Acute Urinary Retention in the Male Child from Urethral Calculi: A Report of Three Cases.

Urinary stones are uncommon in children. Urethral location of calculi can give rise to various clinical manifestations. We report three cases of urethral lithiasis presenting with acute urinary retention in children.

National surveillance data on the epidemiology of cholera in Cameroon.

Background. The cholera burden in Cameroon has increased during the past 2 decades. During 2010 and 2011, the largest number of cholera cases in Cameroon since February 1971 were reported. This article describes cholera outbreaks during 2010-2011. Methods. Data received from the national surveillance system from 2010 and 2011 were compiled and analyzed. Results. The first suspected cholera cases were reported in the Far North region on 6 May 2010. In 2010, 10 759 cholera cases were reported by 8 of the 10 regions in the country, with 657 deaths (case-fatality ratio [CFR], 6.1%). In 2011, through September 22, 17 121 suspected cholera cases, including 636 deaths (CFR, 3.7%), were reported all over the country. During 2010, the Far North region accounted for 87.6% of cases (9421/10 759) and 91.6% of deaths (602/657) recorded. By contrast, during 2011, 5 regions (Far North, North, Center, Southwest, and Littoral) accounted for 90.6% of cases (15 511/17 121) and 84.0% of deaths recorded. Vibrio cholerae was identified in 525 stool specimens, and all organisms were serogroup O1. Conclusions. The ongoing cholera outbreak in Cameroon increased in intensity and geographic spread from 2010 to 2011. Nevertheless, the overall CFR decreased during this period. Strengthening the early warning system and enhancing water, sanitation, and hygiene interventions and sensitization should be considered in addressing cholera outbreaks.

Isolated congenital fusion of the gums.

Isolated congenital fusion of the gums is a rare anomaly. Early surgical treatment is indicated, as longstanding cases will impair normal feeding leading to nutritional and growth problems. We report the first case in the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, which was successfully managed surgically.

[Treatment of early T1 small T2N breast cancers. Our experience at the Yaounde General Hospital. 21 cases]. / Traitement des cancers du sein aux stades précoces T1 petit T2 N-notre experience a l'Hôpital Général de Yaoundé. A propose de 21 cas.

From February 1989 through February 1993, a group of 23 patients suffering from T1 mammary carcinoma small T2 N-MO was treated in the radiotherapy department of the Yaoundé General Hospital, according to a simplified procedure. A first conservative surgery of tumorectomy type (3 cases) and quandrantectomy type (4 cases) was carried out, followed by a postoperative irradiation. In 14 cases, a Patey type radical surgery preceded a local/regional radiotherapy. The general treatment was made up of only a hormonotherapy without chemotherapy. After a 4-year decline, there were 5 cases--i.e. 23.8%--of ganglionic and/or metastatic relapse. In the light of research data, we are analysing the reasons for these unexpected therapeutic failures in this group of tumor considered as favorable prognosis. We raised the problem of the inability of the prognosis factors, presently defined by means of histological and biological factors, to detect all the especially aggressive cancers. We carried out a general review of the new factors defined essentially from molecular and genic bases. We offered an approximative solution which makes it possible to by-pass the technological difficulties in having access to the new factors.

[Abscess of the rectovaginal wall in women. Apropos of a case]. / Abcès de la cloison recto-vaginale chez la femme. A propos d'un cas.

Recto-vaginal septum abscess is a rare entity in women. The authors report a rare clinical observation of a recto-vaginal septum abscess in a 40 year old woman, hospitalized and treated in the Surgical Unit of the Yaounde General Hospital. Medical literature was reviewed and surgical indications discussed.

[Rare association of a non-functional retroperitoneal paraganglioma and nephrotic syndrome]. / Association rare d'un paragangliome rétropéritonéal non fonctionnel et d'un syndrome néphrotique.

Non functional retroperitoneal paragangliomas are rare: less than 50 cases in literature. They are usually asymptomatic and can attain reasonable dimensions. The association with nephrotic syndrome is exceptional. The authors report a clinical observation of non-functional paraganglioma in a 45 year old woman, with repeated surgical abstention. Literature was reviewed and therapeutic indications discussed.

[Postoperative necrotizing fasciitis in infants. Apropos of a case]. / Fasciite nécrosante post-opératoire chez le nourrisson. A propos d'un cas.

A case of postoperative necrotizing fasciitis after a right incarcerated inguinal hernia repair is reported in a six week old baby hospitalized in the paediatric surgical unit of the Yaounde General Hospital. Treatment consisted in a medical reanimation, surgical debridement and an appropriate antibiotherapy. Medical literature was reviewed and therapeutic indications discussed.

[Posterior urethral valves in children. Apropos of 22 cases]. / Les valves de l'urètre postérieur chez l'enfant. A propos de 22 cas.

We reviewed 22 cases of posterior urethral valves over a five year period (January 1986 to December 1990). We looked at initial management before referral to the urologist, treatment and those factors that influence the outcome. We found that nosocomial infection from catheters was the major source of morbidity and mortality. Other determinants of outcome included postobstructive diuresis and the presence of refluxing or obstructing megaureters. The age of the patients was not as important as the degree of obstruction in this group of patients. We recommend percutaneous cystostomy as initial management for these patients as opposed to urethral catheterisation. This should be followed by antegrade or retrograde valve ablation one week later depending on the size of urethra.

[Benign sacro-coccygeal teratoma. A case report in Yaounde, Cameroon]. / Tératome sacro-coccygien bénin. A propos d'un cas observé à Yaoundé, Cameroun.

The authors describe a cases of sacrococcygeal teratoma observed in an infant after pregnancy without ultrasound surveillance. The mass was located in the buttock with a mainly exo-pelvic extension. There was no other malformation. Ultrasound examination revealed a heterogeneous structure with solid and liquid areas. Alphafoetoprotein level was high but the beta-HCG level was normal. The surgical specimen weighed 1990 grams and presented microcystic cavities and calcifications. Histological examination confirmed the diagnosis of benign complex multitissue teratoma. Postoperative recovery was uneventful and development of the child was normal 45 months after the procedure. The authors review the histologic, diagnostic, and prognostic features of teratomas and emphasize the importance of early surgical management, which is usually feasible in Africa.

Difficultes et interets d'une exploitation optimale du role et de la signification des ganglions regionaux dans les cancers au Cameroun. [Mise au point]

Une etude de fiabilite de 209 dossiers medicaux adresses aux consultations de cancerologie radiotherapie a ete menee. Une enumeration de toutes les informations d'origine ganglionnaire regionale qui contribuent a la connaissance du statut tumoral; des facteurs de pronostic du bilan d'extension et de la classification de la maladie maligne avait pour but final d'operer le meilleur choix de la strategie therapeutique. Un rappel didactique de la signification des principaux parametres a ete realise. Un accent particulier a ete mis sur la necessite d'une bonne documentation des dossiers apres que les raisons de leur mauvaise tenue aient ete relevees

[Late exterioration of a postoperative cecal fistula in children. Apropos of a rare clinical case]. / Fistule caecale postopératoire tardivement extériorisée chez l'enfant. A propos d'une observation clinique rare.

The authors report a rare clinical observation of a post-appendectomy caecal fistula retardedly exteriorized, in a 18 year old adolescent, managed in the surgical service of the Yaounde General Hospital. The radical treatment was surgical and consisted in right hemicolectomy. Literature was reviewed and therapeutic indications discussed.

[Benign giant epignathic teratoma in the newborn. Apropos of an unusual clinical case]. / Tératome épignathe géant bénin chez le nouveau-né. A propos d'une observation clinique exceptionnelle.

A rare case of giant epignathus teratoma with intracranial extension is reported in a male newborn. Pre-operative diagnosis of teratoma was made or suspected on radiological evidence of calcification within the tumor and increased level of alpha-foetoprotein. Optimal treatment consisted in complete surgical resection. The literature is revisited and surgical indications are discussed.

[The value of laparoscopy in the diagnosis and treatment of non-palpable testicular cryptorchism]. / Intérêt de la coelioscopie dans l'exploration et le traitement des testicules cryptorchides non palpables.

Laparoscopy is useful in both the diagnosis and the management of impalpable testes. Intra-abdominal testicles can be removed laparoscopically if atrophic or can be partly devascularized by spermatic vessel clipping if apparently normal. Assessment of testicular revascularization would be desirable prior to subsequent orchidopexy. A second-stage vasal-based orchidopexy can then be performed once adequate testicular reperfusion via the deferential pedicle is believed to have occurred. We have used both diagnostic and therapeutic laparoscopy in the management of 103 non-palpable testes over a period of 6 years. Open procedures following laparoscopy included 57 orchidopexies, 11 orchiectomies and one microvascular testicular autotransplant. Thirteen laparoscopic interventions were performed: 5 orchiectomies for atrophic testes and 8 testicular vessel clippings followed by 6 second stage open inguinal orchidopexies. Color Doppler duplex ultrasonography was not found to be reliable for assessment of testicular revascularization following spermatic vessel clipping. There were 3 complications which were all related to puncture with the Veress needle.

[Value of pedicled myoplasty in the treatment of severe mediastinitis. A case report]. / Intérêt de la myoplastie pediculée dans le traitement des médiastinites graves. A propos d'un cas.

Sternotomy is the approach of choice for cardiac surgery. Mediastinitis is a rare complication of median sternotomy with high morbidity and mortality. We describe a case of severe mediastinitis occurring after median sternotomy performed in a patient presenting diving goiter. Two-stage irrigation/drainage was unsuccessful. This failure led to opening of the chest and coverage with a pediculated flap using the grand pectoralis muscle. This stratagem allowed complete healing. This case provides an opportunity to discuss the different surgical techniques used to treat severe mediastinitis and to emphasize the value of muscle flaps in the management of recalcitrant median sternotomy wounds.

Laparoscopic management of the impalpable abdominal testis.

Laparoscopy is useful in both diagnosis and management of impalpable testes. Intra-abdominal testicles can be removed laparoscopically if atrophic or can be partly devascularized by spermatic vessel clipping if apparently normal. Assessment of testicular revascularization would be desirable prior to subsequent orchiopexy. A second-stage vasal-based orchidopexy than can be performed once adequate testicular reperfusion via the deferential pedicle is believed to have occurred. We have used both diagnostic and therapeutic laparoscopy in the management of 103 non-palpable testes over a period of six years. Open procedures following laparoscopy included 57 orchidopexies, 11 orchiectomies, and 1 microvascular testicular autotransplant. Thirteen laparoscopic interventions were performed: 5 orchietomies for atrophic testes and 8 testicular vessel clippings followed by 6 second-stage open inguinal orchidopexies. Color Doppler duplex ultrasonography was not found to be reliable for assessment of testicular revascularization following spermatic vessel clipping. There were 3 complications which were all related to puncture with the Veress needle.

[Treatment of a neglected traumatic perforation of the cervical esophagus by a muscular flap from the sterno-cleido-mastoid muscle. Apropos of a case]. / Traitement d'une perforation traumatique négligée de l'oesophage cervical par plastie musculaire du sterno-cléidomastoïdien. A propos d'un cas.

The diagnosis and management of oesophageal perforation is quite a problem. When the perforation is diagnosed early, treatment is easy with subsequently good results. When the diagnosis is delayed, treatment become complex, with a morbidity rate of about 35% and a high morbidity. This simple case report, describe the use of a sternocleido-mastoid muscle flap in the repair of a traumatic cervical oesophageal perforation with important loss of substance.

[Solitary extra-osseous ovarian plasmacytoma. Apropos of an unusual case in a 12 year old child]. / Le plasmocytome solitaire extraosseux ovarien. A propos d'un cas exceptionnel chez une enfant de 12 ans.

A rare case of extramedullary or solitary ovarian plasmocytoma in a 12 years old patient is reported. Surgery consisted of left adnexectomy associated with omentectomy. Chemotherapy with abdomino-pelvic iradiation were effectuated afterwards. Review of literature and therapeutic indications are discussed.

Diagnosis and treatment of gastroesophageal reflux in 500 children with respiratory symptoms: the value of pH monitoring.

Gastroesophageal reflux (GER) usually presents with digestive symptoms, failure to thrive, and/or respiratory symptoms. During the 8-year period from 1981 to 1989, 1,153 children underwent 20-hour pH monitoring to assess GER. All patients were graded using the scoring system of Euler and Byrne. Patients were classified as severe (score greater than 50), moderate (score 25 to 50), and normal (score less than 25). Five hundred (43.3%) of these patients presented with respiratory symptoms including apnea, cyanosis, or "near miss" sudden infant death syndrome (36%), poorly controlled asthma (28%), recurrent bronchopneumonia (13%), bronchiolitis (9%), and miscellaneous symptoms such as intermittent dyspnea, chronic cough, and stridor (12%). Eight patients (2%) had cystic fibrosis. The ages ranged from 1 month to 20 years (mean, 19.5 months). Twelve patients had technically inadequate studies and were excluded. Severe reflux was present in 156 patients (31%) and moderate reflux in 159 patients (31%). All patients were treated initially by medical therapy for a minimum of 8 weeks. The majority of patients (81%) had resolution of their symptoms with change in position, thickened feedings, and, when indicated, additional therapy with metoclopramide, cisapride, or domperidone. Most of these patients were found to have a specific position, usually prone, which decreased reflux. The remaining 57 patients had documentation of persistent reflux by pH monitoring and underwent an antireflux procedure. Of those patients undergoing surgery 51 had severe reflux and 6 had moderate reflux. Forty-four patients had a posterior 270 degrees wrap (Toupet), 10 had a 360 degrees wrap (Nissen), and 3 had an anterior 180 degrees wrap (Boix-Ochoa).(ABSTRACT TRUNCATED AT 250 WORDS)