Category: Surgical-Pathological-Clinical

School ager with crampy abdominal pain and a non-transient small bowel-small bowel intussusception

Surgical image of small bowel - small bowel intussusception due to Non-Hodgkin lymphoma
Laparoscopic surgical image (above) shows the small bowel-small bowel intussusception. Surgical image of the small bowel after reduction of the intussusception (below) shows the serosa is pink-tan and intact with a 1.5 x 0.6 cm puckered, red, firm area that when opened in pathology revealed a 2.6 x 2.0 cm red-pink mass.

The diagnosis was diffuse B-cell lymphoma (Non-Hodgkin lymphoma) causing small bowel-small bowel intussusception.

School ager with abdominal pain and a non-transient small bowel-small bowel intussusception

Gross pathological image of small bowel - small bowel intussusception due to Burkitt lymphoma
Gross pathological images of the resected segment of intussuscepted small bowel shows on its serosal surface (above) a 2.0 x 1.2 cm irregular, tan-white centrally ulcerated and umbilicated firm area. The opened image of small bowel (below) reveals a 3.4 x 2.9 x 1.2 cm irregular, tan-white, smooth, firm mass which was sectioned to reveal smooth, tan-white, glistening, homogenous cut surfaces.

The diagnosis was Burkitt lymphoma causing small bowel-small bowel intussusception.

Newborn with failure to pass meconium and bilious vomiting

Surgical image of Hirschsprung disease
Surgical image shows a transition zone in the terminal ileum with the proximal portion of the small bowel above the transition zone dilated (on the right) and the non dilated distal small bowel (on the left). The frozen biopsies showed no ganglion cells from the rectum all the way up to the terminal ileum.

The diagnosis was total colonic Hirschsprung disease.

Newborn post op from repair of an anterior abdominal wall defect

Surgical image of gastroschisis
Surgical image shows a prosthetic silo over loops of bowel not encased by a membranous sac that was created by sewing the silo to the fascia on either side of the incision. The silo was then wrapped in cotton gauze and sterile drapes. The patient underwent serial mesh tightening and on day of life eight underwent removal of the silo and final closure of the gastroschisis.

The diagnosis was gastroschisis.

Newborn with anterior abdominal wall defect and dilated small bowel

Surgical image of gastroschisis
Surgical image shows an anterior abdominal wall defect with the small bowel protruding out of the abdomen, with no surrounding membranous sac. The small bowel loops are dilated. There was an atresia just distal to the cecum and the distal colon was small in caliber. A silo for the abdominal contents was constructed. A gastrostomy and cecostomy were also placed.

The diagnosis was gastroschisis and colonic atresia.