A case report of a gastric ulcer in a 2.5-month-old infant in Syria: Helicobacter pylori and Aspirin as possible causes.

A gastric ulcer is a tear in the stomach lining that manifests as abdominal pain, nausea, vomiting, and weight loss. Its occurrence is lesser in children as compared to adults and its incidence in children ranges between 2% and 8%. Helicobacter pylori and nonsteroidal anti-inflammatory drugs are the most common causes of gastric ulcers. In our case, we report a 2.5-month-old male who presented with severe pallor, hematemesis, and melena with normal weight gain. The patient's mother was infected with COVID-19 a month ago and recovered within 5 days but kept using aspirin and nonsteroidal anti-inflammatory drugs for a month during breastfeeding. An upper gastrointestinal endoscopy revealed a gastric ulcer and the Helicobacter pylori antigen was positive in the biopsy. A COVID-19 infection was detected later in the patient. The patient was administered proton pump inhibitor, clarithromycin, and amoxicillin for Helicobacter pylori antigen and symptomatic treatment for COVID-19. This case report shows that a stomach ulcer can appear in infancy, but opportune interventions such as timely diagnosis and treatment can solve the problem. It also marks the pathophysiological connection between Helicobacter pylori and gastric ulcer.

Superior mesenteric artery syndrome in an 8-year-old boy: a case report.

BACKGROUND: Superior mesenteric artery syndrome (SMAS), also known as Wilkie's syndrome, is a rare disease that mainly presents as intestinal obstruction with a variable incidence ranging from 0.013 to 0.3% (Salehzadeh et al. in Case Rep Gastrointest Med, 2019, 10.1155/2019/3458601). In this syndrome, the third part of the duodenum, located between the abdominal aorta and the superior mesenteric artery, is wholly or partially obstructed (Mosalli et al. in J Pediatr Surg 46:e29-31, 2011). Case presentation An 8-years-old Arabian male patient was admitted to the gastrointestinal department at the pediatric hospital in Damascus, Syria, with complaints of chronic abdominal pain and periodic vomiting since he was two years old. At the age of Seven, he was diagnosed with appendicitis, and after two months of persistent symptoms, he was diagnosed with an umbilical hernia. Finally, after a long time of suffering, he was diagnosed with SMAS and underwent a successful surgical operation. After 3 months of follow-up, he was in good health with no symptoms. CONCLUSION: Whenever a patient complains of vomiting and chronic abdominal pain, intestinal obstruction is suspected, Common differential diagnoses were excluded and the cause is anonymous, we should consider superior mesenteric artery syndrome.

Thrombocytopenia with absent radii syndrome with delayed presentation of thrombocytopenic episodes: a case report.

Bilateral radii aplasia with the presence of both thumbs and episodes of low platelets count are the main characteristics of thrombocytopenia with absent syndrome, which is an unusual birth disorder, with an incidence of 0.42\100 000 population. Case presentation: The authors reported a case of a 6-month-old baby girl who experienced thrombocytopenia at the age of 6 months for the first time, as a result of cow's milk being introduced for 45 days with chronic diarrhea and growth failure. She had a deviation of the axis of the hand laterally, and a bilateral absent of radii with the presence of both thumbs. In addition, she had abnormal psychomotor development, marasmus case manifestations. Conclusions: Our aim in publishing the current case report is that clinicians caring for patients with thrombocytopenia with absent syndrome will be aware of the myriad of complications, which may occur in the other organ systems so that they can promptly diagnose and treat any associated abnormalities.

Rectal prolapse as a manifestation of inflammatory bowel disease with celiac disease in a 2-year-old male: a rare case report.

The co-occurrence of inflammatory bowel disease (IBD) and celiac disease (CeD) is uncommon. The typical sign of this co-occurrence is malabsorption which leads to anemia, diarrhea, and malnutrition. In rare cases, recurrent rectal prolapse may also occur. Case presentation: A 2-year-old Syrian male baby presented with failure to thrive and chronic diarrhea for 18 months, along with recurrent rectal prolapse for the last 6 months. Biopsies taken confirmed a diagnosis of stage 3b celiac disease according to the Marsh classification. Furthermore, biopsies taken confirmed a diagnosis of IBD. Then, a high-fiber diet to manage IBD and celiac diet were both needed simultaneously, with signs of rectal prolapse, diarrhea, and bloating, occurring when either or both diets were stopped. Clinical discussion: The diagnosis was initially explained by the malnutrition and anemia. Even after the gluten-free diet, the patient showed no improvement in diarrhea and developed inferior gastrointestinal bleeding suggested anal fissure, infectious colitis, polyps, IBD, or solitary rectal ulcer syndrome. The relationship between celiac disease and IBD, in children, is still unclear. Current studies suggest that such co-occurrence is associated with higher risks of developing other autoimmune-related disorders, growth and puberty delay, and comorbidities. Conclusions: In the cases of pediatric co-occurrence of IBD and celiac disease, a conservative therapy consisting of two-fold diets for the two diseases should be tried first. If this step succeeds in controlling the clinical picture, it removes the necessity of introducing immunological pharmacologic treatments that may induce unfavorable side effects in a child.

Spiral Humeral Fracture During Arm Wrestling: A Case Report and Literature Review.

Arm wrestling places an axial pressure load on the humerus with the glenohumeral joint stabilized and the elbow flexed and fixed. This situation can cause humeral shaft fractures. We present a case of humeral shaft fracture in a 22-year-old healthy man following an arm-wrestling challenge. The patient is known to be a bodybuilder and athlete. He presented to our university emergency department with a swollen and tender arm and intact neurovascular structures, reporting that he had recently engaged in arm wrestling with a colleague of similar shape and power. The fracture was treated conservatively based on the patient's informed decision using closed reduction and physiotherapy. He committed to scheduled clinic visits and physical therapy sessions and showed improvement with complete recovery and normal functioning on the thirteenth week.

Hyperplastic polyps after surgical management of Hirschsprung's disease in children treated with argon plasma coagulation: Case report.

Introduction and importance: The argon plasma coagulation is a technique used for noncontact thermal coagulation of tissue. Hyperplastic polyps are the most common non-neoplastic polyps in the colon. Case presentation: We presented a 3-year-old girl with a chief complaint of bloody stool and rectal tenesmus that began 5 days ago. She was previously being treated because of a history of chronic constipation. She underwent a one stage surgery for Hirschsprung's disease, after a full-thickness rectal wall biopsy was obtained and it consistent with Hirschsprung's disease. Three months after the surgery, the girl presented to our clinic with rectal blood loss and rectal tenesmus. Endoscopic examination of her colon demonstrated sessile and pedunculated polyps. The pedunculated polyps were removed endoscopically. Biopsies were taken from the sessile polyps. Histopathologic examination of the polypectomy specimen and the biopsies of the sessile polyps showed hyperplastic polyps. The endoscopy was repeated for the purpose of argon plasma coagulation ablation of the sessile polyps. Argon plasma coagulation caused an adequate ablation and the entire polyps were burned. Clinical discussion: Argon plasma coagulation is an effective and safe technique in the endoscopic management of gastrointestinal conditions. Conclusion: Further clinical trials including a comparison of argon plasma coagulation to other treatment modalities, as well as long-term follow-up after argon plasma coagulation treatment are required.

Successful Surgical Treatment of a Brain Stem Hydatid Cyst in a Child.

Hydatid disease is a parasitic infestation, which is endemic in the Mediterranean region. It is often located in the liver and the lungs, whereas brain stem hydatid cysts are extremely rare. We report a case of a five-year-old female who presented with hemiparesis, and after investigations, she was diagnosed with a hydatid cyst in the pons. She also had cysts in her liver and kidney. The cerebral cyst was completely removed without rupture, using gentle water-jet dissection (Dowling's technique). She was feeling well after 4-month follow-up. We emphasize the importance of keeping hydatid cysts in the differential diagnosis of pediatric infratentorial cystic lesions.