[Pancreatic pseudocyst in children: about 7 cases]. / Le pseudokyste du pancréas chez l'enfant: à propos de 7 cas.

Pancreatic pseudocyst is a rare benign condition, in particular among children. It is an intra or extra pancreatic juice collection lacking of an epithelial lining. We conducted a retrospective study of 7 children whose medical record data were collected in the Department of Paediatric Surgery at the University Hospital Hassan II in Fez, over a period of 11 years, from 1 January 2005 to 31 December 2016. All children were male, their average age was 6.6 years (15 months - 12 years). An history of abdominal trauma was found in 4 cases, abdominal bloating, pain, vomiting and transit disorders were the primary reason for consultation. Clinical examination showed epigastric tenderness and an alteration of the general state in all cases. Abdominal ultrasound as well as abdominal CT scan helped to diagnose pancreatic pseudocyst before surgery. Six patients, out of a total of seven, underwent surgery; we opted for internal bypass (gastro-cystic anastomosis) in 4 cases, external bypass in 2 cases and therapeutic abstention in one case. Pancreatic pseudocysts are rare. Nevertheless, they are the most frequent (80% of pancreatic cystic lesions are pseudocysts and due to acute and/or chronic pancreatitis, pancreatic trauma or pancreatic ductal obstruction).

Langerhans cell histiocytosis presenting as eosinophilic granuloma of the bilateral forearms in an 8-year-old girl: a case report.

BACKGROUND: Langerhans cell histiocytosis previously known as histiocytosis X is a rare disease of children and young adults with a very broad clinical spectrum. In children, its annual incidence is estimated between 0.2-0.5 per 100,000. CASE REPRESENTATION: An 8-year-old Moroccan girl with no known personal or family history presented to our institution with painful swelling of both forearms. An X-ray and magnetic resonance imaging were inconclusive. We then performed a biopsy curettage (of her left forearm). Microscopic analysis followed by immunohistochemical analysis disclosed a diagnosis of Langerhans cell histiocytosis. No chemotherapy was necessary. Clinical and radiological improvement was achieved after 6 months. CONCLUSION: The particularity of this observation is the bilaterality of the lesion on both forearms and it has not previously been reported. Langerhans cell histiocytosis should be included in the differential diagnosis of osteomyelitis and Ewing's sarcoma.

[Acute appendicitis due to Claudius Amyand's hernia in a newborn with intestinal obstruction]. / Appendicite aigue sur hernie de Claudius Amyand chez un nouveau-né dans un tableau d'occlusion neonatale.

Claudius Amyand's hernia is defined as the incarceration of the vermiform appendix in the hernia sac. The first reported appendicectomy was performed in 1735. It is very rare among children, hence its frequency is not yet established. We report the case of a 22-day old new born with untreated simple inguinoscrotal hernia who had an urgent admission to the Emergency Department due to occlusive syndrome with no evacuation of faeces and no passing of flatus, inflammatory inguinoscrotal swelling and bilious vomiting persisting for 2 days. Treatment was based on the restoration to good health and on preanesthetic assessment. Intraoperative exploration showed necrotic bulging appendix in its distal half with false membranes. Appendectomy was performed with closure of the hernia sac. Patient's evolution was marked by resumption of intestinal transit 24h after surgery.

Multifocal rib osteomyelitis in children: a case report and literature review.

Rib osteomyelitis is a rare disease, occurring in ~1% or less of all cases of haematogenous osteomyelitis. During the last century, 58 cases of rib osteomyelitis were reported in the literature, of which, multiple ribs were involved in only five patients. Because of its rarity and non-specific clinical signs, diagnostic of rib osteomyelitis may be delayed. We report a case of multifocal rib osteomyelitis revealed by a dorsal mass in a healthy 13-year-old female child.

[Tibial spine fractures in children]. / Fracture des épines tibiales chez l'enfant.

Tibial spine fractures are rare lesions which usually occur in adolescent athletes aged between 8 and 17 years. The treatment of displaced fractures requires surgical reduction and fixation in order to achieve adequate tension in the anterior cruciate ligament and to reduce the risk of laxity. This study aimed to report our experience in the treatment of tibial spine fractures in children. We conducted a retrospective study of 11 children with tibial spine fractures over a period of 7 years (2009-2016). The average age of our patients was 13 years and a half. A fall during sport was the main cause of tibial spine fractures in 73% of patients. Meyers and Mac Keever classification, modified by Zaricznyj, was used and allowed to classify the lesions into 4 types. Two cases were orthopedically treated while 9 cases underwent surgical reduction through arthrotomy and fixation using osteosuture. After an average follow-up of 3 years our results were good in 91% of cases, according to Lysholm functional score. Only one case with orthopedically treated type II fracture still had a mean Lysholm functional score. Surgical treatment for types II-IV fractures (with the exception of type I) should be used in order to ensure a good anterior cruciate ligament tonus. The prognosis of tibial spine fractures is good. Surgical reduction should be used when tibial spine fractures are associated with displacement in order to better verify anterior cruciate ligament integrity and to ensure a good knee stability.