Recurrent urinary tract infections led to the diagnosis of cross-renal ectopia: A case report.

INTRODUCTION: Crossed renal ectopy (CRE) is a very rare congenital kidney anomaly. CRE is usually asymptomatic and is most often discovered incidentally, but the patient may sometimes develop various renal manifestations. CASE PRESENTATION: We report a case of a girl who was symptomatic of several episodes of urinary tract infections and whose investigations including ultrasound, uroscan, renal scan and voiding cystourethrogram concluded that she had a crossed left renal ectopy without vesico-ureteral reflux. A regular Follow-up revealed no further symptoms or complications, with partial resolution of the hydronephrosis, and no recurrence of urinary tract infections after hygienic rules. This case didn't require surgical intervention. CLINICAL DISCUSSION: CRE is an infrequently occurring congenital malformation. Uroscan is an excellent tool to describe the full anatomical details of this pathology; and the information provided is crucial for surgeons, nephrologists, and radiologists to aid in the proper handling of this pathology. CONCLUSIONS: CRE is a rare disease that can be diagnosed incidentally. Treatment is only indicated if complications occur or if there is other associated renal disease. Patients require continuous follow-up and need to be examined for potential complications.

Inguinoscrotal hernia revealing a testicular hemangioma: Report of a neonatal case.

Testicular hemangioma (TH) is a congenital, uncommon and non-malignant testicular tumor. In the following report, we present a child who was brought to our emergency department with swelling of the right scrotum. Investigations were consistent with a TH and an associated hernia. We conducted an inguinal exploration given the hernia accompanying the TH. The pathological tissue findings were suggestive of a TH. In our further research, we found that this was the first neonatal hemangioma in the literature. It's important to know that an inguinal hernia can lead to the non-recognition of certain tumors.

Mechanical complications of peritoneal dialysis in Tunisian children.

INTRODUCTION: Peritoneal dialysis (PD) is the method of choice for extra-renal replacement therapy (ERT) for children with end-stage renal disease (ESRD), because of its various advantages. However, it presents different infectious and non-infectious complications, causes of important morbidity and mortality. AIM: To determine the mechanical complications of PD in our center and to identify risk factors of their occurrence. METHODS: We retrospectively collected the records of 99 patients who were treated with PD within the past eleven years in the department of pediatrics of the University Hospital Charles Nicolle of Tunis. Analysis examining possible risque factors were performed using parametric and non-parametric tests. RESULTS: A total of 63 patients had mechanical complications with an incidence of peritoneal dialysis catheter revision of 1 procedure every 38 months. The causes were dominated by catheter migration (27.5%) and obstruction by fibrin or blood clotting (19.8%). A history of peritonitis (p=0.046) and the presence of comorbidity (p=0.008) were the two independent risk factors for catheter revision. Inguinal hernia was noted in six patients. No patient presented with a hydrothorax. Seven patients presented an episode of hemoperitoneum. CONCLUSION: Our results lead us to focus our efforts on preventing peritonitis and controlling morbidity. Prospective studies will enable us to confirm our results.

Congenital giant megaureter prenatally diagnosed: A case report.

Congenital giant megaureter (CGM) is uncommon in pediatic population, defined as congenital localized or total dilatation of the ureter to over 10 times the normal diameter with a normal bladder. Herein, we reported an entirely dilated CGM presented as neonatal bowel obstruction in a newborn baby. Our experience has suggested that CGM should be considered as a differential diagnosis of abdominal distension and occlusive syndrome.

Chest Wall Monophasic Synovial Sarcoma in a 12-Year-Old Boy: A Case Report.

We report a rare case of synovial sarcoma of the chest wall in a child. A 12-year-old male presented to our pediatric surgery department with chief complaint of swelling accompanied by slight pain of the upper right side of the anterior chest wall since approximately 5 months. Firstly, we performed an ultrasound (US)-mass biopsy. Histopathological examination showed fibromatosis. After that, we underwent surgical resection. Pathological examination revealed a monophasic type synovial sarcoma. Immediately post-operation, the patient manifested a loss of the extension of the forearm, hand, and fingers on the right side. Physical therapy was performed with good results. On the basis of our diagnosis, we performed 6 cycles of multi-drug adjuvant chemotherapy and then radiotherapy. After 3 years of surgery, there was no evidence of recurrence. However, careful observation may be required.

Place of Laparoscopy in Peritoneal Tuberculosis.

Introduction: Peritoneal tuberculosis (PT) is a rare form of extrapulmonary tuberculosis in children. The diagnosis is difficult because of its clinical polymorphism. Laparoscopy is the gold standard to make the diagnosis by exploring and performing peritoneal biopsies. Our aim was to show the place of laparoscopy in the diagnosis of PT, to compare the anatomopathological results of peritoneal biopsies with a macroscopic appearance to quick start antituberculosis treatment. Case Reports: We reported 4 patients with PT, 3 girls and 1 boy. The middle age was 9 years old. The revealing symptomatology was ascites in all cases. Radiological exploration was not contributing. Laparoscopy was performed for all patients. The exploration revealed an agglutination of the intestinal loops with the presence of whitish micronodules scattered over the entire abdominal cavity. Peritoneal biopsies were done in all cases. Histological examination confirmed the diagnosis of PT in all patients and antituberculosis treatment was introduced. There was a good clinical evolution with a follow-up of 30 months. Conclusion: PT is a public health problem due to its clinical and biological polymorphism. Laparoscopy with peritoneal biopsies remains the essential means for the diagnosis of this pathology in children.

A rare case of lumbosacrococcygeal mass in newborn: a human tail.

Caudal cutaneous appendage is a rare condition. According to association with underlying spinal dysraphism, it can be classified into true or pseudotails. Management and prognosis depends closely on spinal anomaly. Fewer than 40 cases of true tail were reported. We describe a rare case of true tail in a newborn explored and operated in our unity.

Primary hydatid cyst of the small intestine masquerading as intestinal duplication in a child.

Hydatid disease or hydatidosis is a worldwide zoonosis disease caused by the tapeworm of Echinococcus granulosus and still widely endemic in Tunisia especially in rural areas where the sheep-dog cycle is dominant. It is an important public health problem in the pediatric age group causing significant morbidity and mortality. We report a case of primary hydatid cyst of the small intestine in a child and we want to highlight the difficulty that we meet in the diagnosis despite the contribution of imaging.

[Pancreatic-pleural fistula in children: a rare cause of great abundant pleurisy]. / La fistule pancréatico-pleurale chez l'enfant: étiologie rare d'une pleurésie de grande abondance.

Pancreatic-pleural fistula is a very rare complication of false cysts of the pancreas. Our study aimed to describe this rare pathology affecting children. We emphasized the importance of evoking this diagnosis in the presence of great abundant pleurisy even in the absence of the digestive signs. We here report the case of a 2-year old child with false cyst of the pancreas complicated by pleural fistula detected after great abundant pleurisy with no digestive signs associated.