Operation procedure of sacrococcygeal fetus in fetu

Fetus in fetu is a condition in wich a fetiform calcified mass often presents in the abdomen of its host, a newborn. It is extremely rare condition, estimated once in 500,000 deliveries and has a 2: 1 male predominantly; with most patient presenting with an abdominal mass in the first year of life. 5,13 The term fetus in fetu is used to point out an unequal division of totipotential cells of blastocyst where the result is the inclusion of a small cellular mass in the more mature embryo. It was encapsulated, pedunculated and represents a malformed monozygotic, monochorionic, diamniotic parasitic twin. In 80% cases, fetus in fetu is located retroperitonealy but can be found in unusual location such as in oropharynx, neck, skull mediastinum, pelvis, iliac mesentery, adrenal gland, sacrococcygeal region and scrotal sac.

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Fetus in fetu: two case reports from North African country

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-020-00049-5 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Moutaz Ragab ◽

Omar Nagy Abdelhakeem ◽

Omar Mansour ◽

Mai Gad ◽

Hesham Anwar Hussein

Keyword(s):

Histopathological Examination ◽

Case Reports ◽

Abdominal Mass ◽

Mature Teratoma ◽

Surgical Techniques ◽

Rare Condition ◽

Mass Effect ◽

Fetus In Fetu ◽

Vascular Connection ◽

First Case

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.

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Fetus-in-fetu in an 8-month-old girl

10.7287/peerj.preprints.2295 ◽

2016 ◽

Author(s):

Bei Bei Zhao ◽

Yu Zuo Bai

Keyword(s):

Abdominal Mass ◽

Mature Teratoma ◽

Abdominal Distension ◽

Axial Skeleton ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Cranial Cavity ◽

Fetus In Fetu ◽

Live Births ◽

Sacrococcygeal Region

Fetus in fetu (FIF) is a very rare congenital malformation with an incidence of 1/500,000 live births. These children are often hospitalized because of vomiting, abdominal distension or abdominal mass found by their parents. The most common position for the parasitic fetus is the retroperitoneum but other position such as the scrotal sac, cranial cavity, sacrococcygeal region, back , oral cavity has been reported. FIF is often misdiagnosed as a mature teratoma. Ultrasound, CT, MRI are of great significance in distinguishing between FIF and teratoma. The postoperative pathological examination may reveal axial skeleton which can make a definitive diagnosis of FIF. In this report, we present a case of FIF in an 8-month-old girl.

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Intestinal Malrotation, Mesocolic Hernia, and Meckel Diverticulum – Differential Diagnosis of Abdominal Pain in Adults: Case Report and Literature Review

Journal of Coloproctology ◽

10.1055/s-0041-1732327 ◽

2021 ◽

Vol 41 (03) ◽

pp. 325-328

Author(s):

Marcus Vinícius Silva Costa ◽

Márcia Cristina de Alencastro ◽

Samyra Braz de Linica ◽

Tiago dos Santos Ferreira ◽

Edson Soares Bezerra ◽

...

Keyword(s):

Embryonic Development ◽

Mesenteric Artery ◽

Rare Condition ◽

Anatomical Variations ◽

Intestinal Malrotation ◽

First Year ◽

Meckel Diverticulum ◽

Intestinal Segments ◽

First Year Of Life ◽

Specific Symptoms

AbstractIntestinal malrotation is a congenital anomaly caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. Embryonic development and its anatomical variations were described by Dott in 1923.Intestinal malrotation is a rare condition among adults – prevalent in a mere 0.0001% to 0.19% of the population –, and it may be associated with other anatomical deformities. It can be asymptomatic or manifest with varying intensity, from obstruction to necrosis of intestinal segments. In general, this abnormality is diagnosed in the first year of life; however, symptoms may appear later in life, making diagnosis in adults difficult on account of non-specific symptoms.In the present study, we report a case of intestinal malrotation associated with chronic non-specific symptoms progressing to mesenteric angina.

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Pediatric Urachal Anomalies: Monocentric Experience and Mini-Review of Literature

Children ◽

10.3390/children9010072 ◽

2022 ◽

Vol 9 (1) ◽

pp. 72

Author(s):

Matthias Nissen ◽

Phillip Rogge ◽

Volker Sander ◽

Mohamad Alrefai ◽

Anna Romanova ◽

...

Keyword(s):

Abdominal Pain ◽

Abdominal Mass ◽

First Year ◽

Complication Rates ◽

Symptomatic Disease ◽

Lower Complication ◽

Complicated Course ◽

First Year Of Life ◽

Surgical Unit ◽

Non Surgical Treatment

Background: Surgery is the current mainstay for the treatment of urachal anomalies (UA). Recent literature data support the theory of a spontaneous resolution within the first year of life. The aim of this study, comprising solely surgically treated children, was to identify age specific patterns regarding symptoms and outcomes that may support the non-surgical treatment of UA. Methods: Retrospective review on the clinico-laboratory characteristics of 52 children aged < 17 years undergoing resection of symptomatic UA at our pediatric surgical unit during 2006–2017. Data was dichotomized into age > 1 (n = 17) versus < 1 year (n = 35), and complicated (pre-/post-surgical abscess formation or peritonitis, n = 10) versus non-complicated course (n = 42). Results: Children aged < 1 year comprised majority (67%) of cohort and had lower complication rates (p = 0.062). Complicated course at surgery exclusively occurred in patients aged > 1 year (p = 0.003). Additionally, complicated group was older (p = 0.018), displayed leukocytosis (p < 0.001) and higher frequencies regarding presence of abdominal pain (p = 0.008) and abdominal mass (p = 0.034) on admission. Regression analysis identified present abdominal pain (OR (95% CI), 11.121 (1.152–107.337); p = 0.037) and leukocytosis (1.435 (1.070–1.925); p = 0.016) being associated with complicated course. Conclusions: This study provides evidence that symptomatic disease course follows an age-dependent complication pattern with lower complication rates at age < 1 year. Larger, studies have to clarify, if waiting for spontaneous urachal obliteration during the first year of life comprises a reasonable alternative to surgery.

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Suprapatellar bursitis in a newborn

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic644 ◽

2021 ◽

Vol 10 (2) ◽

pp. 199-202

Author(s):

IIya O. Erenkov ◽

Ivan S. Denisov ◽

Svetlana A. Zarubina

Keyword(s):

Knee Joint ◽

Blood Test ◽

White Cell Count ◽

Treatment Strategies ◽

Rare Condition ◽

Well Being ◽

Patient Treatment ◽

First Year ◽

First Year Of Life

Introduction. One of the most frequent pathologies in childhood is bursitis of the knee joint. Such conditions may occur in infectious pathologies, traumatic disorders, overuse syndromes, and other various pathologies. Diagnostic and treatment strategies depend on the cause of bursitis development. Particular attention should be paid to bursitis cases in newborns since the frequency of such pathologies is casuistic and clinical guidelines for treating patients in this age group are absent. Materials and methods. A 26-day-old newborn arrived for consultation with complaints of knee joint pain and movement restrictions for four days. From five to 21 days of life, she has had in-patient treatment at another clinic because of pneumonia and a urinary tract infection. Intravenous and intramuscular injections of antibacterial drugs were prescribed for two weeks. The condition of the newborn was satisfactory upon consultation in our clinic. Her physical examination showed swelling and muscle tightness on the distal part of the thigh. The range of motion of the shinbone was restricted. Her blood test showed that her white cell count was unchanged. According to an X-ray examination of the knee, no pathology was detected. According to the US-examination, exudative suprapatellar bursitis was detected. The nonsteroidal anti-inflammatory drug, Nimesulid, was prescribed for seven days. Results. Daily remote monitoring of the patient's well-being during treatment was performed. Movement restrictions reduced the swelling on day 3 of treatment. A follow-up blood test on day 4 of treatment showed no pathology. According to the follow-up US-examination after six days of drug therapy, no signs of bursitis were detected. Conclusion. Inflammation of the suprapatellar bursa is a rare condition in newborns. In isolated cases of bursitis in children during the first year of life, a bacterial presence was noted, with the predominance of staphylococcal and streptococcal floras. However, in our opinion, there is a possibility of developing aseptic forms of bursitis in infants. In these cases, it may be prudent to refrain from prescribing courses of antibiotic therapy.

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Fetus In Fetu — A Mystery in Medicine

The Scientific World JOURNAL ◽

10.1100/tsw.2007.56 ◽

2007 ◽

Vol 7 ◽

pp. 252-257 ◽

Cited By ~ 3

Author(s):

A. K. Majhi ◽

K. Saha ◽

M. Karmakar ◽

K. Sinha Karmakar ◽

A. Sen ◽

...

Keyword(s):

Vertebral Column ◽

Rare Condition ◽

The Body ◽

Long Bones ◽

Retroperitoneal Mass ◽

Fetus In Fetu ◽

X Ray ◽

Parasitic Twin ◽

Vertebral Bodies ◽

Well Differentiated

Fetus in Fetu (FIF) is a rare condition where a monozygotic diamnionic parasitic twin is incorporated into the body of its fellow twin and grows inside it. FIF is differentiated from teratoma by the presence of vertebral column. An eight year old girl presented with an abdominal swelling which by X-ray, ultrasonography and CT scan revealed a fetiform mass containing long bones and vertebral bodies surrounded by soft tissue situated on right lumber region. On laparotomy, a retroperitoneal mass resembling a fetus of 585 gm was removed. It had a trunk and four limbs with fingers and toes, umbilical stump, intestinal loops and abundant scalp hairs but was devoid of brain and heart. Histology showed various well-differentiated tissues in respective sites. FIF is a mystery in reproduction and it is scarce in literature in such well-developed stage.

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Fecaloma Complicating Colostomy for Hirschprung Disease

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz113.074 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S67-S67

Author(s):

Samuel Ohayi ◽

Nnaemeka Onyishi ◽

Kevin Chukwubuike

Keyword(s):

Ganglion Cells ◽

Abdominal Mass ◽

Rectal Biopsy ◽

Distal Portion ◽

Definitive Treatment ◽

First Year ◽

Surgical Specimen ◽

History Of ◽

Colon Segment ◽

First Year Of Life

Abstract Background Hirschprung disease (HD) is a congenital disorder characterized by absence of ganglion cells in the distal portion of the large intestine with resultant obstruction. It commonly manifests shortly after birth, hence its usual diagnosis in the first year of life. A defunctioning colostomy precedes definitive treatment. Prolonged obstruction following untreated HD or any condition may progressively lead to fecaloma, a mass of inspissated feces commonly in the rectosigmoid that is much harder than impacted feces. If prolonged, affected intestine looks like a tumor. We present a case of fecaloma of the transverse colon complicating colostomy done for Hirschprung disease. Case Report A 6-year-old boy with a 6-year history of difficulty with passing stool with progressive abdominal swelling had Swenson’s procedure (ie, proctectomy) and prolapsing of ganglionic colon to the anus with left hemicolectomy. He had presented to the pediatric surgery unit of our hospital 4 years previously with these symptoms with a defunctioning colostomy performed for suspected HD. He reportedly passed meconium a day after birth and subsequently passed stool once in 7 to 14 days spontaneously or after digital manipulations. Stooling frequency progressively reduced but no vomiting. Following administration of herbs, he developed diarrhea, and with worsening symptoms, he presented to our hospital. Three years postcolostomy, rectal biopsy was performed with a histology confirming aganglionosis of the rectum (HD). Barium enema had shown long-segment HD with dilated rectosigmoid colon but no fecaloma. Surgical specimen received in the histopathology laboratory consisted of colon segment comprising a colostomy stump with a ring of skin (colostomy stoma) and a proximal markedly dilated portion filled with fecaloma followed by a hypertrophied proximal portion. Histology showed presence of ganglion cells in these segments. Conclusion Fecaloma should be suspected in a protracted colostomy with abdominal mass proximal to the stoma.

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Cyst of Canal of Nuck in a 62-Year-Old Woman: Case Report of a Rare Disease

International Journal of Surgical Case Reports ◽

10.31487/j.ijscr.2020.02.03 ◽

2020 ◽

pp. 1-5

Author(s):

Livia Bressan ◽

Barbara Pozzetto ◽

Bussani Rossana ◽

Livia Bressan ◽

Marina Bortul ◽

...

Keyword(s):

Spermatic Cord ◽

Inguinal Canal ◽

Rare Condition ◽

Round Ligament ◽

First Year ◽

Female Development ◽

Prolene Mesh ◽

Case Presentation ◽

Canal Of Nuck ◽

First Year Of Life

Introduction: Cyst of Nuck in women is a rare development disorder corresponding to hydrocoele of the spermatic cord in males; it can be associated with inguinal hernia in 30-40% of cases. Only 400 cases have been described in literature and in there are no older than 50. Case Presentation: A 62-year-old presented a right aching inguinal swelling. On physical examination the mass was not reducible, without signs of incarceration or strangulation. On ultrasound the lesion was mostly hypoechoic. CT saw an over liquid lesion, confirmed on MRI as a lesion hypointense in T1 and hyperintense in T2. The patient underwent open surgery: the cyst was separated from the round ligament and excised in mass and the defect was repaired with a prolene mesh. The histopathological exam confirmed the hydrocoele (calretinin positive, mesothelial cells on the inner surface). Discussion: The canal of Nuck is a small evagination of the parietal peritoneum that accompanies the round ligament into the inguinal canal during the first year of female development and is normally obliterated in the first year of life. Failure of obliteration of Nuck canal results in a hydrocoele that could develop intraabdominal or extra – abdominal or both. Ultrasound shows a thin walled, well defined, echo free cystic structure but the perfect diagnosis is given by MRI. Therapy is surgical and it can be open or, more recently, laparoscopic, depending on the expertise of the surgeon. Conclusion: A cyst of Nuck is a rare condition but it should always be considered in differential diagnosis of cystic inguinal lumps in women. Most of the reported cases concern children and young men. To our knowledge this is the only case regarding a more than 50-year-old.

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Fetus-in-fetu in an 8-month-old girl

10.7287/peerj.preprints.2295v1 ◽

2016 ◽

Author(s):

Bei Bei Zhao ◽

Yu Zuo Bai

Keyword(s):

Abdominal Mass ◽

Mature Teratoma ◽

Abdominal Distension ◽

Axial Skeleton ◽

Definitive Diagnosis ◽

Pathological Examination ◽

Cranial Cavity ◽

Fetus In Fetu ◽

Live Births ◽

Sacrococcygeal Region

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Spontaneous Perforation of the Extrahepatic Bile Ducts in an Infant

PEDIATRICS ◽

10.1542/peds.70.4.601 ◽

1982 ◽

Vol 70 (4) ◽

pp. 601-603

Author(s):

Dan Andersson ◽

Ingemar Helin ◽

Sven-Caspar Nettelblad ◽

Clas-Göran Cederlund

Keyword(s):

Surgical Treatment ◽

Obstructive Jaundice ◽

Biliary Atresia ◽

Bile Ducts ◽

Surgical Intervention ◽

Rare Condition ◽

First Year ◽

Spontaneous Perforation ◽

Extrahepatic Bile Ducts ◽

First Year Of Life

Spontaneous perforation of the extrapepatic bile ducts, with an accumulation of bile in the peritoneal cavity, is a rare condition. Nevertheless, it is second in frequency to biliary atresia as the cause of obstructive jaundice during the first year of life.1 Although approximately 60 cases of this condition have been described in the literature, it is only occasionally listed in pediatric textbooks. Nevertheless, it is important that the condition be recognized in time to perform lifesaving surgical intervention. We therefore consider it instructive to present a patient with the classic features of this condition who was cured by surgical treatment on the 29th day of life.

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