circumcision: is it an insignificant act?

The circumcision is one of the most frequent interventions practised to a male child; it is defined as surgical removal of the prepuce for a religious or traditional reasons. The surgical removal of the prepuce, is carried out either in emergency in case of paraphimosis, or normally case of phimosis. The complications of the circumcision are frequent and varied; haemorrhage and infection are described as early complications while generaly the urological complications are known as late complications. Those are even more frequent when the circumcision is performed in a traditional way or by non professional [paramedical agents, hajjamas...] without a rigorous asepsis and in unfavourable material conditions. If the ritual circumcision is uncertain, the circumcision performed in surgical conditions remains a benign intervention

[Abdominal pains in childhood: viewpoint of the paediatric surgeon]

The abdominal pains are very frequent symptoms in pediatric pathology. concerned that is has multiple aetiologies we distinguish that the actue abdominal pains are generally of organic aetiology dominated by surgical intervention and reccurent als abdominal pains generally of functional artiology. The diagnosis of an abdominal pain above all will be determined by the most precise possible semiological anaysis [anamnesis], and by the physical examination. The place of the complementary examinations must remain limited, according to the clinical assumptions or be summarized with simple examinations of orientation. The pediatric surgeon in practice is in front of a double trap: to standardize abdominal pains which will prove to be of organic origin, or to contemplate organic cause with the risk to suggest expensive and intensive complementary examinations to the child and his family, which are likely to fix them still more on this symptom

[Primitive eosophageal achalasia in children: a 20 cases report]

The aim of this study is to evaluate the results of Heller intervention in the treatment of oesophageal achalasia in children. Method: it's a retrospective study of 20 cases of oesophageal achalasia in children during 19 years [1985-2003]. The mean age was 8 year-old. No etiological factor has been reported. Dysphagia was the main symptom [80%], regurgitations were present in 50% of cases, and respiratory troubles in 45% of cases. A body weight insufficiency was reported in 60% of cases. All the children had Heller intervention which was systematically associated to an antireflux system. After a mean follow-up of 3 years, the results were excellent in 70% of case and had confirmed the efficacy of Heller intervention in oesophageal achalasia in children