The treatment of long-tracheal lesion is difficult because there are currently no viable grafts for tracheal replacement. To solve this problem, we have developed an autologous Tissue-Engineered Trachea (aTET), which is made up of collagenous tissues and cartilage-like structures derived from rat chondrocytes. This graft induced successful long-term survival in a small-animal experiment in our previous study. In this study, we investigated the regeneration process of an aTET to attain reproducible success. We prepared an aTET by using a specially designed mold and performed patch tracheoplasty with an aTET. We assigned twenty-seven rats to three groups according to the three types of patch grafts used: aTET patches (the aTET group), fresh tracheal autograft patches (the Ag group), or polylactic acid and polycaprolactone copolymer sheets (the PPc group). In each group, gross and histological evaluations were performed at 1 month (n = 3), 3 months (n = 3), and 6 months (n = 3) after implantation. We obtained high survival rates in all groups, but only the PPc group attained thick tracheal walls with granular tissues and no tracheal regeneration. On the other hand, the aTET and Ag groups reproducibly achieved complete tracheal regeneration in 6 months. So, an aTET could be a promising candidate for tracheal regeneration grafts.

Multiseptate gallbladder is a rare congenital anomaly characterized by multiple intraluminal septa. While often asymptomatic, it can present with abdominal pain or complications, such as gallstones. Cases of multiseptate gallbladder with gallstones have been rarely reported. We describe the case of a 15-year-old girl with multiseptate gallbladder complicated by cholelithiasis. No other biliary ductal anomalies were identified. Laparoscopic cholecystectomy was performed and the gallstones were identified as bilirubin stones. Complete symptom relief was achieved postoperatively. This case highlights that multiseptate gallbladder may contribute to bile stasis and pigment stone formation, even in the absence of other congenital anomalies. Early imaging is essential to confirm the diagnosis and guide management. Magnetic resonance cholangiopancreatography enabled exclusion of associated anomalies, guiding management.

A 4-month-old female presented with progressive abdominal distention and feeding difficulties. Diagnostic laparoscopy with peritoneal drainage yielded 970 mL of milky ascites. Fluid analysis confirmed chylous ascites (triglyceride level, 3177 mg/dL; lymphocyte predominance, 94.8%) with negative culture and cytology results. Contrast-enhanced abdominal computed tomography revealed massive ascites without intra-abdominal lesions or significant lymphadenopathy. Despite conservative therapy and continuous high-output drainage (approximately 500 mL/day), the leak persisted. Planar lymphoscintigraphy with technetium-99m radiotracer injected subcutaneously into the dorsum of both feet confirmed lymphatic leakage into the ascites and provided regional guidance regarding the suspected source; however, no discrete focal hotspots were identified. Based on these scintigraphic findings, intraoperative near-infrared fluorescence lymphography using indocyanine green was performed the following day, enabling real-time visualization of active leakage and facilitating targeted laparoscopic treatment. Targeted electrocautery ablation markedly reduced leakage on real-time fluorescence imaging, and a fibrin sealant was subsequently applied. The patient ultimately achieved full oral feeding and showed no recurrence of ascites at the 2-year follow-up. This case illustrates a practical sequential imaging approach for refractory pediatric chylous ascites: lymphoscintigraphy for functional confirmation and regional guidance, followed by intraoperative indocyanine green fluorescence for focal confirmation and targeted treatment.