Pathological Case of the Month

Abstract

A 5-MONTH-OLD male infant had presented with chronic nonbilious emesis at age 3 weeks and was briefly hospitalized owing to dehydration from emesis and constipation for 4 days, the latter relieved by barium enema. An abdominal x-ray film showed distended bowel loops. Two months later, emesis recurred with diarrhea and a low-grade fever. A stool sample was positive for rotavirus. Soy-based formula was administered. At 3 months of age, symptoms recurred with abdominal pain. Distended bowel loops were noted on abdominal x-ray film. He responded to volume resuscitation and broad spectrum antibiotics. At 5 1 ⁄2 months of age, he had recurrent dehydration and foul-smelling stools. His white blood cell count was 50 ϫ 10 9 /L with a shift to the left. A repeated barium enema showed an "apple core" deformity (Figure 1). An extrinsically obstructed segment was resected from the splenic flexure. The specimen was 3.5 cm in diameter and 7.0 cm long. Mucosal hyperemia of the dilated segment and polypoid hyperplasia near the obstructed region was seen. The opened bowel and histologic sections are shown in Figures 2, 3, and 4. The postoperative course was uneventful, and he was discharged 7 days postoperatively. He was asymptomatic at follow-up 6 months later.

Congenital Solitary Intestinal Fibromatosis

“…Intestinal involvement may present as part of the spectrum of multiple fibromatosis (13). Solitary intestinal involvement is rare and solitary colonic involvement is extremely rare (8,10). The prognosis is excellent when the lesion is excised fully in the solitary form.…”

A Solitary Intestinal Myofibroma: A Rare Cause of Neonatal Anemia

“…A solitary lesion in the abdomen though is very rare. A literature search revealed only 20 other reported cases of a solitary infantile abdominal myofibroma (Table 1 ); however, it is the first case in which anemia is the primary presentation of the underlying disease [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. The typical presentation of an intestinal myofibroma is associated with bowel perforation or obstruction, accompanied by obstructive symptoms such as vomiting and abdominal distention [ 18 ].…”