[Percutaneous endoscopic gastrostomy in children]

The Percutaneous endoscopic gastrostomy is currently the way initially of reference for the prolonged enterale food. The simplicity and the speed of the technique, the evolution of the materiel make that the pediatre and the surgeon pediatre are solicited and that the instalation is accessible to any endoscopist. The respect of the contre-indication and the rigour in the realization of the procedure are the key of the success of the endoscopic gesture, of the weak rate of morbidity and mortality

[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

Thyroid cancer in child [about 7 cases]

We report here a study of 7 cases of thyroid cancer in childhood. This study that we reinforced by literature review aims to point out the different aspects of this affection: clinical features, the complementary examinations and the management to diagnoses it with certainty and lastly, the different therapeutical attitudes. It is a study of 7 children between 8 and 15 years aged, with a female daminance, without pearicular previous medical histories. Clinically, these children present an euthyroidal goitre, cervical adenopathies with conservation of good general health condition. Scintigraphy showed a cold nodule that was proved to be neoplastic at the anatomo-pathological study, it was papillar or papillo-vesicular carcinoma. The surgical management has at the present time a tendancy to conservative surgery combined or not with a ganglionic curage, followed by a substitute hormonal treatment. In general, the prognosis of this affection is good for the differentiated forms whereas it remains has for bad anaplastic non differentiated forms

Currarino's syndrome

Currarino's triad is a congenital malformation involving the combination of anorectal stenosis, a presacral mass and an anterior sacral bony defect. A new case is reported in a male neonate, who developed intestinal obstruction on the second day of life. The examination revealed a high anorectal malformation. A colostomy was performed. Partial agenesis of the sacrum was diagnosed radiologically. Computed tomographic myelography demonstated an anterior sacral meningocele and a tethered spinal cord. Excision of the meningocele and untethering of a tethered spinal cord were performed. Secondly, posterior sagittal anorectoplasty was performed. Colostomy was closed 3 months after rectal dilatations. Early diagnosis and management is recommended to avoid the high mortality and morbidity associated with this condition

Lesfibromatoses juveniles: a propos de deux cas

Although the diagnosis of fibromatosis remains based on histologic data, the local extension check-up must define the most Positive therapeutic means to manage each case. Several classifications have been done; However few reports deal with the usefulness of surgery associated to raditherapy or chemotherapy. We report here two cases reflecting the complementary supply of chemotherapy and radiotherapy to the surgical management