ABSTRACT
Kawasaki disease [KD] is the first cause of cardiopathy acquired by children in developed countries. The aim of this study is to find out, in a precise way, the epidemiological, clinical and evolutionary aspects of the cardiovascular disorders in the Kawasaki disease and to determine their potential risk factors. It is a multicenter retrospective study conducted over the laps of 10 years [1007-2006] and which was a subject of interest for five hospital-university pediatrics services, during which the total of 29 observations of KD including 16 boys and 13 girls whose ages ranged between 6 months and 12 years [average age = 4 years] were analysed. The cardiovascular disorder was noticed in 11 cases [37, 93 per cent]. It consists in a myocarditis in 4 cases, a pericarditis in 1 cas and an endocarditis in 1 other case. The coronary artery problem [6 cases] from 54, 54 per cent of the cardiovascular disorders and 20, 68 per cent of the total number of patients. The diagnosis of the coronary disorders was made between 7 and 90 days [average 24 days]. Asai score was not correlated at the risk of appearance of coronary aneurysms. 5 patients out of 6 had received veinoglobulins and 3 of them before the 10[th] day of the disease evolution. The evolution was favourable in 4 cases who developed anevrysms under 8 mm. The 2 patients with multiple and huge anevrysms were complicated with a thrombosis and myocardial ischemia in 1 case and with stenosis of the left interventricular in the other. The cardiovascular disorder in the KD is dominated by the anevrysmal coronary disorder. This conditions the short term prognosis and causes the later complications
ABSTRACT
Caustic ingestion is a relatively frequent accident in infants. The most redoubtable complication is the oesophageal stenosis which requires a multidisciplinary management. The aim of this work is to study epidemiological, clinic, endoscopic, therapeutic aspects and out comes of caustic esophagitis. We report a retrospective study about 86 cases of caustic esophagitis registered in the paediatric service of Ibn El Jazzar's hospital of Kairouan during the period between 1[st] January 1996 and 31[st] December 2006. The hospital prevalence was 0.3per cent. The median age was 4 years. The most incriminated caustic products were bleach and soda. Clinic examination was more often poor. Among the 86 patients, 41 had a serious caustic esophagitis, all of them received great doses of methyl-prednisolone. 12 patients developed a stenosis. Pneumatic dilatation was done for 9 patients with good results and two patients underwent surgery. However, prevention represents the only way to minimize the dramatic consequences of caustic ingestion on the patient him self, his surroundings and the society