculosis. Conclusion: Empyema necessitans is uncommon consequence of pleural space infection. pulmonary mycobacterium tuberculosis, Actinomyces, and nontuberculous organisms such Staphylococcus aureus are the most prevalent causes.

Rare case cystic scrotal lymphangioma presented as a hydrocele.

INTRODUCTION AND IMPORTANCE: Cystic scrotal lymphangiomas are very uncommon lesions caused by congenital lymphatic malformation. These tumors are usually located in the neck and axilla, occasionally in the mediastinum, retroperitoneum, and thigh. The scrotum and perineum are the least frequented sites. They present as painless scrotal swelling and are easily misdiagnosed as hydrocele. We present here a case of cystic scrotal lymphangioma in a school-aged child who presented to us with a massive scrotal swelling. CASE PRESENTATION: We present here a case of a 6-year-old child who presented with scrotal swelling, which was sonographically identified as chronic hydrocele. The right testis could be felt separately from the mass, and the left scrotum was normal. Scrotal ultrasound reveals multiple cystic lesions with septa in the right hemiscrotum extending to the proximal inguinal canal. Median raphe incision and excision of the lobulated mass Cyst testicular lymphangioma was confirmed histopathologically. CLINICAL DISCUSSION: Cystic lymphangiomas are benign congenital tumors with no identifiable cause. The majority of lymphangiomas (90%) appear during the first two years of life, and half of them are present at birth. Lymphangiomas are categorized into three types: capillary, cavernous lymphangiomas, and cystic hygromas. A scrotal lymphangioma is frequently misdiagnosed as a hydrocele, inguinal hernia, hematocele, varicocele, or even testis torsion. In our case, the diagnosis was made by ultrasonography with Doppler and confirmed by a biopsy of an excised mass lesion. The scrotum is a very uncommon site for cystic lymphangioma. CONCLUSION: A cystic or septate cystic mass discovered intra-operatively should not be dismissed as a complex hydrocele, since cystic lymphangiomas predictably recur if incompletely resected. A proper diagnosis of the scrotal lymphangioma and its extent using the US is essential for planning an appropriate surgical approach.

Waardenburg-Shah syndrome rare and challenging case report from Somalia.

INTRODUCTION AND IMPORTANCE: Waardenburg-Shah disorder could be an uncommon autosomal recessive inherited ailment characterized by aganglionic megacolon with a high mortality rate. Babies born with Waardenburg syndrome may have typical features of hair, skin and eye pigmentary abnormalities, and hearing loss. Here we present a case with typical presentation of Waardenburg Shah syndrome. CASE PRESENTATION: This is a case of neonatal intestinal obstruction caused by a rare syndrome known as Waardenburg-Shah syndrome, with clinical manifestations of abdominal distension, bilious vomiting, and a history of delayed meconium passage with a family history of variant forms of this syndrome. The patients underwent first laparotomy, which found no atresia.post op colongarphy revealed a narrowed colon. Then reoperated, and a biopsy was taken and opened ileostomy. The pathology result showed gangilion negative. The patient was lost due to uncontrollable sepsis at the age of 2 months. CLINICAL DISCUSSION: Waardenurg syndrome is a congenital audito-pigmentary syndrome first described in 1951.Waardenurg syndrome is classified into four types, WS1 to WS4, and they share the common presence of congenital sensoneural hearing loss and pigmentary defects. The diagnosis of WS has major and minor criteria. The definitive management of this disorder involves surgical removal of aganglionic segment of the bowel and connecting functioning gangilioic bowel to the anus. CONCLUSION: Shah-Waardenburg syndrome TYPE-4 is a relatively unusual syndrome characterized by a higher prevalence of whole colonic aganglionosis with or without small bowel involvement, resulting in substantial morbidity and mortality in the neonatal age range.