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Abstract Background The fetu in fetu (FIF) is an extremely rare congenital condition characterized by a 2nd fetus that grows into the body of the healthy twin. Its thoracic location is more exceptional. Case presentation We report a case of intrathoracic mass in a 5-month-old female infant, diagnosed after an assessment for respiratory distress. She underwent an emergency left thoracotomy which allowed for the removal of a large thoraco-mediastinal mass inside a membranous sac containing a clear liquid mixed with vernix caseosa. The mass was completely covered with normal skin, three lobes similar to rudimentary outline of the head and limb. It was attached to a single large vascular pedicle. The pathological examination concluded that there was a high possibility of FIF. The postoperative follow-up was uncomplicated, and the child is still in good clinical condition after the 5-month follow-up. Conclusion The assessment of the respiratory distress in an infant with a mass centered by an axial skeleton on the chest x-ray and thoracic CT scan may suggest a diagnosis of intrathoracic FIF.

Abstract Background Esophageal perforation is a rare surgical pathology in children. Thoracic esophageal perforation is more severe than cervical esophageal perforation. Iatrogenic cause, mainly by endoscopy, is the most common in esophageal perforation. However, perforation induced by “Magill forceps” is exceptional. Case presentation A systematic physical examination revealed pyrexia severe respiratory distress and right-sided pleural effusion. We report the success of non-operative treatment applied to thoracic esophageal perforation due to Magill forceps in a 24-month-old male infant. The immediate and short-term outcomes were excellent. Conclusions Non-operative treatment is possible in iatrogenic perforation of thoracic esophageal in infants. This treatment delivers excellent outcome in carefully selected patients.