ABSTRACT
Open surgery is the standard option for the treatment of hydatid pulmonary cysts. Surgeons are able to replicate the principles of conventional surgery using minimally invasive techniques ,in particular thoracoscopy. However, there are few reports about this subject in children. To our knowledge, this is one of the biggest pediatric series ever reported in the literature.The purpose of this study was to determine the best indications of the thoracospic surgery for the treatment of the pulmonary hydatid cysts in children. We report a series of 25 cases with pulmonary hydatid cysts treated using the thoracoscopic approach from 2005 to 2009. We retrospectively analyzed the patients' sex, age, symptoms, biological data, characteristics of hydatid cysts [location, number and size] and the medical treatments. Pulmonary hydatid cyst diagnosis was performed on Chest x-ray, abdominal ultrasound and biological data in all the cases. Tomography was not systematic. All patients underwent video-assisted surgery. A conversion to thoracotomy was conducteded in 2 cases. All the patients had a chest tube and received an antibio-prophylaxy, without Albendazol . A concurrent hydatid cyst at the opposite lung or in the peritoneal cavity was treated later
ABSTRACT
Hyperinsulinaemic hypoglycaemia [HHI] is the most frequent aetiology of recurrent severe hypoglycaemia in newborn and infant. This pathology arises the problem of early medical and surgical management to prevent brain damage. The aim of this work is to stress on the treatment emergency, to underline difficulties to distinguish damage. The aim of this work is to stress on the treatment emergency, to underline difficulties to distinguish between focal forms and diffuse forms, and to discuss our results with literature data. Our work is a retrospective study of 3 observations of symptomatic newborn HHI. Due to failure of glucose supplementation and medical treatment based on diazoxide and hydrocortisone, the 3 patients were operated between 50 and 107 days of life. Surgical exploration did not find any macroscopic pancreatic abnormality and intervention consisted of subtotal pancreatectomy [90-95 percent]. Anatomopathological study showed diffuse form in 2 cases and focal form in one case. After a follow up of 3 months to 2 years and a half the 3 patients have a normal glycaemia with no need to medical treatment. Yet 2 patients present brain damages .HHI is an emergency which needs a rapid medical management. Medical treatment failure should lead quickly to surgery to prevent neurological complications
ABSTRACT
Background: Primary peritonitis is rare in children. It raise problems of aetiology diagnosis, and therapy. The aim of this study is to review the particularities of this pathology by emphasizing these difficulties of the treatment
Methods: Its a retrospective study of 14 cases of primary peritonitis treated in the infant surgery unit of Monastir hospital in the period between January 1984 and December 2003.The mean age was 2 years ;the sex ratio was 1/6.The beginning of the clinical symptoms were usually acute
Results: The diagnosis was done by surgical exploration in 13 cases/14; in only one case the diagnosis was highly suspected because of the results of the peritoneal drainage. The post operative course was uneventful for 11 patients; two died probably because of liver failure and presented a residual peritonitis
Conclusion: primary peritonitis of the child is rare. until now, it is still a controversial pathology. Its treatment can be only medical but the surgical treatment which can be laparoscopic must be indicated if there is a doubt