The incidence of inflammatory bowel disease has risen in recent years. Although its pathophysiology remains unclear, evidence suggests that dietary factors, especially ultra-processed foods, may play a role.

Over recent decades, research has steadily accumulated evidence on the relationship between childhood maltreatment (CM) and adult intestinal disorders, yet the findings remain inconsistent across studies. To address this, a three-level meta-analysis was conducted to quantitatively synthesize existing data, assessing both the overall association and its specificity across disease subtypes and maltreatment types. A comprehensive literature search identified 22 studies (comprising 498,709 participants and 75 effect sizes) from PubMed, Embase, Web of Science, Scopus, ScienceDirect, and PsycINFO databases up to April 2026. Pooled results revealed a significant positive association between CM and the risk of adult intestinal disorders (OR = 1.53, 95% CI [1.35, 1.74]). Notably, this association exhibited substantial specificity: irritable bowel syndrome was consistently linked with nearly all maltreatment types (OR range: 1.44-1.91), while functional dyspepsia showed no statistically significant association. Inflammatory bowel disease is not significantly associated with childhood abuse. Neither Crohn's disease nor ulcerative colitis showed a significant association with any form of abuse. Sensitivity analyses affirmed the robustness of effect sizes, with no significant publication bias detected. This three-level meta-analysis highlights CM as a notable risk factor for specific adult intestinal disorders, highlighting the need to integrate early-life adversity into etiological models and trauma-informed clinical care for intestinal conditions.

Combined vascular malformations in children often involve multiple structures, with lymphatic-venous malformations being the most common. These malformations tend to cause significant distortion and morbidity than other types, making their treatment a significant challenge for healthcare providers. This report focuses on managing a giant gluteal venolymphatic malformation in a 5-year-old with a neglected, ulcerated, and bleeding condition. We discuss surgical insights, multimodal management strategies, and relevant literature.

 A 4-year-old, neutered male domestic cat was presented with an indolent, non-ulcerated and painless subcutaneous nodule on the left hindlimb. Abdominal ultrasonography revealed generalized lymphadenomegaly and splenomegaly with a honeycomb pattern. The cat tested negative for feline leukemia virus and feline immunodeficiency virus. Fine-needle aspiration of the lesion showed mixed inflammatory cells, including eosinophils and macrophages containing small intracytoplasmic basophilic inclusions considered suspicious for Leishmania-like organisms. The mass was surgically excised for histopathological and molecular evaluation. Histopathology demonstrated eosinophilic granulomatous inflammation with secondary furunculosis, without unequivocal visualization of amastigotes. Quantitative RT-PCR was positive for Leishmania species, and conventional PCR targeting the ITS-1 gene, followed by sequencing, showed 99.62% identity with Leishmania infantum. No anti-Leishmania treatment was administered because the lesion was completely excised, the cat remained clinically well and specific anti-Leishmania drugs are not readily accessible in Costa Rica. At the 7-month follow-up, no recurrence of the nodule was observed.

Complex soft tissue defects in children require reconstructive solutions that are stable, adaptable, and compatible with long-term growth. The free anterolateral thigh flap offers several advantages in this setting because it can be tailored according to the defect, either as a durable resurfacing flap or as a source of vascularized tissue volume. We report two pediatric cases managed with a free anterolateral thigh flap for different reconstructive purposes. The first patient was an eight-year-old boy with a painful and unstable post-traumatic scar of the right heel after a road traffic accident and previous split-thickness skin grafting. After complete scar excision, reconstruction was performed using an ipsilateral fasciocutaneous anterolateral thigh flap. At two-year follow-up, the flap remained stable, painless, and free of ulceration; the visual analog scale pain score decreased from 6/10 preoperatively to 0/10, and the patient resumed school activities, walked independently with definitive adapted footwear, and required no secondary debulking procedure. The second patient was a seven-year-old boy with xeroderma pigmentosum who presented with a large nasal squamous cell carcinoma extending to the upper lip and pre-nasal cheek region. After tumor excision with 1 cm lateral margins, resection through a healthy deep plane, and bilateral cervical lymph node dissection, reconstruction was achieved using a free fasciocutaneous anterolateral thigh flap harvested from the left thigh. The cervical lymph node dissection was negative, and no adjuvant radiotherapy was administered after multidisciplinary tumor board discussion because complete excision had been achieved and the benefit-risk balance was considered unfavorable in the context of xeroderma pigmentosum. At one-year clinical follow-up, there was no evidence of recurrence. These two cases illustrate how the free anterolateral thigh flap may address different pediatric reconstructive needs, ranging from durable heel coverage to vascularized filling of a central facial cavity after oncologic resection.

Acquired factor V deficiency (AFVD) is a rare disease characterized by a relative deficiency of coagulation factor V (FV) due to the presence of internal FV inhibitors. Patients may exhibit a range of symptoms from asymptomatic to severe bleeding. The heterogeneity of AFVD among clinical conditions makes its diagnosis challenging. Infection is a common secondary cause of FV inhibitors. This article reported a case of a patient with ulcerative colitis (UC) in the latent tuberculosis infection (LTBI) stage, who had abnormal initial screening of coagulation function. Traditional treatment strategies targeting the primary disease and empirical anti-infection therapy did not improve the patient's condition. It was not until the laboratory reported high-titer FV inhibitors followed by the clinical team providing immunomodulatory treatment with intravenous immunoglobulin and preventive anti-tuberculosis therapy, which successfully led to the elimination of FV inhibitors and significant improvement in the bleeding and infection symptoms of the primary disease. This article reviews relevant literature to provide ideas for the clinical diagnosis and treatment of rare factor inhibitors. To our knowledge, this is the first report of FV inhibitor in patients with UC during LTBI, as well as the first observation of a benefit in using immunoglobulin regimen to clear cycle inhibitors.