[Gastric duplication with pancreatic homes hyterotopie in children]

The digestive duplications are defined as tubular or cystic-like malformations, sitting on a segment of the gastro-intestinal tract from the oral cavity to the anus. The wall of the duplication is formed by a double muscular tunic lined interiorly by a digestive-type mucous membrane. These malformations are characterized by a very large pathogenic, clinic and path anatomic polymorphism. It can be revealed by benign signs or sometimes by serious ones when a complication occur [hemorrhage, perforation]. Despite the fact, that the diagnosis is suspected clinically and largely evoked on the radiologic exams, it requires path anatomic confirmation. The authors report three cases of girls aged respectively 2,6 and 12 years without previous medical history, which first showed diffuse abdominal pain and periodicals, the radiological assessment including ultrasound abdominal CT scan and barium strongly suspected duplication in all three cases; however, confirmation was made by pathologists in three cases. Surgical excision has healing in our three patients. Our retrospective work consists of a survey of three gastric duplication cases seen at our hospital between years 1988 and 2008. It insists on different clinical and radiological aspects; relate diagnostic difficulties and therapeutic choices. Finally our set is particular by the presence of islands of heterotopic pancreatic tissue in all cases

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

[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