Esophageal atresia occurs in 1 out of 2500 to 4500 live births; an isolated variant occurs in 8% of the cases. In this case report and literature review, we present a rare case of isolated distal esophageal atresia happening just 2 cm above the diaphragmatic right leaflet with the connecting band between the two esophageal parts. The location raised the possibility of a direct vascular accident to that segment as a cause of the atresia. Post-operative ambu bagging may facilitate leak at the anastomosis site and should be done carefully, as well as, to introduce contrast with suckling not with jet injection for the same reason. We mentioned that to raise a wariness as this mishap may cause problems.
Background Spontaneous perforation of the urinary bladder is a rare disease entity. Due to its rarity, it is often hard to diagnose. Case presentation We present a case of a 2-year-old patient who presented with bowel obstruction and renal failure after scheduled correctional vertebroplasty due to congenital kyphosis. During exploratory laparotomy, two perforations were found at the dome of the urinary bladder, and an idiopathic spontaneous perforation of the urinary bladder was diagnosed. Primary double repair of the perforations was done, and no primary or secondary cause of the perforation was found. Conclusion The constellation of an acute abdomen and abnormal kidney function tests should increase the index of suspicion towards urinary bladder perforation. Due to its rarity, exploratory laparotomy is the gold standard method of diagnosis and treatment.
Intussusception is the invagination of a proximal bowel segment into a distal segment causing bowel obstruction, especially in children. In some cases, it can be caused by a pathological lead point, such as Burkitt lymphoma. Burkitt lymphoma has several patterns of clinical presentations, such as jaw or facial bone tumor in the endemic form, in contrast to an abdominal presentation most often with massive disease and ascites. We describe a case of a 4-year-old male who presented bowel obstruction. Using X-ray and ultrasound findings, ileocecal intussusception was then diagnosed. Resection and anastomosis was performed after multiple trials of failed hydrostatic reduction. On the pathology report of the resected segment, Burkitt lymphoma was found to be the cause and chemotherapy was initiated. The patient is doing well and is following up every 6 months for 2 years. A pathological lead point, especially Burkitt lymphoma, should be suspected in patients with failed conservative treatment, and prompt diagnosis of the pathology should be performed to prevent further sequela of the disease.
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