[Alimentary tract duplication in children]

Duplications of the alimentary tract are a rare congenital anomalie in children, characterized by an important anatomoclinical polymorphism. Diagnosis suspected on clinics and evoked by radiology, requires histological confirmation. Thirty four children with duplications were managed in our department, from 1991 to 2009. Their hospital chart was retrospectively studied. Clinical signs consisted on pain and abdominal mass. The radiological investigations depended on the location of the digestive duplication. There was four oesophageal duplication, five on the stomach, the pylorus was involved in two cases, the duodenum in three cases, the jejuno-illeum is seventeen cases, the colon in two cases and the rectum in one case. All cases benefited from surgical treatment, and resection procedure was chosen according to duplication type and site. Histological study showed six cases of ectopic gastric mucosa. Diagnosis and surgical precocious treatment of digestive duplications are the only warn complications of this benign pathology

[Long terms result of surgical treatment of intestinal malrotation]

The total volvulus of small intestine [TVSI] on intestinal malrotation [IM] is a rare pathology. The incidence is 16 for one thousand neonatal occlusions. The purpose of this work was to evaluate the long-term results of the Ladd procedure in the treatment of the TVSI on IM. It's a retrospective study concerning 36 cases of TVSI on IM treated in the unity of pediatric surgery "B" in Tunis children's hospital over a period of 18 years. This study was about 26 boys and 10 girls, old from one day to 9 years at the time of the diagnosis. Twenty nine children were of less than 1 year old [80,5 per cent], among which 24 cases [66,6 per cent] before 1 month. The bilious vomits were the most frequent mode of revelation [91 per cent]. The diagnosis was realized by the ultrasound in 63 per cent of the cases [19/30] and by the oesogastroduodenal enema in 92 per cent of the cases [13/14]. All the patients were treated according to the Ladd procedure with immediate simple consequences operating in 80 per cent of the cases. Among 33 operated and alive patients, the distant evolution was favorable in 90 per cent of the cases with an average recession of 8 years. No patient presented a second recurrence of the volvulus. A single patient presented an occlusion on brides and two patients have a chronic constipation. The treatment of intestinal malrotation is based on the Ladd procedure which is a safe and effective surgical technique