[Delayed congenital diaphragmatic hernia in children. [study of 8 cases]]

Congenital diaphragmatic hernia [CHD] is the result of a defect of the musculo-aponevrotic septui which separate the thoracic cavity from the abdominal cavity allowing migration of the abdominal viscera in thorE, Its global frequency is estimated at 1/300010 1/5000 living births. In the majority of cases, it appears in the fir 24 hours of life revealed by an acute respiratory distress. In 5 to 25% of cases, the CHD was lately reveale beyond 4 weeks of life to several months or sometimes several years

Patients and methods: We report retrospective study of 8 cases of CHD with delayed revelation enrolled in the department of pediatrics on a peric of 22 years between 1984 and 2005

Results: Six patients of our cases had postero lateral hernia by th Bochdalek foramen of divided on 5 in the left side and one case on the right side. Only 2 patients had retro-cost[xyphoidien hernia of Larrey. Epidemiologic data reported 3 girls and 5 boys with the mean age of one year an half [range from 47 days to 3 years and half]. On the clinical plan the mode of beginning was acute on 6 case or chronic on' one case. CHD was fortuity discovered in one case during exploration of axillary lymph node! Respiratory symptoms were predominant in 7 cases associated to gastrointestinal symptoms in 4 cases. patients benefited from chest radiography that revealed digestive clarities on the lung bases. TOGD has bee also achieved in all cases and permitted to confirm the diagnosis and to specify the herniated organs. Thorac[abdominal scan in 2 cases and IRM in only one case revealed a right HDC with ascension of the liver. Seve patients have been operated. One child died quickly some hours after his admission by refractory hypoxernii Post operative outcome are favourable in six cases. One child dead one day after surgery by refractor respiratory distress

Conclusion: The diagnosis of the delayed CHD must be evoked in presence of respirator or digestive symptoms associated to unusual radiological abnormalities of the lung bases. Early surgic; treatment is efficient in the majority of the cases

Cervico-facial cellulitis

About 20 cases of cervico- facial cellulitis, the authors try to highlight the severity of the affection. The original entry was dentary in 80.5% of cases. Emphysema was inconstant [20%]. Anaerobes are responsible of the overwhelming majority of cases of cellulitis. The severity of this infection may be controlled by an adequate and early treatment consisting of Penicillin G at high dose, an aminoglycosid and metronidazole. A possible surgical drainage combined with systematic treatment of the original entry is a rule. It is only at this price that the evolution could be favourable

Etude comparative de trois sphingolipidoses: maladie de gaucher, maladie de niemann pick, syndrome des histiocytes bleu de mer: cytologie, ultrastructure et cytochimie

In view of problems of clinical diagnosis from different Sphingolipidoses the authors have made a comparative study of morphological, optical, ultrastructural, cytochimical and biochemical data of the three principal diseases of this kind: Gaucher's disease, Niemann Pick's disease, syndrom of " sea blue " histiocyte. From these data, the kind of overload can be pointed out, for identification of the disease but not for evaluation of causal enzymatic disease which can be pointed out only by enzymatic activity control