[Aetiologies and outcome of bronchiectasis in children: a study of 41 patients]

Bronchiectasis remains an important cause of chronic suppurative lung disease in the developing world. This study is to describe the epidemiological characteristics, clinical features, underlying aetiologies and Outcome of bronchiectasis in the paediatric hospital of Tunis. A retrospective study of 41 children with bronchiectasis was conducted between January 1994 and December 2006. Diagnosis was made in patients with clinical suspicion of bronchiectasis associated with abnormalities on chest X ray [n=37] and/or on high resolution computed tomography [HRCT] [n=36]. Mean age at diagnosis was 5 years 9 months; [range: 6 months-14 years]. Persistent cough and bronchorhea were the most common symptoms. Fourteen patients [34%] had dyspnoea on first presentation, 11 of them [26.8%] had chest deformation and/or finger clubbing. Haemoptysis was noted in only two cases. Mean time to diagnosis from symptom onset was 2.7 years [range: 2 months- 4 years]. The underlying aetiologies were identified in 52% of patients. Cystic fibrosis [17%], previous pneumonic illness [9.7%], primary ciliary dyskinesia [9.7%] and immunodeficiency [9.7%] were the most common causes. After a mean follow-up of 6.6 years, the annual lower respiratory infection rate decreased from 7.2 +/- 3 to 3.1 +/- 2.6 [p<0.05], Twenty one point nine per cent of patients had chronic respiratory failure and five patients required surgery. Delays diagnosis of bronchiectasis remains important in our country. Congenital and indeterminate aetiologies are the most common forms. Prognosis is poor with a high prevalence of chronic respiratory failure

[Colorectal polyps in children. A study of 34 patients]

Aim: To assess the frequency and the clinical features of polyps of the colon and rectum in children

Methods: A total of 34 patients [20 boys and 14 girls, mean age: 5.4 years] were enrolled in this 14-years retrospective study. Diagnosis was done for almost all patients by colonoscopy [n=8] or recto-sigmoidoscopy [n=19]. After endoscopic polypectomy, polyp's type is determined by histological examination

Results: Minimal and relapsing rectal bleeding was the most frequent finding of polyps of the colon and rectum [85.3%] followed by spontaneous emission of polyp [n=3], rectal prolapses [n=2], chronic constipation [n=1] and abdominal pain [n=1]. The polyp was unique in all cases and with a mean size of 12 mm. The majority of polyps were localized in the rectum or sigmoid [97%] and were pediculate [81.2%]. Endoscopic polypectomies concerned 26 polyps while two small polyps were left. Most of the polyps corresponded histologically to juvenile polyps [96.2%]. The immediate post-op course was uneventful for 26 children

Conclusion: Our study suggests that rectal bleeding is the most frequent finding of polyps of the colon and rectum in childhood. Outcome after endoscopic polypectomy is good