[Retrospective study of visceral surgical emergencies in children at the University Hospital Center of Brazzaville (Congo)]. / Etude rétrospective des urgences chirurgicales viscérales de l'enfant au CHU de Brazzaville (Congo).

The purpose of this study was to estimate the Incidence of visceral surgical emergencies In children and to determine the main causes and their prognoses. A retrospective study was carried out among children ranging from 1 month to 15 years who underwent emergency visceral surgery in the pediatric surgery unit of the University Hospital Center in Brazzaville, Congo. A total of 185 of the 206 children (14.1%) admitted for emergency visceral surgery were included In the study. The study population was predominantly male (67%). Most patients (71.3%) were over 5 years of age. The main indications for visceral surgery were acute appendicitis (30.3%), peritonitis (28.1%), strangulated hernia (22.2%), abdominal contusion (7.6%), intussusception (6.4%), other causes of intestinal obstruction (2.7%), and abdominal wounds (2.7%). Peritonitis was due to ruptured appendix in 76.9% of cases. Strangulated hernias were inguinal in 70.7% of cases and wnbilical in 29.3%. Intussusception was idiopathic in all cases and usually observed in infants under 6 months of age (58.3%). Postoperative recovery was uneventful in 79.5% of cases and complicated in 16.2%. EIght deaths (4.3%) were recorded. For the patient that died, the delay between initial symptoms and admission was longer than 3 days in 87.5% of cases and the interval for surgical treatment was longer than 6 hours in all cases. Early diagnosis and prompt surgical treatment are favorable prognostic factors for the outcome of emergency visceral surgery.

Etude retrospective des urgences chirurgicales viscerales de l'enfant au CHU de Brazzaville (Congo)

Apprecier la frequence des urgences chirurgicales viscerales de l'enfant et en identifier les differentes causes d'une part; evaluer leur pronostic d'autre part. L'etude; retrospective; a concerne les enfants ages de 1 mois a 15 ans hospitalises dans le service de Chirurgie pediatrique du CHU de Brazzaville (Congo) et ayant une urgence chirurgicale viscerale. Sur 206 (14;1) enfants admis pour une urgence chirurgicale viscerale; 185 ont fait l'objet de l'etude. Parmi les 185 enfants ayant une urgence chirurgicale viscerale; il existait une predominance masculine (67). La plupart des patients (71;3) etait agee de plus de 5 ans. Les causes des urgences chirurgicales viscerales etaient representees par les appendicites aigues (30;3); les peritonites (28;1); les hernies etranglees (22;2); les contusions abdominales (7;6); les invaginations intestinales (6;4); les autres causes d'occlusions (2;7) et les plaies abdominales (2;7). Les peritonites etaient imputees a une perfo ration appendiculaire dans 76;9des cas ; les hernies etranglees etaient inguinales (70;7) et ombilicales (29;3) ; l'invagination intestinale; idiopathique dans tous les cas; s'observait volontiers chez les moins de 6 mois (58;3). Les suites operatoires ont ete simples dans 82;4des cas; compliquees dans 17;6des cas ; 8 deces (4;3) ont ete enregistres. En cas de deces; le delai de recours etait superieur a 3 jours dans 87;5des cas et le delai de prise en ch a rge superieur a 6 heures pour tous. Un diagnostic plus precoce et une prise en ch a rge initiale plus prompte constituent des fa c t e u rsd'amelioration du pronostic des urgences chirurgicales viscerales

[Hepatic hydatid cyst and splenic hydatid cyst--their surgical treatment with splenic preservation]. / Chist hidatic hepatic si chist hidatic splenic--tratament chirurgical cu pastrarea splinei.

The hydatid cyst located in the spleen is very rare and the association of the liver location concomitant with the spleen location is exceptional. If the elective surgical intervention for the hydatid cyst of the liver with abdominal evolution is the operation Lagrot, most of the authors preferred a splenectomy in the hydatic cyst of the spleen. It is presented the case of such an association, pointing out the role of the echography for diagnosis and the opportunity of deciding on the preservation of the spleen in treatment.

[Retroperitoneal phlegmon in the left mesenteric-colonic space. A discussion of a case]. / Flegmon retroperitoneal în spatiul mezenterico-colic stâng. Discutii asupra unui caz.

It is presented the case of the child with an altered general health situation and with an abdominal suffering; paraclinical investigations were irrelevant and only the surgical exploration had established the diagnosis: a phlegmon with unusual location retroperitoneal, in the left mesenterico-colonic space, next to the mesenteric basis, it is discussed the novel of this location, differential diagnosis with mesenteric adenolimphite, an eventual filiation with a previous thigh phlegmon and it points cut the value of the therapeutical solution.