Objective: Various esophageal replacement grafts have been used in children, although none can equal the native esophagus. The purpose of this study was to review the complications and outcomes associated with using different techniques in a single institute. Methods: A retrospective medical record review was conducted from 2006 to 2016. Patient demographics, perioperative clinical courses, complications and long-term outcomes were reported as percentages and categorized according to the surgical procedure performed. Results: A total of 15 children underwent esophageal replacement procedures, comprising 7 (47%) isoperistaltic gastric tubes, 3 (20%) colonic interpositions, 3 (20%) gastric transpositions and 2 (13%) reversed gastric tubes. Indications for esophageal replacement included long-gap esophageal atresia (5; 33%), esophageal atresia with severe postoperative complications (6; 40%), and caustic injury (4; 27%).The mean age of patients was 2.9 years (range: 0.2-15 years). The average follow-up duration was 3.6 years (range: 0.4-8 years). There was no perioperative mortality and no graft loss in any group. The long-term outcomes were acceptable, with no late stricture. Eightysix percent of the patients in the isoperistaltic gastric tube group and all patients in the other procedural groups achieved full oral feeding. Nevertheless, the patients had various degrees of malnutrition. Conclusion: Esophageal replacement remains a major challenge in children. Our experience indicates that children can be safely operated on using any of these methods, with acceptable outcomes and no deaths. Nevertheless, the long-term consequences and complications should be monitored throughout adulthood.

Background Idiopathic pediatric artery aneurysm is extremely rare and sometimes behaves like a pelvic neoplasm. As it is associated with a high mortality while ruptured, the accurate diagnosis is indispensable to avoid life-threatening complications. Angiographic imaging is the gold standard for diagnosis and treatment planning of the aneurysm. Due to the considerably higher radiation sensitivity of children, single portal venous-phase scanning of the abdominopelvic computed tomography (CT) is, however, reasonably utilized for the evaluation of a clinically palpable mass; the erroneous diagnosis of such aneurysm can be feasible. Case presentation A giant idiopathic concealed right iliac artery aneurysm in a 47-day-old girl presented with a palpable pelvic mass regardless of unidentifiable predisposing factors. Non-angiographic abdominopelvic CT was reappraised by the radiology consultant according to discordance between the mass characteristics on initial CT report and those on second-look sonography, revealing the concealed aneurysm instead of solid neoplasm as it originated from right internal iliac artery. The patient underwent an emergency laparotomy with successful proximal ligation of right internal iliac artery despite intraoperative aneurysmal rupture. Conclusions Typical CT features for the infantile iliac artery aneurysms may be overlooked, especially if the angiographic phase is omitted; thus, the imaging characteristics of the aneurysms are more difficult to appreciate and can mimic a pelvic neoplasm. Therefore, the identification of the origin of the mass should be more practical to achieve the precise diagnosis.