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.

Toddler with a right suprarenal mass

Gross pathological image of extralobar pulmonary sequestration
Gross pathological images show a right-sided subdiaphragmatic / suprarenal mass similar in appearance to the lung above it (above left). When the aorta was opened (above right), the orifice of an arterial vessel supplying the mass was seen coming off of the aorta just above the tip of the upper hemostat on the right side of the aorta. The relationship of the feeding vessel off of the aorta to the mass is more clearly demonstrated on the specimen image (below).

The diagnosis was a subdiaphragmatic extralobar pulmonary sequestration.

Preschooler with progressive respiratory distress

Surgical image of congenital lobar emphysema
Surgical image taken just after opening the right chest shows a very large and emphysematous right upper lobe which was allowed to herniate out through the incision, thus decompressing the other intrathoracic structures. The patient’s respiratory status improved immediately. The tip of the normal right middle lobe can be seen under the over inflated right upper lobe.

The diagnosis was congenital lobar emphysema.

Infant with enterocolitis

Gross pathological image of Hirschsprung disease
Pathological image shows a narrow caliber rectum and sigmoid colon (to the lower right) until a transition zone is encountered in the caliber of the colon (in the middle right) at which point the caliber of the colon is dilated all the way back to the hepatic flexure (upper left). The caliber of the ascending colon, appendix (middle left) and terminal ileum (lower left) are normal.

The diagnosis was Hirschsprung disease with a transition zone in the sigmoid colon.