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.

Premature newborn with respiratory distress on a ventilator

Gross pathology image of pulmonary interstitial emphysema — Gross pathological image of the right lung shows bubbles of air throughout the pulmonary interstitium of the lung.

The diagnosis was pulmonary interstitial emphysema in a patient with respiratory distress syndrome.

Newborn with prenatal ultrasound that showed marked bilateral hydroureteronephrosis

Clinical image of prune belly syndrome / Eagle Barrett syndrome — Clinical image shows a small thorax, a bulging abdomen due to hypoplastic abdominal wall musculature, and bilateral undescended testicles.

The diagnosis was Prune Belly Syndrome.

Toddler with an abdominal mass

Gross pathological image of Wilms tumor — Gross pathological image shows a whitish-tan mass with areas of hemorrhage and necrosis arising from the lower pole of the kidney. Note the compression of the adjacent renal tissue which manifests itself on imaging as the renal “claw” sign.

The diagnosis was Wilms tumor.

Toddler with abdominal distension after gastrojejunostomy tube placement 2 days ago

Surgical image of duodenal perforation — Surgical image shows the forceps within a hole in the fourth portion of the duodenum.

The diagnosis was duodenal perforation due to gastrojejunostomy tube placement.

Infant with abnormal facies and congenital heart disease

Surgical image of absent thymus in DiGeorge syndrome — Pathologic image shows near-complete absence of the thymus.

The diagnosis was DiGeorge syndrome

Teenager with pleuritic chest pain

Pathological image of Ewing sarcoma of the rib — Pathological image shows a tumor which was brown and grossly necrotic and was seen to be located predominantly in the soft tissues and not in the rib.

The diagnosis was Ewing sarcoma.

Newborn with an anterior abdominal wall defect

Clinical image of Pentalogy of Cantrell — Clinical image shows the umbilical cord entering an omphalocele sac. The apex of the heart can be seen under the superior portion of the sac. The upper portion of the heart is covered by skin but the sternum is split.

The diagnosis was Pentalogy of Cantrell.

Newborn with an anterior abdominal wall defect on prenatal ultrasound

Surgical image of gastroschisis — Surgical image shows the abdominal wall defect with stomach and small bowel protruding out of the abdomen, with no surrounding membranous sac.

The diagnosis was gastroschisis.

Newborn with a chest mass on prenatal ultrasound

Pathologic image of congenital diaphragmatic hernia — Pathological image of the lungs shows the markedly hypoplastic left lung. Functionally and histologically the right lung was also hypoplastic.

The diagnosis was congenital diaphragmatic hernia.

Newborn with bilious vomiting

Surgical image of jejunal web — Surgical image shows an abrupt caliber change in the proximal jejunum.

The diagnosis was jejunal web.

Newborn with a solid renal mass on prenatal ultrasound.

Surgical image of mesoblastic nephroma — Surgical image shows an extremely large right renal tumor displacing the cecum into the left lower quadrant.

The diagnosis was mesoblastic nephroma.

Newborn with several days of bilious vomiting

Surgical image — Surgical image shows the entire small bowel, from the jejunum to the terminal ileum, to be infarcted.

The diagnosis was malrotation with midgut volvulus.

Newborn with failure to pass meconium

Clinical image of meconium plug — Clinical image shows a contiguous plug of meconium that was expelled by the patient after a water-soluble contrast enema.

The diagnosis was meconium plug syndrome.