Toddler with unusual pigmentation on the back

Clinical image of neurocutaneous melanosis — Clinical image shows a giant nevus covering the entire back.

The diagnosis was neurocutaneous melanosis.

Preschooler with progressive abdominal distension who has a history of necrotizing enterocolitis

Surgical image of colonic stricture due to necrotizing enterocolitis — Surgical image (above left) shows a massively dilated transverse colon (held between the fingers) and massively dilated small bowel to the left of the image. Examination of the splenic flexure of the colon (above right) reveals a transition zone between the transverse colon and descending colon (center of image). Further dissection near the transition zone shows a tight stricture at the transition zone (below in the center of the image).

The diagnosis was a stricture at the splenic flexure of the colon after necrotizing enterocolitis.

Newborn with a soft tissue mass protruding from the back of the skull

Clinical image of occipital encephalocele — Clinical image shows a primarily skin covered lesion herniating through a defect in the posterior skull that contains neural tissue.

The diagnosis was occipital encephalocele.

School ager with abdominal pain who is status post cardiac arrest

Gross pathology image of Meckel diverticulum — Gross pathological image shows a resected loop of necrotic distal ileum. The necrotic Meckel diverticulum is noted in the upper center of the image, arising from the antimesenteric border of the bowel.

The diagnosis was closed loop small bowel obstruction due to Meckel diverticulum.

School ager with abdominal pain who is status post cardiac arrest

Surgical image of Meckel diverticulum causing closed loop small bowel obstruction — Surgical image shows a dark and necrotic appearing distal ileum (left side of image) with a dark and necrotic Meckel diverticulum along the antimesenteric border of the bowel (upper image) causing an internal hernia and a closed loop small bowel obstruction with the necrotic distal ileum herniating through the band of the vitelline duct.

The diagnosis was closed loop small bowel obstruction due to Meckel diverticulum.

School ager with abdominal pain

Surgical image of Meckel diverticulum causing closed loop small bowel obstruction — Surgical image shows a dark and necrotic appearing distal ileum and a dark and necrotic appearing Meckel diverticum on the antimesenteric border of the bowel with a prominent vitelline artery (upper right corner of image) and volvulus of the adjacent intestine around it.

The diagnosis was closed loop small bowel obstruction due to Meckel diverticulum.

Toddler with abdominal pain for 4 days and now with feculent vomiting

Surgical image of Meckel diverticulum causing ileocolic intussusception — Surgical image (above) shows an ileocolic intussusception which upon reduction is seen to be caused by a Meckel diverticulum (below in center of image with forceps pointing to it) on the antimesenteric border of the small bowel.

The diagnosis was ileocolic intussusception due to Meckel diverticulum.

School ager with abdominal pain and emesis

Surgical image of Meckel diverticulum causing closed loop bowel obstruction — Surgical image shows a closed loop small bowel obstruction caused by a small band of tissue (between the forceps) extending from small bowel to a purple in color Meckel diverticulum (center of image) arising from the antimesenteric border of the small bowel.

The diagnosis was closed loop small bowel obstruction due to Meckel diverticulum.

Newborn with bilious vomiting

Surgical image of malrotation without midgut volvulus — Surgical image shows the patient was malrotated but without volvulus. An aberrant umbilical vein (just to the right of the rectractor) was present extending from the base of the mesentery to a dilated superior mesenteric vein which was causing small bowel obstruction with the dilated loops seen in the upper part of the image.

The diagnosis was malrotation without midgut volvulus.

School ager with abdominal pain and ileocolic intussusception

Surgical image of lymphoid hyperplasia — Surgical laparoscopic image shows a thickened edematous terminal ileum containing multiple small bumps within it (to the left of image) representing lymphoid hyperplasia.

The diagnosis was ileocolic intussusception due to lymphoid hyperplasia.

Newborn with a bump on the back

Clinical image of lipomyelomeningocele — Clinical image of the back shows a skin covered soft tissue mass just to the left of the midline of the spine.

The diagnosis was lipomyelomeningocele.

Preschooler with ileocolic intussusception twice over the last 2 weeks which was successfully reduced each time who is being explored for an etiology

Surgical image of juvenile polyps — Surgical image after cecectomy and opening of the surgical specimen shows multiple polyps arising from the mucosa of the cecum, including a large one being held between the surgical forceps.

The diagnosis was recurrent ileocolic intussusception due to juvenile polyps.

Preschooler with ileocolic intussusception twice over the last 2 weeks which was successfully reduced each time

Colonoscopy image of juvenile polyps — Colonoscopy images shows a polyp on a stalk in the ascending colon (above) and a sessile polyp in the rectum (below).

The diagnosis was recurrent ileocolic intussusception due to juvenile polyps.

Newborn with a loopy abdomen

Surgical image of jejunal atresia — Surgical mage shows a dilated proximal jejunum (between the fingers) and a normal caliber distal jejunum (between the forceps).

The diagnosis was jejunal atresia.

Newborn with cystic mass in the right adnexa on prenatal ultrasound

Surgical image of ileal duplication — Surgical laparoscopic images show a large hypervascularized lesion in the center of both images that is in close proximity with / adherent to the normal appearing small intestine around it.

The diagnosis was ileal duplication.

Newborn with bilious vomiting who had passed meconium

Surgical image of ileal atresia — Surgical image shows an extremely dilated C-shaped loop of distal ileum with a normal caliber terminal ileum being held between the fingers at the top of the image.

The diagnosis was ileal atresia.

Infant with a bump over the right eyebrow

Clinical image of orbital soft tissue hemangioma — Clinical image shows a red / purple mass over the superior aspect of the right orbit.

The diagnosis was soft tissue hemangioma.

Newborn with an anterior abdominal wall defect

Clinical image of gastroschisis — Clinical image shows a dilated stomach (above center) and small bowel (below center) which are not enclosed by a sac.

The diagnosis was gastroschisis.

School ager who started coughing while eating pizza

Bronchoscopic image of airway foreign body — Bronchoscopic image at the level of the carina (above) shows a blue foreign body in the left mainstem bronchus which was pulled out of the airway (middle) and upon removal was found to be a blue crayon (below).

The diagnosis was airway foreign body in the left mainstem bronchus.

Preschooler with a nasal mass

Clinical image of frontonasal encephalocele — Clinical images show a large mass in the midline of the face which is enlarging the nose.

The diagnosis was frontonasal encephalocele.

Newborn with Trisomy 21 and large residuals with feeding

Surgical image of duodenal atresia — Surgical image shows the dilated first part of the duodenum in the center of the image and the normal caliber second part of the duodenum being held between the forceps. There was a 5 cm gap between the first and second parts of the duodenum.

The diagnosis was duodenal atresia.

Premature newborn with respiratory distress

Pathology image of Wilson Mikity syndrome / bronchopulmonary dysplasia — Post-mortem gross pathological image of both lungs (above) shows the lungs to have an irregular surface due to the presence of multiple cysts in the lungs. Magnified image (below) better shows the heterogenous nature of the cysts in the lung.

The diagnosis was Wilson Mikity syndrome / bronchopulmonary dysplasia.

Toddler with a right-sided abdominal mass

Pathology image of Wilms tumor and renal crossed fused ectopia — Post-mortem gross pathological images obtained anteriorly (on the left) and posteriorly (on the right) show a mass in the upper pole of the right kidney. The upper pole of the left kidney is fused to the lower pole of the right kidney.

The diagnosis was Wilms tumor in a patient with renal crossed fused ectopia.

Teenager with abdominal pain and bloody stools

Pathology image of ulcerative colitis — Gross pathological image of the sectioned colon shows colonic pseudopolyps arising from the mucosa of the colon.

The diagnosis was ulcerative colitis.

Newborn with respiratory distress

Pathology image of tracheal atresia — Post-mortem gross pathological image with the esophagus sectioned open shows absence of the trachea with the mainstem bronchi communicating with the esophagus as demonstrated in the center of the image.

The diagnosis was tracheal atresia.