Congenital segmental dilatation of the colon is a very rare entity of unknown etiology, characterized by a localized dilatation of a bowel segment of the colon of variable length and an abrupt transition between the normal and dilated intestine. It can affect any part of the colon, with the rectosigmoid colon being the most commonly affected site. The clinical and radiological features may resemble that of Hirschsprung disease, but differ in that the normal ganglion cells are found in the dilated and normal segment of the colon. We performed laparoscopic-assisted transanal endorectal pull-through for segmental dilatation of rectosigmoid colon in an 8-year-old boy with chronic constipation since the age of 5 months.
Child* ; Colon* ; Constipation ; Dilatation* ; Ganglion Cysts ; Hirschsprung Disease ; Humans ; Intestines ; Male

Intestinal atresia is a frequent cause of intestinal obstruction in the newborn. We reviewed the clinical presentation, associated anomalies, types of atresias, operative managements, and early postoperative complications in 36 cases of intestinal atresia treated at the Department of Surgery, Kyungpook National University Hospital between January 1994 and February 2003. Location of the lesion was duodenum in 17 patients, jejunum in 11 patients and ileum in 8 patients. The male to female ratio was 1:1.4 in duodenal atresia (DA), 2.7:1 in jejunal atresia (JA) and 7:1 in ileal atresia (IA). The most common type was type III (41.1 %) in DA, and type I (52.6 %) in JA and IA. The most common presenting symptoms was vomiting(88.2 %) in DA, but in jejunoileal atresia, vomiting(89.4 %) and abdominal distension(89.4 %) were the most common sign and symptom. All cases of DA were diagnosed by plain abdominal radiography. There were 6 cases of DA with congenital heart disease, 3 cases of DA with Down syndrome and 3 cases of JA with meconium peritonitis. Segmental resection was performed in 13 cases, duodenoduodenostomy in 11 cases, membrane excision in 7 cases, jejunojejunostomy in 2 cases, gastroduodenostomy in 2 cases and ileocolic anastomosis in 1 case. There were 9 postoperative complications including 3 each of anastomotic leakage, wound infection, and intestinal obstruction 3 cases. The mortality rate for DA was 11.8 %(2/17). Both deaths in DA were attributed to congenital heart disease. The mortality rate for JA was 18% (2/11). Both cases died with sepsis and short bowel syndrome.
Anastomotic Leak ; Down Syndrome ; Duodenum ; Female ; Gyeongsangbuk-do ; Heart Defects, Congenital ; Humans ; Ileum ; Infant, Newborn ; Intestinal Atresia* ; Intestinal Obstruction ; Jejunum ; Male ; Meconium ; Membranes ; Mortality ; Peritonitis ; Postoperative Complications ; Radiography, Abdominal ; Sepsis ; Short Bowel Syndrome ; Wound Infection

Pancreatoblastoma is a rare pediatric neoplasm with distinct acinar and squamoid differentiation that generally affects infants and young children. Although the prognosis is relatively favorable over typical pancreatic cancer, the optimal treatment of pancreatoblastoma has not been established. We experienced two cases of pancreatoblastoma in a 2-year-old girl and boy which was found incidentally by the parents due to the detection of abdominal masses.
Child ; Humans ; Infant ; Pancreatic Neoplasms ; Parents ; Preschool Child ; Prognosis

We experienced a case of a 4-year-old girl presenting with vomiting, abdominal pain and mobile mass in the periumbilical area. On physical examination, the abdomen was soft and a 10x10 cm sized, painless firm mobile round mass was palpated in the periumbilical area. An abdominopelvic computed tomography scan showed a huge hypodense mass with encapsulation and multiple septation in the left lower quadrant of the abdomen, compressing the intestinal loops. At operative exploration, she was found to have a soft, yellowish round mass originating from the ileal mesentery, situated 10 cm proximal to the ileocecal valve. The mass was completely excised together with the adjoining ileum, and bowel continuity was restored. Histopathologic diagnosis revealed a mesenteric lipoma, composed of mature adipocytes with no evidence of necrosis or malignancy. The postoperative course was uneventful.
Abdomen ; Abdominal Pain ; Adipocytes ; Child ; Humans ; Ileocecal Valve ; Ileum ; Lipoma ; Mesentery ; Necrosis ; Physical Examination ; Preschool Child ; Vomiting

Although hemangiomas are common vascular tumors that can occurany where in the body, they seldom involve the gastrointestinal tract. Hemangiomas of the gastrointestinal tract in infants and children are rare benign vascular tumors that most commonly present with gastrointestinal bleeding. We describe here the case of 2-year-old boy with intestinal bleeding caused by a large jejunal cavernous hemangioma, which was treated by laparoscopy-assisted resection of the affected portion of the jejunum.
Anemia ; Caves ; Child ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Hemangioma ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Infant ; Jejunum ; Laparoscopy ; Preschool Child

Thyroglossal duct cysts (TGDC) are the most common type of congenital developmental anomaly encountered in the anterior midline of the neck in childhood. The aim of the study was to evaluate the clinical characteristics of TGDC and identify any factors that could be related to recurrence after surgery. This study consisted of a retrospective chart review of 45 patients treated at Kyungpook National University Hospital for TGDC between 1990 and 2008. All records were reviewed for age and sex, length of history, presentation, diagnostic methods, sizes and locations of cyst, surgical management, histopathology of the lesion and recurrences. The statistical analysis of risk factors for recurrence was made using the Fisher's exact test with a significance level of p < 0.05. The male to female ratio was 2.2:1 with a male preponderance. The mean age at operation was 5 years and 2 months (4 months - 17 years). The most common presenting symptom was a nontender cervical mass (78%). Most TGDC were found in the midline position. Twenty four were infrahyoid, 17 were hyoid, and 4 were suprahyoid level. Forty one (91%) patients received the Sistrunk operation, and 4(9%) patients received cyst excision. Postoperative a seroma developed in six patients in the early postoperative days. There were a total of 3(6.6%) recurrences, 2 in patients who had excision only and in one patient who had the Sistrunk operation. Univariate analysis for risk factors with recurrence showed that there was no statistical relationship between the presence of preoperative infection and the development of recurrence. The removal of hyoid bone along with TGDC was a statistically significant risk factor for recurrent disease. This study suggests that the Sistrunk operation is the treatment of choice for TGDC in order to reduce recurrence.
Child ; Female ; Humans ; Hyoid Bone ; Male ; Neck ; Recurrence ; Retrospective Studies ; Risk Factors ; Seroma ; Thyroglossal Cyst

There have been a few reports of familial anorectal malformations extending over more than one generation. We experienced a case of a family with 3 members spanning 2 generations affected with isolated low type anorectal malformations. They had same low type of anorectal malformations. In all 3 patients, a perianal anoplasty was performed.
Family Characteristics ; Humans

PURPOSE: To compare the efficacy of a 20-gauge and an 18-gauge needle in sono-guided percutaneous automated gun biopsy for establishing the specific diagnosis of renal parenchymal disease in pediatric kidneys. MATERIALS AND METHODS: In 60 pediatric patients with renal parenchymal diseases, percutaneous sono-guided gun biopsy was performed by an experienced radiologist. In two groups of 30 patients, regardless of their age, two needle passes were performed, using alternately an 18-gauge or a 20-gauge biopsy needle. The core of renal tissue thus obtained was examined with light, immunofluorescent or electron microscopy by the renal pathologist. The mean number of intact glomeruli of whole tissue core per biopsy, as seen on the light microscopy, and post-bioptic complications were compared between the two different needle size groups. RESULTS: The number (mean+/-1 standard deviation) ofglomeruli obtained per biopsy was 17+/-8 in the 18-gauge needle group, and 14+/-5 in the 20-gauge group. Between two groups, there was no major post-bioptic complication requiring specific treatment, nor a statistically significant difference in the frequency of minor complications. CONCLUSION: Even though more glomeruli were obtained with an 18-gauge needle, the number obtained with a 20-gauge needle also permitted adequate pathologic examination. Both an 18-gauge and a 20-gauge needle may thus be suitable for renal biopsy in pediatric patients.
Biopsy* ; Diagnosis ; Humans ; Kidney ; Microscopy ; Microscopy, Electron ; Needles*

No abstract available.
Endodermal Sinus Tumor ; Follow-Up Studies ; Germ Cells ; Liver ; Neoplasms, Germ Cell and Embryonal

Median raphe cyst (MRC) of the perineum is rare congenital midline cyst of the male genitalia. MRC is thought to be caused by congenital alterations in the embryologic development of the male genitalia during fetal life. MRC can be found on the midline position between the urethral meatus and the anus. The lesion can be cystic, but sometimes it looks like an elongated configuration called a raphe canal. Diagnosis in childhood is particularly rare because they are usually asymptomatic, but some cases have reportedly been identified after infection. Although conservative treatment can be possible in small asymptomatic lesions, the treatment of choice is simple excision followed by primary closure in symptomatic cases. We describe here the case of 2-year-old boy presented at our institution with a 10-month history of anomaly of the perineal median raphe, which was treated by surgical excision.
Anal Canal ; Child, Preschool* ; Diagnosis ; Genitalia, Male ; Humans ; Male* ; Perineum