ABSTRACT
We report the case of a 9-year-old boy with progressive thoracic scoliosis and crossed hemihypertrophy who was discovered with a Chiari 1 malformation and syringomyelia. These disorders are connected by complex physiopathological mechanisms; their association deserves attention. This observation reviews the importance of the clinical examination, particularly the neurological exam, in childhood scoliosis. The features suggesting a neurogenic background of spine deformation should be sought. Scoliosis with hemihypertrophy can be the sign of an underlying neurological abnormality.
Subject(s)
Arnold-Chiari Malformation/diagnosis , Arnold-Chiari Malformation/complications , Child , Humans , Hypertrophy/etiology , Male , Phenotype , Scoliosis/etiology , Syringomyelia/complicationsABSTRACT
From 1979 to 1990 37 children with sickle cell disease underwent surgery for cholelithiasis. Mean age was 11,3 years. Twenty-four children had a history of recurrent abdominal pain; 8 of them were admitted for an acute gallstone complication. In 9 cases the stones were detected by systematic echography. The incidence of gallstones increasing with age, the rate of complications, the frequent resolution of recurrent abdominal pain after cholecystectomy justify elective surgery at the time of diagnostic of the stones. A transfusion preparation considerably reduces the risk of post-operative complications.
Subject(s)
Anemia, Sickle Cell/complications , Cholelithiasis/surgery , Abdominal Pain/etiology , Abdominal Pain/surgery , Acute Disease , Adolescent , Child , Child, Preschool , Cholecystectomy/adverse effects , Cholecystitis/etiology , Cholecystitis/surgery , Cholelithiasis/etiology , Chronic Disease , Female , Humans , MaleABSTRACT
The authors report 16 cases of tibia vara in children. They insist on: the difficult diagnosis of that pathology at the beginning, the early surgery (simple osteotomy) give a complete restoration, in neglected cases they recommend to elevate the medial condyle of the tibia with bone grafting, a tibial osteotomy and an epiphysiodesis of the lateral tibial condyle and proximal fibula.
Subject(s)
Osteochondritis/diagnostic imaging , Tibia/diagnostic imaging , Child , Child, Preschool , Humans , Infant , Male , Osteochondritis/surgery , Osteotomy/methods , Radiography , Tibia/surgeryABSTRACT
Homozygous SS sickle cell anemia affects 0,25% of the population of the West-Indies, and 10% of these children have biliary lithiasis. Together with the vascular thromboses, these stones are the cause of frequent painful abdominal crises. A group of 12 children with biliary lithiasis were operated upon between 1979 and 1983. Emphasis is placed on the relative frequency of complications of the cholelithiasis, on the high morbidity of the operations, and the almost constant good results as shown by disappearance of the abdominal pains. It is concluded that routine ultrasound imaging should investigate the possible presence of bile stones in children, and operative treatment for these stones should be systematic. Post-operative complications should diminish as a result of pre- and immediate post-operative exchange transfusions.
Subject(s)
Anemia, Sickle Cell/complications , Cholecystectomy , Cholelithiasis/surgery , Pain/diagnosis , Abdomen , Adolescent , Anemia, Sickle Cell/therapy , Child , Child, Preschool , Cholelithiasis/diagnosis , Cholelithiasis/etiology , Female , Humans , Male , Pain ManagementABSTRACT
We describe a new method for the cutaneous repair of umbilical hernias. The cut of the skin makes two flaps suppressing the navel which is generally salient. After the aponevrotic repair which is made by vertical suture with slowly resorbable material, the repair of the two cutaneous flaps builds a new navel which aspect is very close to the natural one. This method has been used once with complete satisfaction, for the repair of an omphalocel.
