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Hakimi T, Seyar F, Halimi SA, Jawed MA. Childhood mesenteric cyst: A rare intra-abdominal entity with literature review. Int J Surg Case Rep 2023; 106:108216. [PMID: 37068457 PMCID: PMC10130205 DOI: 10.1016/j.ijscr.2023.108216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Mesenteric cysts are uncommon intra-abdominal benign masses that appear in childhood with varying degrees of clinical manifestations, ranging from being asymptomatic to presenting as an acute abdomen. The diagnosis is made incidentally during the work-up for other abdominal pathologies such as acute appendicitis, bowel obstruction, etc. The treatment is mostly surgical and varies depending on the clinical type of the lesion. CASE PRESENTATION A 26-month-old child was referred to our teaching hospital's pediatric surgery department with an abdominal mass. The patient had previously complained of constipation and been treated symptomatically with laxatives. Ultrasonography reported ovarian cysts confirmed by computerized tomography scanning (as a misdiagnosis report of an ovarian cyst instead of a mesenteric cyst), done outside the hospital in a private diagnostic center. CLINICAL DISCUSSION The patient was prepared for operation and during the surgical procedure, she was found to have a duplex cyst, which was mostly incorporated in the mesentery of the distal 1/3 of the transverse mesocolon. The cyst was enucleated through a lower midline laparotomy incision without bowel resection and anastomosis. The histopathological analysis of the specimen confirmed a mesenteric cyst. CONCLUSION Mesenteric cysts are rare lesions in children and should be considered when approaching any intra-abdominal mass. Except for the rare cases where intestinal resection and/or partial cyst excision are required, all mesenteric cysts can be excised while preserving intestinal integrity and vascular supply.
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Affiliation(s)
- Turyalai Hakimi
- Department of Pediatric Surgery, Kabul University of medical science, Maiwand Teaching Hospital, Kabul, Afghanistan.
| | - Farukh Seyar
- Department of Abdominal Surgery, Kabul University of medical science, Ali Abad Teaching Hospital, Kabul, Afghanistan
| | - Sultan Ahmad Halimi
- Department of Pathology, Kabul University of medical science, Kabul, Afghanistan
| | - Mohammad Anwar Jawed
- Department of Pediatric Surgery, Kabul University of medical science, Maiwand Teaching Hospital, Kabul, Afghanistan
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Hakimi T, Mangal M, Ibrahimi MA, Aslamzai M, Ekram K, Shiwa MH, Hakimi Z, Noory AT, Hamdard AG, Halimi SA, Jawed MA. A challenging high-risk surgery for necrotizing pneumonia in a right bilobed lung. BMC Pediatr 2023; 23:170. [PMID: 37046243 PMCID: PMC10099639 DOI: 10.1186/s12887-023-03999-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/08/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Necrotizing pneumonia is rare in children and is one of the most serious complications of a lung infection caused by antibiotic failure. We present a 12-year-old leukopenic child with a long-lasting lung infection, presenting as having a lung hydatid cyst, but diagnosing with necrotizing pneumonia in the right bilobed lung. Failure to medical treatment and ongoing leukopenia justified surgical intervention with positive results. CASE PRESENTATION The patient was referred to our teaching hospital's pediatric surgery department. He had previously been diagnosed with intestinal tuberculosis (TB) and received anti-TB treatment. On referral to our hospital, the patient was suffering from restlessness, frequent coughing, fever, vomiting, and diarrhea. Following the completion of the clinical work-up, a blood test revealed leukopenia (white blood cell count of 2100/microliter), a normal platelet count, and a lesion in the right lung. Computerized tomography scanning (CT-Scan) image reported a lung hydatid cyst. In the pediatrics ward, a broad-spectrum antibiotics regimen with triple-antibiotic therapy (linezolid, vancomycin, and metronidazole) was instituted and continued for a week with no response, but worsening of the condition. In the pediatric surgery ward, our decision for surgical intervention was due to the failure of medical treatment because of a pulmonary lesion. Our team performed right lung upper lobe anterior segment wedge resection due to necrotizing pneumonia and followed the patient 45 days post-operation with a reasonable result. CONCLUSION Living in remote rural areas with low resources and inaccessibility to proper and specialized diagnostic and treatment centers will all contribute to an improper diagnosis and treatment of lung infection. In total, all of these will increase the morbidity and mortality due to lung necrosis in the pediatric population, regardless of their age. In low-resource facilities, high-risk patients can benefit from surgical intervention to control the ongoing infection process.
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Affiliation(s)
- Turyalai Hakimi
- Department of Pediatric Surgery, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan.
| | - Mohmand Mangal
- Department of Pediatrics, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Mohammad Akbar Ibrahimi
- Department of Pediatrics, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Mansoor Aslamzai
- Department of Neonatology, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Khesrow Ekram
- Department of Pediatrics, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Mohammad Hussain Shiwa
- Department of General Surgery, Kabul University of medical science, Ali Abad teaching hospital, Kabul, Afghanistan
| | - Zamaryalai Hakimi
- Department of Infectious disease, Kabul University of medical science, Ali Abad teaching hospital, Kabul, Afghanistan
| | - Abdul Tawab Noory
- Department of Infectious disease, Kabul University of medical science, Ali Abad teaching hospital, Kabul, Afghanistan
| | - Abdul Ghafar Hamdard
- Department of Dermatology, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Sultan Ahmad Halimi
- Department of Pathology, Kabul University of medical science, Kabul, Afghanistan
| | - Mohammad Anwar Jawed
- Department of Pediatric Surgery, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
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Hakimi T, Rezavi F, Farook MI, Jawed MA. Polyorchidism presenting as cryptorchidism. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hakimi T, Hakimi Z, Jawed MA. Amyand's hernia with appendicular inflammatory mass collection. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2021.102097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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