[Splenectomy among thalassemia major patients: a study of 44 cases]

The present study was designed to explore the principle indications of splenectomy in transfusion dependant thalassemie patients and to evaluate incidence, risk factors and degree of severity of splenectomy among these patients. In a retrospective analysis, we identified patients with thalassemia major who underwent splenectomy within an 9 years period. Transfusion needs were calculated by the volume of annual blood units devided by the patients' weight at the middle of the same period. Occurrence of hypersplenism is defined by transfusion's requirement over 250ml/kg/year with or without periphericcytopenia. Statistical analysis was carried out using software [SPSS version 11.5]. 44 thalassemie patients took part in the study [mean age, 13 years; range: 42 months-18years]. The mean age of splenectomy was 6 years and 9months [2years-1 Syears and Gmonths]. The mean indication of splenectomy was the increase of transfusion requirement. Pneumococcal, haemophilus influenzae and meningococcal A+C vaccinations were administered respectively to 97.7 per cent, 88.6 per cent and 90.9 per cent of patients. We assisted clinically to a reduction of transfusion requirement and biologically to the increase of haemoglobin's mean level. Ferritinemia and iron overload were notably decreased. Of the 44 patients who underwent splenectomy 10 developed complications [22.7 per cent]. Splenectomy is also beneficial in treating thalassemia major. It reduces patients' transfusion requirement and iron overload and increases the mean level of haemoglobin. Overwhelming post splenectomy infection remains a serious complication in these patients

[Congenital short small intestine. a new case study]

Backgrounds: Congenital short bowel syndrome associated with malrotation and intestinal dysmotility is a rare condition. We describe a new case of this syndrome without malrotation

Case report: Mootez is born from consanguineous parents without any familial histories. He presented with bilious vomiting at the age of ten days. The radiological exams show no sign of intestinal obstruction. Laparotomy revealed a short small bowel measuring 40 cm without malrotation. The appendice showed no anatomopathologic abnormalities. After surgery, recurrent bilious vomiting persist. He died at tow months of age from severe denutrition

Conclusion: a precocious clinical onset and intestinal dysmotility seem to be associated with a poor prognosis. The cause of congenital short small intestine is not known. A recessive inheritance is suggested

[Ectopic testis with mature teratoma. a case report]

Tesicular tumors are rarely seen in childhood. Most teratoma reported to occur in cryptorchid males. The purpose of this paper is to report imaging features of intra-abdominal testis with teratoma in a 4 months-old child admitted to explore abdominal mass. Abdominal ultrasound and CT scan exploration showed a solid mass occuping the right flank including calcified, liquid and fat areas. Surgical exploration found intraabdominal teratoma developed from the right testis