Preschooler with a palpable midline abdominal mass

Surgical image of rhabdomyosarcoma of the bladder
Surgical image shows the mass (between the surgeon’s fingers) to be extraperitoneal in location, originating from the left posterior aspect of the dome of the bladder. The mass did not appear to invade any normal structures except where it originated in the bladder, which is along the inferior edge of the image.

The diagnosis was rhabdomyosarcoma of the bladder.

Female infant with a right ovarian cyst on prenatal ultrasound and an incidental abdominal calcification noted on a CXR

Surgical image of ovarian torsion
Surgical image shows a large circular and soft mass that was adherent to, but not invading, the hepatic flexure, omentum, and distal ileum and which was no longer connected to any pelvic structures. There was no ovarian tissue in the right adnexa. The left ovary was normal.

The diagnosis was ovarian torsion that most likely occured in-utero.

School ager with appendectomy 3 months ago, now with abdominal pain and vomiting

Surgical image of small bowel obstruction due to abdominal adhesions
Surgical image shows dilated and congested loops of small intestine in the upper right corner and normal sized decompressed loops of small bowel adjacent to them. A volvulus was noted at the level of the terminal ileum, caused by adhesions from the cecum to the small bowel, forming a closed loop obstruction that was causing bowel wall congestion.

The diagnosis was small bowel obstruction due to abdominal adhesions.

Infant with non-bilious and bilious vomiting

Surgical image of Meckel's diverticulum
Surgical image shows shows multiple dilated loops of small bowel in the background with a sharp transition point seen in the center of the image in the terminal ileum where on its anti-mesenteric border a diverticulum is seen with an omphalomesenteric duct remnant coming off it. This remnant had been attached to the under surface of the umbilicus, serving as a fulcrum for a small bowel volvulus, resulting in a small bowel obstruction.

The diagnosis was Meckel’s diverticulum causing a small bowel volvulus and a small bowel obstruction.

Newborn with vomiting and a palpable abdominal mass

Surgical image of duodenal duplication
Surgical image shows a cystic mass attached to the inner surface of the C-loop of the duodenum from just distal to the pylorus to slightly proximal to the region of the ampulla of Vater. The distal antrum is visible in the upper left corner of the incision and the gall bladder is visible in the right corner of the incision between the liver and the mass.

The diagnosis was duodenal duplication.

Newborn with failure to pass meconium

Surgical image of colonic atresia
Surgical images show numerous loops of small bowel which are dilated, thickened and inflamed along with an extremely dilated ascending colon which is at the lower part of the left image and to the left side of the right image. An area of atresia was identified at approximately the hepatic flexure. The downstream colon (not shown) had the appearance of a microcolon. On the right image, the forceps are on the dilated appendix.

The diagnosis was colonic atresia near the level of the hepatic flexure.

Infant with 5 days of vomiting and abdominal distension who now has peritoneal signs and currant jelly stools

Surgical image of ileocolic intussusception
Surgical image shows an ileocolic intussusception extending into the mid ascending colon with a dusky terminal ileum (to the right) intussuscepting into the cecum (to the left). Note that the appendix (in the middle of the image) is intussuscepted with the ileum. The intussusception was reduced without great difficulty manually. No lead point was seen.