An unusual cause of duodenal perforation due to a lollipop stick

Children have a natural tendency to explore objects with their mouths; this can result in the swallowing of foreign objects. Most ingested foreign bodies pass uneventfully through the gastrointestinal tract. However, some foreign bodies cause obstruction or perforation of the gastrointestinal tract, requiring surgical intervention. Perforation of the gastrointestinal tract may be associated with considerable morbidity and mortality. The most common sites of intestinal foreign body perforation are the ileocecal and rectosigmoid regions. Foreign body perforation of the duodenum is relatively uncommon. We report the first Korean case of duodenal perforation by an ingested 8-cm lollipop stick. Lollipops are popular with the children and fairly accessible to them, as most parents are not aware of their potential harm. Pediatric clinicians should be aware of the risks associated with lollipop stick ingestion. Our report also describes the feasibility and safety of laparoscopic diagnosis and management of pediatric patients with peritonitis induced by the ingestion of foreign bodies

A large intrahepatic duodenal duplication cyst in a 3 year-old girl

Duodenal duplication cyst consists 6% of alimentary tract duplications and the prevalence is estimated to be less than 1 per 100,000 live births. This report is the first case report in a pediatric patient. A 19-month-old female patient was detected with a 5.2 cm sized intrahepatic cystic lesion in her follow-up ultrasonography examination for hydronephrosis. In her regular check-up, findings suggestive of food materials were detected inside the cyst. Further evaluation showed a 7 cm sized cyst located inside segment IV of the liver, connected to the duodenal bulb with a possibility of biliary communication. On exploration, duodenal duplication cyst with a 1.5 cm long stalk starting from the duodenal bulb to the hilum of the liver was identified. Due to its sophisticated location and possible communication with the biliary tree, Roux-en-Y cystojejunostomy was performed after resecting the stalk. The histopathologic finding of the stalk showed serosa, muscle, submucosa and duodenal mucosa which suggested its duodenal origin. The patient has been followed up without any complications for 7 months