Abdominal Masses In Children Research Articles

Removed: Giant mesenteric cysts: A rare case series with clinical insights

Introduction and significanceMesenteric cysts are rare, non-cancerous tumors found mainly in children. The symptoms can vary depending on the size and location of the cyst. While the exact cause is unknown, complete surgical removal is the main and most effective treatment for mesenteric cysts. Case presentationThree cases involving young boys were presented. They primarily complained of abdominal swelling without pain. Radiological tests revealed mesenteric cysts near the jejunum and transverse colon, and another near the sigmoid colon, which were both successfully removed. Clinical discussionDespite being uncommon, mesenteric cysts should be considered when diagnosing abdominal masses in children. ConclusionSurgical intervention is crucial for patients with mesenteric cysts. Complete surgical removal leads to a positive prognosis, even for large or complex cases. This stresses the importance of considering. Environmental factors are potential causes for the formation and development of these tumors.

Upper abdominal mass in children.

Upper abdominal mass in children.

Prevalence and Characteristics of Pediatric Abdominal Mass in Radiology Department Prof. Ngoerah General Hospital Bali, From January 2018 to December 2020

Introduction: Abdominal mass is one of the common pediatric tumors that can manifest as abdominal pain or a distended abdomen, and it requires immediate management. Some of them can often be incidentally discovered by parents, during routine pediatric examination in an outpatient clinic, or detected on imaging multimodalities. This study is aimed to evaluate the prevalence of pediatric abdominal mass and to demonstrate tumor characteristics by radiology imaging findings in Prof. I G. N. G. Ngoerah Hospital Denpasar. Methods: We conducted a descriptive, cross-sectional study of patients with abdominal masses discovered by Abdominal CT scan in the Radiology Department of Prof. I G. N. G. Ngoerah Hospital from January 2018 to December 2020. Medical record review and data analysis were done retrospectively. Results: We identified 143 pediatric patients diagnosed with abdominal masses discovered by a CT scan in the Radiology Department of Prof. I G. N. G. Ngoerah Hospital from January 2018 to December 2020. Female patients were found more than male patients (77 vs. 66 patients). Out of all patients, the majority of age were 1 to 9 years old (65 patients, 45%), while the second were 10 to 18 years old (52 patients, 35%), and the rest were one month – 11 months (17 patients, 12%) and <1 month (5 patients, 4%) respectively. The average age was 7.44 years old. Conclusion: The abdominal imaging and histopathological findings help evaluate abdominal mass in children. An accurate diagnosis is essential for proper management.

An approach to oncological abdominal masses in children

Abstract Approximately 1400 children in England are diagnosed with cancer each year and in these children an abdominal mass is a common finding, particularly in those under 5 years of age. Here we present an initial diagnostic framework and suggested management plan for children presenting with an abdominal mass, with short summaries of the most common malignant paediatric pathologies. Initial assessment should begin with a thorough history and examination, followed by blood and urine tests in addition to radiological imaging. Management should first be directed at acute concerns requiring immediate attention and then to supportive care, including analgesic, blood product and fluid requirements. Early communication with the local tertiary oncology unit is encouraged to obtain advice on any acute issues and also to plan for transfer and further investigation. Open and honest communication with the family is essential to develop a trusting relationship and prepare them for transfer to an oncology ward environment.

The Pattern of Presentation of Abdominal Masses in Children

Background; The abdominal masses in infants, neonate or child is a worrying sign that every clinician must be aware of as these masses can sometimes show malignant transformation. The outcome of this study would give an overview to the paediatric surgeons/ urologist about presenting spectrum of abdominal masses in children in our population which would enable them to manage these patients properly. Study Design: A Descriptive Cross-sectional Study conducted at Children Hospital, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS Islamabad and Urology department of Islam Medical College/ Teaching Hospital, Sialkot for the duration of one year from January 2022 to December 2022. Material & Methods: This descriptive cross sectional study include ninety four (n=94) patients of less than 12 years of age irrespective of either gender who presented with abdominal mass. Patients suspected of having abdominal mass were screened from the outpatient (OPD) and emergency departments. Results; Out of 94 children, sixty five (69.15%) children were males whereas twenty nine (30.85%) were females. The male to female ratio was 2.24:1. Thirty five (37.33%) children were less than 1 year old, Twenty six (27.66%) were between age 1 and 3 years, nineteen (20.12%) children were between age 3 to 7 years and fourteen (14.89%) of children were elder than 7 years of age. The mean age was 7.4 months ± 2.1 Standard Deviation (SD). Most of the masses are benign and cystic in nature, however, Wilms’ tumour and neuroblastoma are two conditions that need a vigilant monitoring as these are the two malignant tumours (22.34% : n=21) in children where they usually present with abdominal mass. Conclusion; In a nutshell, any child presented with abdominal symptoms in surgical department must be investigated and managed accordingly. Any delay in diagnosis may cause fatal outcome. Keywords: Abdominal mass, UPJO-ureteropelvic junction obstruction, VUR (vesico-ureteric reflux), Hydronephrosis.

Kết quả sinh thiết kim lõi dưới hướng dẫn siêu âm trong chẩn đoán u bụng tại Bệnh viện Nhi Trung ương

Background: The gold standard for diagnosing tumor lesions is the result of pathology. Previously, patients had to perform the opened biopsies. Recently, most patients underwent ultrasound - guided core needle biopsy. Objective: recommendations for results and safety of ultrasound-guided core needle biopsy (UCNB) in the diagnosis of abdominal masses in children. Subjects and Methods: From June 2019 to June 2020, there were 105 patients with abdominal solid tumor who had been indicated to perform ultrasound-guided core needle biopsy in the National Children’s Hospital. Results: Of the 105 patients involved in the study, 88 were malignant (accounting for 83.8%) with the majority being neuroblastoma. 100% of patients had been performed procedures successly, but accurate pathological diagnosis reached 95.2%. 10.5% of patients was performed in an emergency clinical situation. Rate of complication with bleeding was 6.7%. Mortality was 1% due to severe hemorhage. Conclusion: Ultrasound-guided core needle biopsy is a method for result successful highly. The rate of severe bleeding complications is acceptable.

Series of rare diagnosis and presentations of abdominal mass in children: a great learning experience

Abdominal mass is a common finding in children, either palpable or radiologically evident surprisingly. Some of them are rare tumors. Functional active tumors are rarely palpable but present with varied arrays of symptoms. In this series authors are discussing few rare cases with atypical presentations such as- teratoma arising from adrenal gland, teratoma presenting with hypertension, fetus in fetu (Girl and Boy child), adrenocortical tumor presenting as precocious puberty and adrenal pheochromocytoma with features of cushing’s syndrome. These atypical presentations may have pose a challenge in diagnosis and management for the treating team with first time occurrence specifically if they are handling them for first time.

Ender Bir Olgu: Bir Bebekte İki Taraflı Abdominoskrotal Hidrosele Bağlı İki Taraflı Hidronefroz

Abdominoscrotal hydrocele is a rare entity and first described by Dupuytren in 1834. Its etiology is still unclear. Rare complications are hydroureter/hydronephrosis, testicular flattening and malignant mesothelioma of tunica vaginalis associated with intraabdominal testis in an abdominoscrotal hydrocele. Herein we report a 7-month-old boy with bilateral abdominoscrotal hydrocele with secondary bilateral hydronephrosis due to contiguous pressure. Bilateral hydrocelectomies were performed. The postoperative course was uneventful without complication. Six month after the operation the renal ultrasound was normal. This entity, although unusual, should be considered in the differential diagnosis of a lower abdominal mass in children, as well as a cause of hydronephrosis. After surgical removal, healing is usually complete, including regression of the hydronephrosis.

Differential diagnosis of cystic abdominal masses in children

Cystic abdominal masses are acommon main or incidental finding in daily radiological practice; however, differentiation is not always trivial. In children, cystic abdominal masses represent aspecial feature compared to adults, since the spectrum of congenital lesions must be taken into consideration. The article gives astructured overview of the most common entities. The standard methods in abdominal imaging in pediatric radiology are ultrasound and MRI. Based on a literature review, the most important differential diagnoses with their characteristics in ultrasound and MRI were compiled. With anatomical classification, presence or absence of solid components as well as the contrast agent behavior in the MRI, the cystic masses can be well differentiated and classified into three groups: congenital and acquired cysts as well as neoplasms.

Study on clinical profile and management of abdominal tumours in children

Background: The discovery of an abdominal mass in a child usually presents a challenging problem in the diagnosis and treatment to the paediatrician, surgeon and urologist. Because of the heterogenicity of the lesion knowledge of differential of a mass in abdomen is essential for the logical evaluation of a child.Methods: The present study comprises of 25 children who presented with an intra-abdominal mass were included. The medical causes of the abdominal masses i.e. hepatosplenomegaly and leukemias were excluded. All patients admitted were routine investigated and whichever necessary. After the diagnosis, surgery was done wherever indicated and post-operatively the diagnosis was confirmed after the histopathological report.Results: All the cases presented with mass in abdomen while the other presentations were pain in abdomen (36%), fever (20%) and haematuria and vomiting (16% each). It was found that 64% of the masses were urological in origin while 36% of the masses were non-urological in origin. 21 (84%) patients underwent surgery, 10 (40%) patients took chemotherapy, 9 (36%) patients took radiotherapy.Conclusions: Routine investigations were only helpful in diagnosing the infection in infecting cases. Most reliable specific investigation was intravenous pyelography. It was found that majority of the abdominal masses in children were arising from urinary system. Correlation between pre-operative and post-operative diagnosis was found almost consistent.

Accuracy of ultrasonography in the evaluation of abdominal masses in children in Nigeria.

Introduction:Abdominal masses in children constitute a spectrum of lesions of diverse origin, nature and significance. In a low-income setting with limited investigative facilities, accurate diagnosis of abdominal masses can be very challenging. However, ultrasound has been used preferentially as a diagnostic tool in evaluating abdominal masses in children. This study aimed to determine the accuracy of ultrasound evaluation of abdominal masses in children.Materials and Methods:This was a prospective descriptive study of 135 consecutive children presenting with palpable and/or suspected abdominal masses over a 1-year period at a tertiary hospital. Data analyses were done using SPSS version 17 software and level of significance was set at P < 0.05.Results:Abdominal mass was located in the kidney in 40 (32.3%) patients. Definitive diagnoses of abdominal masses were confirmed intraoperatively in 33 (24.4%) and by histopathological examination in 102 (75.6%) cases. Abdominal masses were detected in 124/135 (91.9%) of the participants. Ultrasound (US) correctly identified 109/124 (87.9%) of the pathologies. The sensitivity and specificity of USS were 87.9% and 81.8%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) were 97.2%–98.2% and 37.5%–45.7%, respectively. The overall US diagnostic accuracy was 87.4%. The predictive value of US for intussusceptions, Wilms' tumour and hydronephrosis was high (sensitivity was 92.0%, 95.8% and 81.1% and PPV was 90.0%, 83.0% and 93.8%, respectively). On the other hand, the sensitivity indices for appendiceal mass/abscess, lymphoma and neuroblastoma were low (28.6%, 66.7% and 57.1%, respectively), while their PPV was low too (66.7%, 42.9% and 77.7%, respectively). The PPV was especially poor for lymphoma. The specificity and NPV indices for these six disease conditions were good.Conclusion:Ultrasound is a reliable tool in the evaluation of abdominal masses in children in this setting.

Characterization of neoplastic and cystic abdominal masses in children, reporting to the government tertiary care center in Vishakhapatnam – A longitudinal, prospective study

Characterization of neoplastic and cystic abdominal masses in children, reporting to the government tertiary care center in Vishakhapatnam – A longitudinal, prospective study

Tumors and Beyond: an Array of Abdominal Masses in Children

Tumors and Beyond: an Array of Abdominal Masses in Children

Cystic intra-abdominal masses in children.

Benign intra-abdominal cystic masses in infancy are fairly uncommon and their etiopathogenesis, histology and clinical presentation differ significantly. Our aim is to report our experience in their treatment in order to discuss the best diagnostic and treatment modality. The medical records of 5 children (2M, 3F) with cystic intraabdominal masses referred to our hospital between November 2012 and September 2016, were retrospectively reviewed. All patients underwent open surgery and subsequent histopathologic analysis. Different clinical presentations, localizations of the masses, diagnostic tools, surgical approaches, histological examinations and outcomes were reviewed. Patients mean age was 5.4 years (range: 8 months-9 years). Two patients presented recurrent abdominal pain and abdominal distension; 1 patient had a palpable mass discovered incidentally and 2 complained acute abdominal pain. Routine laboratory tests, tumor markers and abdominal ultrasound were immediately done in all patients. Three patients underwent MRI and 1 abdominal CT. At laparotomy 2 hepatic cysts, 2 mesenteric cyst and 1 retroperitoneal cyst were discovered. Histology reports described: 1 hepatobiliary cystadenoma, 1 benign hepatic hamartoma and 3 cystic lymphangiomas (1 retroperitoneal and 2 mesenteric). There were no major postoperative complications, deaths, or recurrences in our series (follow-up 3-24 months). Despite the rarity of these lesions, benign cystic abdominal masses in children are not so uncommon and should be considered as causes of acute abdominal pain. The differential diagnosis is not always possible preoperatively. In our series, radical excision of the lesions was possible in all cases, allowing reliable histological results and avoiding recurrences.

XANTHOGRANULOMATOUS PYELONEPHRITIS IN A CHILD: A RARE ENTITY

Xanthogranulomatous Pyelonephritis is chronic pyelonephritis uncommonly described in adults and rarely in children. It is characterised by replacement of renal parenchymal tissue by lipomatous cells making it non-functional and may be mistaken for pyonephrosis, cystic or solid tumor, and most commonly wilms tumour. It often presents as abdominal mass in children and more commonly involves left kidney. Imaging by CT scan is characteristic and histology is diagnostic. We are reporting a case in child who presented with prolonged febrile illness and documented urinary tract infection with nephrolithiasis without any abdominal lump and received antibiotics for multiple times without any improvement. USG was suggestive of pyonephrosis and multiple abscesses. However, CT scan done subsequently diagnosed as xanthogranulomatous pyelonephritis of right kidney which was confirmed on histology. After documenting no function in affected kidney with other being normal, unilateral nephrectomy was done resulting in rapid symptomatic improvement. Results for genetic analysis for suspected hereditary tubular disorders are pending.

Giant mesenteric teratoma in a 6 month-old

Abstract Objective We report a case of mesenteric teratoma in a healthy 6 months old baby girl. The purpose of this report is to familiarize the pediatric surgery doctors with the characteristic appearance of this tumor, which is rare. Method Case report and review of the English-language literature (using PubMed, Ovid, and Proquest databases). Results Case of mesenteric teratoma occurred in an infant girl to be reported in the English-language literature. Conclusion Mesenteric teratoma is an uncommon tumor that included all three embryonic layers. Although the presurgical diagnosis might be difficult in some cases, mesenteric teratoma must be kept in the differential of abdominal masses in children. The present case highlights the importance of considering mesenteric teratoma in the clinical and pathological differential diagnosis of intra-abdominal/retroperitoneal masses. Complete Surgical excision is almost always curative.

Benign Cystic Mesothelioma in a Child: Case Report and Review of the Literature.

Benign cystic mesothelioma (BCM) is a rare tumor with benign characteristic. There are only 8 child cases reported in the English literature. In this report, we present this rare entity a brief review of the literature. A two year-old boy presenting with abdominal swelling was hospitalized. Physical examination revealed a mass filling the abdomen. Laboratory findings were not specific. Abdominal computerized tomography showed a 15×13×11 cm cystic mass extending from the bladder to the liver with no solid components and no infiltration to adjacent organs. Operation revealed a cystic mass filled with yellow-green serous fluid which was attached to the right lobe of the liver with a 1 cm thick peduncle. Total excision of the mass was performed by clamping and cutting the narrow attachment. Recovery was uneventful. Pathology revealed multiple cysts lined with mesothelial cells. No recurrence was seen after 5 years of follow-up. BCM should be kept in mind as a rare cause of the abdominal mass in children, as it may lead to confusion in preoperative diagnosis. Although rare, patients should be followed throughout life because of the risk of recurrence and malignant degeneration.

EMERGENCY LAPAROSCOPY IN THE DIAGNOSIS AND TREATMENT OF CHILDREN WITH SPACE-OCCUPYING ABDOMINAL LESIONS (clinical observations)

Palpable abdominal masses in children urgently hospitalized with acute abdominal pain require a hands-on diagnostic and treatment approach. The clinical observations of children operated for ovarian torsion and localized appendicular peritonitis demonstrate objective difficulties of ultrasound evaluation of the abdominal cavity in complicated forms of the diseases, the effectiveness of laparoscopy for diagnosis and determination of the adeqaute scope of surgical intervention. The article is supplemented with the results of radiological studies, laparoscopy, and a brief review of the literature.

A rare pediatric case of grossly dilated ureter presenting as abdominal mass.

Renal masses account for 55% of cases presenting as palpable abdominal mass in children.[1] An eight year male presented with palpable abdominal mass and pain. The patient underwent renal dynamic scan, which raised possibility of left duplex kidney with non-functioning moiety, as the size of left kidney was smaller than seen on Ultrasonography (USG). Magnetic resonance (MR)urography confirmed the findings with patient undergoing left hemi-nephrectomy and is doing well. In case of discrepancy in size of kidney on USG and renal scan, duplex kidney should be considered as differential, other causes being, renal cyst, benign/malignant mass and renal calculi. Gross hydro-ureter presenting as palpable abdominal mass is very rare with few reported cases.[234]

Akut Batın ile Başvurmayan Apendiksin Burkitt Lenfoması

Burkitt's lymphoma is a high grade B cell neoplasm typically presenting with abdominal mass in children in non-endemic regions. Primary appendicular lymphoma (PAL) is very rarely observed and comprises about 0.015% of all gastrointestinal lymphomas. Cases with PAL generally present with acute abdomen and are usually diagnosed in the postoperative period. In this study, a case of Burkitt Lymphoma in our clinic, which has originated from the appendix, without symptoms of acute abdomen with right lower quadrant swelling for 2 months, has been evaluated. Right hemicolectomy+end-lateral ileotransversostomy were performed on the patient. Postoperative treatment was continued with the classic combination of cyclophosphamide, doxorubicine, vincristine and prednisone (CHOP). On the control computed tomography performed 12 months later, there was no tumor residue detected in the abdomen and the pelvis.