ABSTRACT
Objectif: Le but de cette etude est d'evaluer la prise en charge du priapisme dans notre service en vue de proposer une conduite a tenir a partir d'une revue de la litterature.Patients et methodes: Il s'agit d'une etude retrospective portant sur 7 dossiers de patients suivis pour priapisme dans le service de chirurgie pediatrique du CHU de Treichville; de Janvier 2006 a Octobre 2010. Nous avons analyse: l'age; les antecedents; le delai de prise en charge; l'etiologie; les aspects cliniques; le traitement; et l'evolution.Resultats: Il s'agissait de 7 enfants de race noire; de sexe masculin; ages de 3 ans a 14 ans. Nous avons observe : un priapisme aigu chez 4 enfants (85.71) drepanocytaires SSFA2; un priapisme intermittent chez 2 enfants heterozygotes AS et 1 cas de priapisme intermittent idiopathique. Le priapisme aigu a ete traite chirurgicalement par shunt caverno-balanique unilaterale sans excision d'albuginee selon le procede de Falandry. Le priapisme intermittent a ete traite par l'administration orale d'etilefrine. Apres la chirurgie; nous avons observe 3 bons resultats immediats (75) et 1 bon resultat 24 heures apres. Aucune recidive ni aucun trouble de l'erection n'ont ete observes apres un recul moyen de 14 mois. Conclusion: Le priapisme est une complication frequente de la drepanocytose qui doit etre recherchee et traitee de facon concomitante. Nous preconisons l'injection intracaverneuse precoce d'etilefrine suivie; en cas d'echec; par la chirurgie selon la technique de Al-gorhab modifiee Falandry. Des etudes doivent etre effectuees afin d'apprecier le resultat a long terme; de cette technique; sur la fonction erectile. L'accent doit etre mis sur la sensibilisation afin de prevenir la survenue d'une impuissance sexuelle irreversible
Subject(s)
Academic Medical Centers , Child , Disease Management , Priapism , Priapism/etiologySubject(s)
Developing Countries , Esophageal Atresia/surgery , Adolescent , Burkina Faso , Child , Child, Preschool , Cote d'Ivoire , Esophageal Atresia/diagnosis , Esophageal Atresia/mortality , Female , Follow-Up Studies , Hospital Mortality , Hospitals, Pediatric , Hospitals, University , Humans , Infant , Infant, Newborn , Male , Retrospective Studies , Young AdultABSTRACT
The aim of this study is to demonstrate the role of spermatic or testicular artery with regard to fertility. 100 male rats Sprague-Dawley, consisted of 50 young rats (aged from 10 to 12 days old) and 50 adult rats were concerned. Unilateral ligation of the testicular artery with delayed controlateral orchiectomy were performed in 20 young rats. Only unilateral orchiectomy was planned in 20 other young rats and the 10 remaining were the absolute control group. Mating was observed for 2 weeks after 14 weeks of life. In adult rats, 20 underwent a bilateral ligation and division of the spermatic artery while 20 others were submitted to unilateral ligation-division associated with controlateral orchiectomy in 20 others. The 10 remaining represented the control group. The mating period was 3 weeks. After sacrificing animals, results were noted with regard to histological features and fertility. Among young rats, 45% were fertile and had normal gonadal tissue. From adult rats, only 10 to 15% were fertile. Atrophic testes were observed in 55% of infertile young rats while acute inflammatory lesions were predominant in most of adults. We conclude that ligation or division of spermatic artery is responsible for histological changes thus occurring in infertility in young and adults rats.
Subject(s)
Infertility, Male/etiology , Rats/anatomy & histology , Testis/blood supply , Age Factors , Animals , Arteries/anatomy & histology , Arteries/physiology , Arteries/surgery , Atrophy , Cryptorchidism/physiopathology , Disease Models, Animal , Female , Ligation , Male , Orchiectomy , Rats, Sprague-Dawley , Testis/growth & development , Testis/pathologyABSTRACT
Humeral, tibial and cutaneous localizations of Histoplasma capsulatum var. duboisii were observed on a 6 year old boy. The diagnosis was made possible by anatomo-pathological and mycological examinations. Treatment with terbinafine was administrated for 4 months. The boy recovered without after-effects in the tibial localization, but did suffer after-effects in the humeral localization.
Subject(s)
Bone Diseases/microbiology , Dermatomycoses/microbiology , Histoplasma/isolation & purification , Histoplasmosis/microbiology , Antifungal Agents/therapeutic use , Bone Diseases/diagnostic imaging , Bone Diseases/drug therapy , Child , Cote d'Ivoire , Dermatomycoses/drug therapy , Histoplasmosis/diagnostic imaging , Histoplasmosis/drug therapy , Humans , Humerus , Male , Naphthalenes/therapeutic use , Radiography , Terbinafine , TibiaABSTRACT
Over the past 10 years, we have seen sixteen children (15 males and 1 female) with the prune-belly syndrome. We have managed 12 of these children, but 4 of them were never reviewed. Abdominal wall reconstruction was performed in 11 children by dissection of spermatic vessels and fixing the testis in the scrotum. Because of our conservative approach to the management of urinary tract dilatation, we performed only one nephrostomy and 3 unilateral nephro-ureterectomies. Seven children were reviewed. The result of abdominal wall reconstruction was good in terms of cosmetic appearance and psychologic effect for the parents; we have observed no atrophic testes after orchidopexy. One of these children suffers from chronic renal failure, while the other children have good renal function. Prune-belly syndrome is a disease with a broad spectrum. The prognosis depends on the degree of renal dysplasia. These children require long-term follow-up.
Subject(s)
Prune Belly Syndrome/surgery , Abdominal Muscles/surgery , Child , Child, Preschool , Cote d'Ivoire , Dilatation, Pathologic/surgery , Dissection , Esthetics , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Kidney Diseases/surgery , Kidney Failure, Chronic/etiology , Male , Nephrectomy , Postoperative Complications , Prognosis , Prune Belly Syndrome/psychology , Plastic Surgery Procedures , Retrospective Studies , Scrotum/surgery , Spermatic Cord/surgery , Testis/surgery , Ureter/surgery , Ureteral Diseases/surgery , Urinary DiversionABSTRACT
Seven successive cases of acquired rectovaginal fistula have been diagnosed on children of three and half to eighteen months old. These fistula were localised on the fourchette. The seropositivity for HIV of five cases confirmed the results of similar reports found in literature. Surgical treatment of these girls was not done because of their bad presentation. Two of these children died. The other did not come for follow-up. The acquired rectovaginal fistula seems to be a sign of HIV infection. This work is meant to emphasise the relationship between AIDS and acquired rectovaginal fistula for a closer surveillance of future cases.
Subject(s)
HIV Infections/complications , Rectovaginal Fistula/etiology , Antidiarrheals/therapeutic use , Cause of Death , Dehydration/etiology , Dehydration/therapy , Diarrhea, Infantile/drug therapy , Diarrhea, Infantile/etiology , Female , Follow-Up Studies , HIV Seropositivity , Humans , Infant , Patient Dropouts , Rectovaginal Fistula/surgery , Rehydration Solutions/therapeutic useABSTRACT
The care and follow-up of children with bladder exstrophy is still a major problem in West Africa. From 1986 to 1994, we saw 17 cases of bladder exstrophy predominantly in females. We performed 13 successful bladder closures and two ureterosigmoidostomies. The high mortality was due to lack of adequate intensive care structures.
Subject(s)
Bladder Exstrophy/surgery , Adolescent , Cause of Death , Child , Child, Preschool , Colon, Sigmoid/surgery , Cote d'Ivoire , Critical Care , Developing Countries , Female , Follow-Up Studies , Hospitals, University , Humans , Infant , Male , Postoperative Complications , Reoperation , Sex Factors , Surgical Wound Dehiscence/etiology , Treatment Outcome , Ureter/surgery , Urinary Bladder Diseases/etiology , Urinary Diversion/methods , Urinary Fistula/etiology , Vesico-Ureteral Reflux/etiologyABSTRACT
From 1984 to 1994, 105 children with hypospadias were seen. Only 52 of them were treated. Hypospadias was distal (glandular subglandular or subcoronal hypospadias) in 38.4% of cases and involved the penile distal shaft or penile midshaft in 38.4% and posterior hypospadias in 23% of cases. Meatotomy with circumcision was performed in 70% of cases of distal hypospadias. The best results were obtained with distal penile shaft hypospadias by Mathieu's method. The fistula rate was high (17.3%). 2-or-3-stage treatment of posterior hypospadias is now performed in one stage using Duckett's or Duplay's method. The results of these methods are discussed.
Subject(s)
Hypospadias/surgery , Adolescent , Anastomosis, Surgical/adverse effects , Child , Child, Preschool , Circumcision, Male , Fistula/etiology , Follow-Up Studies , Hospitals, University , Humans , Hypospadias/classification , Infant , Male , Penile Diseases/etiology , Penis/pathology , Penis/surgery , Reoperation , Senegal , Treatment OutcomeABSTRACT
The above account concerns 50 cases of caudal anaesthesia with 2% plain lidocaine (i.e. without adrenaline), after a preliminary and a complementary general anaesthesia for surgical operations in the infra umbilical region not exceeding one hour in duration. The anaesthetic effect was as rapid as the recovery from it. The analgesic effect was excellent in 98% of cases. No per or post operative complications were observed with the employment of this technique. The authors recommend that this technique should be employed more frequently in day case pediatric surgery.
Subject(s)
Ambulatory Surgical Procedures , Anesthesia, Caudal/methods , Anesthesia, Caudal/statistics & numerical data , Hospitals, University , Anesthesia, Caudal/adverse effects , Anesthesia, Caudal/instrumentation , Anesthesia, General/methods , Anesthesia, General/statistics & numerical data , Bupivacaine , Child, Preschool , Cote d'Ivoire , Evaluation Studies as Topic , Female , Humans , Infant , Lidocaine , Male , PediatricsABSTRACT
An investigation on the effects of hand burns has been undertaken about 32 children admitted in the plastic surgery outpatients Department. Accident occurs among the lower class population and heat is the major factor pointed out. The most frequent effects are hand palmar contracture. The surgical treatment completed with the functional re-education has given very good results in 79% cases. However the cheloid contractures are the most difficult to cure. Indeed the authors insist or the prevention and the creation of a center of burned patients and a plastic surgery Service to take care of patients whose life prognostic is optimistic.
Subject(s)
Burns/complications , Hand Injuries/complications , Adolescent , Burns/epidemiology , Burns/surgery , Child , Child, Preschool , Contracture/epidemiology , Contracture/etiology , Contracture/rehabilitation , Cote d'Ivoire/epidemiology , Female , Follow-Up Studies , Hand Injuries/epidemiology , Hand Injuries/surgery , Hospitals, University , Humans , Male , Population Surveillance , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/rehabilitation , Splints , Surgery, Plastic , Treatment OutcomeSubject(s)
Esophageal Achalasia/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Cote d'Ivoire , Female , Gastroesophageal Reflux/prevention & control , Humans , Male , Methods , Middle Aged , Postoperative ComplicationsABSTRACT
This study is the authors' account of their experience of oesophagoplasty with the colon carried out among children in an african population. From 1978 to 1982, they performed 10 substernal intrathoracic transplantation of the colon to replace accidentally strictured oesophagus. The stricture in all cases is one to swallowing of corrosive substance, basic products (potassium lye and locally made bases) in half of the cases and battery acid in the other half. Follow-up has been between 9 months and 5 years. The results are as follows: In the immediate postoperative period there were: -- 1 death after surgery due to anesthetic error, -- 6 complications : -- 4 upper (cervical) anastomotic leakage, -- 1 incomplete stricture of the cervical anastomosis, -- 1 temporary dumping syndrome, -- 1 purulent pleurisy and parietal abscess; -- 3 cases without any complications. Before discharging the patients from the hospital, the functional results were evaluated on clinical features (quality of the deglutition, weight increase) and radiographically by a barium swallow (permeability of the colon transplant); these results were satisfactory. Long term follow-up was possible in 4 children (one monthly for the first 6 months, then once every 3 months for 6 months). Follow-up was less regular for the remaining 5 children. Except for a case of recurrent stricture of the cervical anastomosis which required reoperative surgery, normal deglutition was restored in all the patients, as was confirmed by a barium meal and a satisfactory weight gain.
