Littre's Umbilical Hernia in a Child: A Case Report and Scoping Review.

Littre's umbilical hernia (UH) is a rare disease, the third most common Littre hernia. Most case reports interest adult patients. We reported the case of a four-year-old girl with anemia and symptomatic UH, with an incidentally diagnosed Meckel's diverticulum (MD) containing pancreatic ectopic tissue. We reviewed case reports on Littre's umbilical hernia without a date or language restriction. Including our patient, 21 cases were reviewed, of whom 15 (71.4%) were adults and 13 (61.9%) were males. Complicated umbilical hernia occurred in 13 patients (61.9%) and symptomatic MD in two children (9.5%). Investigations preoperatively diagnosed two patients (9.5%). Eighteen patients (85.7%) underwent open surgery, Meckel's diverticulum removal was performed in 18 patients (85.7%), and primary umbilical hernia repair was performed in 16 (76.2%). Ectopic tissue was present in four patients (19.1%), and long-term outcomes were excellent in all patients.

Ileal perforation peritonitis secondary to ingestion of magnetic beads in the older child: A case report.

INTRODUCTION AND IMPORTANCE: Foreign body ingestion is frequent in younger children, with generally good outcome on conservative management. However, magnetic beads ingestion is an exceptional cause of intestinal perforation in the older children. CASE PRESENTATION: An 8-year-old boy presented with clinical signs of generalized acute peritonitis. Abdominal plain X-ray confirmed the foreign object in the digestive tract and oriented the etiology by highlighting several air-fluid levels, distended small bowel loops, pneumoperitoneum and the presence of a bilobed foreign body projected adjacent to the 5th lumbar vertebra. Open surgical exploration was performed and revealed a peritoneal fluid, 2 perforations in the small bowel and 2 adhered pieces of magnets. A 20 cm ileal resection, including the segment with the 2 perforations, was performed followed by a terminal ileostomy. The restoration of gastrointestinal continuity was performed 16 days later. After a follow-up of 2 years and 8 months, the patient was free of any symptom. CLINICAL DISCUSSION: In cases of acute peritonitis due to perforation, the general condition deteriorates progressively. Fever may be absent, as was the case with our patient. Abdominal pain is the predominant symptom, it is often accompanied by vomiting that can be alimentary, bilious, or even fecaloid and/or by cessation of bowel movements and/or gas. Abdominal rigidity is a major physical sign, sometimes replaced by generalized guarding. CONCLUSION: Ingestion of gastrointestinal foreign bodies is rare in older children, the presence of more than one magnet can lead to peritonitis due to intestinal perforation.

Management of Umbilical Hernia in African Children: The Experience of 2146 Cases.

Aims: Umbilical hernia (UH) is common in African and African-descent children. In high-income countries (HICs), it is considered benign, which is not the case in Sub-Saharan ones. Through this study, we aimed to share our experience. Materials and Methods: A descriptive review was conducted from January 01, 2012 to December 31, 2017 at Albert Royer National Children's Hospital Center. Among the 2499 patients, 2146 cases were included in the review. Results: UH had a frequency of 6.5%, with patients having a mean age of 2.6 years, with a male preponderance of 63%. Emergency consultation occurred in 37.1%. The symptomatic hernia was present in 90.9%. The congenital type was found in 96%, a history of painful episodes was reported in 46%, and medical and surgical comorbidities were found in 30.1% and 16.4%, respectively. Multimodal anesthesia was used in 93.1%. A lower umbilical crease incision was made in 83.2%, the sac was not empty in 16.3%, and additional umbilicoplasty was performed in 16.3%. During a 14-month follow-up, a complication occurred in 6.5% and mortality in 0.05%. Conclusion: In our region, the pediatric UH was predominantly symptomatic, with its natural evolution leading to more complications than in HICs. Its management carried acceptable morbidity.

Blunt Abdominal Trauma in Children: A Review of 105 Cases.

Aims: The aim of the study is to identify the epidemiological, diagnostic, therapeutic, and evolutionary characteristics of patients admitted for blunt abdominal trauma (BAT) in a level 3 children's hospital. Results: The frequency was 13.1 cases/year. The mean age was 6.6 years. The sex ratio was 3.56. Road traffic accidents were the most frequent cause (54.3%). Abdominal tenderness (88.6%) was the most common physical sign. Associated lesions were found in 40% of cases. Abdominal sonography (85.7%) was the most common imaging tool followed by an abdominal computed tomography scan (34.4%). The liver was the most affected organ (24.7%) and contusion was the most frequent lesion (65.4%). The majority of patients had received nonoperative treatment (93.3%). The average length of hospitalization was 5.6 days. The outcome in all cases was favorable. No mortality was reported. Conclusions: BAT in children is common in boys under the age of 10. They are caused by road accidents. Physical examination combined with abdominal ultrasound is very important in the therapeutic decision, which in most cases is a conservative one. Morbidity and mortality are almost nil.

Fibromatosis Colli: About 26 Cases.

Aims: The aim is to identify the epidemiological, diagnostic, therapeutic, evolutionary aspects, and risk factors related to the occurrence of this condition. Subjects and Methods: It was a retrospective and descriptive study of a series of 26 cases of fibromatosis colli collected over a period of 3 years (from January 1, 2017 to December 31, 2019). We studied the following parameters: frequency, age, sex, delay of consultation, motive of consultation, gravidity, parity, type of delivery, notion of birth trauma, birth weight, examination findings, ultrasound results, type of treatment, and evolutionary modalities. The data were collected from patients' files. The analysis was done on Excel 2016. Results: The frequency was 6.5 cases/year. The mean age was 2.1 months. The average delay of consultation was 6.3 weeks. A notion of obstetrical trauma was found in 16 cases (61.5%). Primiparity was noted in 15 cases (57.5%). Associated torticollis was noted in 03 cases. Cervical ultrasonography was performed in all cases (n = 26/26) enabling diagnostic confirmation. Surveillance was the main treatment (84.6%). After a mean follow-up of 20.8 months, evolution was favorable in the majority of patients. The average time of complete regression of the mass was 3.8 months. Conclusions: Rare condition of the newborn and infant for which the diagnosis is clinical and the confirmation is based on ultrasound. The management is simple and based on surveillance. The evolution is most often toward spontaneous regression.

Brachial Plexus' Schwannoma in a Child.

Children's schwannoma is a rare condition, generally occurring in a sporadic way. Its aetiology is still not fully understood. We report the case of a 10-year old girl who presented a left shoulder mass, along motility reduction of the left upper limb for 24 months before presentation at our service. A biopsy resection of the mass gave the diagnosis and 6 months after surgical resection, no complication occurred.

[Management of congenital diaphragmatic hernia in sub-Saharan Africa: experience in the Albert Royer National Children's Hospital Center, Senegal]. / Prise en charge de la hernie diaphragmatique congénitale en Afrique sub-Saharienne: l'expérience du Centre Hospitalier National d'Enfants Albert Royer au Sénégal.

Introduction: congenital diaphragmatic hernia has been rarely reported in Africa. It can manifests early or late. Prognosis mainly depends on associated malformations. The purpose of this study is to report our experience in the Albert Royer National Children's Hospital, Dakar, Senegal. Methods: we conducted a retrospective study of patients treated for congenital diaphragmatic hernia between January 2010 and December 2019. Results: twelve patients were enrolled, with an average age of 8.9 months. Bochdalek hernias were detected in 10 patients. The most common symptoms were respiratory symptoms (83.3%), followed by digestive symptoms (41.6%). Thoraco-abdominal X-ray was used to make a diagnosis in all patients. Three patients underwent preoperative stabilization. All patients underwent laparotomy. Hernia sac was found in 10 patients, and 50% of patients had a defect measuring between 5 and 10 cm. The postoperative course was simple in 10 patients; a polymalformed patient died. Conclusion: congenital diaphragmatic hernia is a reality in our environment; it most often manifests beyond the neonatal period. Prognosis is generally good in our context.

Acute appendicitis revealing a giant mesenteric pseudocyst: case report.

Mesenteric pseuodycst is a very rare benign childhood tumor, accounting for less than 1 out of 250,000 hospital admissions. We here report a case of giant mesenteric pseudocyst incidentally detected in a 11-year-old boy with acute appendicitis. He complained of persistent abdominal pain for the past 48 hours. He had a history of intermittent pain for several months. Physical examination showed fever and abdominal pain. Ultrasonography showed large peritoneal fluid related to peritonitis probably of appendicular origin. The patient underwent exploratory laparotomy revealing giant abdominal mesenteric cyst and acute appendicitis. Open resection of the cyst and appendectomy were performed. The diagnosis of uncomplicated acute appendicitis associated with mesenteric pseudocyst was made. Preoperative diagnosis of pseudomesenteric cysts is a clinical challenge. Knowledge is essential and suspicion should be maintained in patients with nonspecific symptoms.

Factors associated with mortality in congenital malformations of the gastrointestinal tract in a tertiary center in Senegal.

Objective: Patients with congenital malformations (CMs) of the gastrointestinal tract (GIT) have a very high mortality. However, the literature on the factors associated with mortality in these patients is scarce in sub-Saharan Africa. The aim of this study is to identify independent risk factors for mortality in patients with CMs of the GIT at our pediatric surgical department. Methods: We conducted a retrospective analysis of cases with CMs of the GIT managed at a tertiary center from 2018 to 2021. Patients were subdivided into two groups based on the outcomes, and variables with a significant difference were analyzed by logistic regression. Results: Our review included 226 patients, 63 of whom died (27.88%). Patient age ranged from 0 to 15 years. Taking into account statistical significance, mortality was more frequent in neonates than in older patients (57.30% vs 6.15%), in patients coming out of the Dakar area than in those from the Dakar area (43.75% vs 19.18%), in patients with abnormal prenatal ultrasound than in those with normal ultrasound (100% vs 26.67%), in premature children than in those born at term (78.57% vs 21.87%), in patients with an additional malformation than in those with an isolated malformation (69.23% vs 25.35%), and in those with intestinal, esophageal, duodenal and colonic atresia than in those with other diagnoses (100%, 89%, 56.25% and 50%, respectively). Referred patients died more than those who changed hospitals or came from home (55.29% vs 25% and 9.09%, respectively). On multivariable logistic regression, two independent factors of mortality were identified: presence of associated malformation [odds ratio (OR)=13.299; 95% Confidence interval (CI) 1.370 to 129.137] and diagnosis of esophageal atresia (OR=46.529; 95% CI 5.828 to 371.425). Conclusion: The presence of an associated malformation or diagnosis of esophageal atresia increases mortality in patients with CMs of the GIT in our environment.

[Epidemiological and lesion aspects of hand fractures in children in the Pediatric Surgery department of the Aristide Le Dantec Hospital in Dakar]. / Aspects epidemiologiques et lesionnels des fractures de la main chez l'enfant au service de Chirurgie Pediatrique du chu Aristide Le Dantec de Dakar.

PURPOSE: Report the epidemiological and lesion aspects of hand bone fractures in children. PATIENTS AND METHOD: We did a retrospective and descriptive study over a 10-year period. This study involved 222 childre nunder the age of 16 with 261 fracture cases. The parameters studied were frequency, age, sex, mechanism, circumstances of fracture, consultation time, data from standard physical examination and x-ray of the hand, and associated lesions. RESULTS: Hand bone fractures accounted for 6.4% of all fractures in children in our service. The average age of the children was 8.5 years with a standard deviation of 4. There was a male predominance with a sex ratio of 2. Domestic accidents led the way with 44.3% of cases. They were followed by playful accidents with 33.94% of cases. Receiving heavy objects and fallingwith hand reception were the most common mechanisms. 62.8% of patients consulted within the first 24 hours. All fractures were in the metacarpals and phalanxes with 31% and 69% of cases, respectively. Head and diaphysis fractures each accounted for 28.1% of cases followed by cervical fractures with 27.8%. Non-displaced fractures accounted for 65% of cases. Associated lesions were found in 10 patients. CONCLUSION: Hand bone fractures are quite common. They often interest the bigchild in the decoy of a domestic or playful accident, by crushing the hand or falling with reception on the hand. Fractures of the phalanxes are the most common while those of carp are absent.

BUT: Rapporter les aspects épidémiologiques et lésionnels des fractures des os de la main chez l'enfant. PATIENTS ET MÉTHODE: Nous avons fait une étude rétrospective et descriptive sur une période de 10 ans. Cette étude concernait 222 enfants âgés de moins de 16 ans et ayant présenté 261 cas de fracture. Les paramètres étudiés étaient la fréquence, l'âge, le sexe, le mécanisme, les circonstances de survenue de la fracture, le délai de consultation, les données de l'examen physique et de la radiographie standard de la main ainsi que les lésions associées. RÉSULTATS: Les fractures des os de la main représentaient 6,4% de l'ensemble des fractures chez l'enfant dans notre service. L'âge moyen des enfants était de 8,5 ans avec un écart-type de 4. On notait une prédominance masculine avec un sexe ratio de 2. Les accidents domestiques arrivaient en tête avec 44,3% des cas. Ils étaient suivis des accidents ludiques avec 33,94% des cas. La réception d'objets lourds et les chutes avec réception sur la main étaient les mécanismes les plus fréquents. 62,8% des patients ont consulté dans les 24 premières heures. Toutes les fractures siégeaient au niveau des métacarpes et des phalanges avec respectivement 31% et 69% des cas. Les fractures de la tête et de la diaphyse représentaient chacune 28,1% des cas suivies des fractures du col avec 27,8%. Les fractures non déplacées représentaient 65 % des cas. Des lésions associées ont été retrouvées chez 10 patients. CONCLUSION: Les fractures des os de la main sont assez fréquentes. Elles intéressent souvent le grand enfant au décours d'un accident domestique ou ludique, par écrasement de la main ou chute avec réception sur la main. Les fractures des phalanges sont les plus fréquentes alors que celles intéressant le carpe sont absentes.

[Meckel's diverticulitis by ascaris in children: about a case]. / Diverticulite de Meckel d´origine ascaridienne chez l´enfant: à propos d´un cas.

We here report the case of a 4-year-old male child presenting with congenital umbilical bud that, recently, had begun to bleed. Physical examination showed pinkish umbilical bud with blood stains but without any fistula, measuring about 1,5 cm in diameter. Abdominal ultrasound was performed, which suggested urachal sinus. Surgery revealed umbilical bud communicating, in the abdominal portion, with hyperemic, inflammatory Meckel´s diverticulum placed 90 cm away from the ileocaecal angle in which many ascaris were detected. Anatomo-pathological examination of the surgical specimen showed diverticulitis. Thus, the diagnosis of Meckel´s diverticulitis by Ascaris was retained. Resection and anastomosis with bud excision were performed. The postoperative course was simple even after a 6-month follow-up period.

Choledochal cyst in children in dakar: Diagnostic and therapeutic aspects.

CONTEXT: Choledochal cyst is a rare malformation that mainly affects girls. AIMS: The aim of this work is to report the diagnostic, therapeutic and evolutionary aspects of bile duct cyst in children in Dakar. SUBJECTS AND METHODS: we conducted a prospective monocentre descriptive study from 1 July, 2016, to 30 June, 2019, in the Pediatric Surgery Department of Albert Royer Children's Hospital in Dakar. The studied parameters featured clinical, biological, radiological, therapeutic and evolutionary data. Overall, ten patients, including eight girls and two boys, were selected. RESULTS: Two patients presented the classic triple-syndrome complex featuring an abdominal pain, an abdominal mass and jaundice. Most of the patients presented a symptomatology associating abdominal pain and vomiting. Biological cholestasis syndrome was present in six cases and biological cytolysis syndrome in five cases. The abdominal ultrasound-computed tomography (CT) scan confirmed the diagnosis and helped to set the Todani classification with a predominance of Types 1 and 4. Surgical treatment by laparotomy consisted of total excision of the cyst followed by a Y-en-Roux hepatico-jejunal anastomosis in nine cases, whereas we performed a drainage of the cyst in one case. Two patients presented a morbidity of anastomotic suture release and evisceration and had a good outcome after surgical repair. There was no mortality. CONCLUSIONS: The diagnosis of choledochal cyst dilatation (CCD) can be suspected in the postnatal period on the basis of a gastro-intestinal symptomatology with or without associated to jaundice. The combination ultrasound-abdominal CT-scan helps set the diagnosis. The laparatomic approach always has its place for the management of CCD, especially in our context.

[Cryptorchidism in Prune Belly syndrome]. / La Cryptorchidie dans le Syndrome de Prune Belly.

PURPOSE: To analyze the epidemiological, diagnostic, therapeutic and evolutionary aspects of cryptorchidism in Prune Belly syndrome. PATIENTS AND METHOD: This is a retrospective and descriptive study over an 11-year period involving 24 cases of children admitted for cryptorchidism that is part of Prune Belly syndrome in the paediatric surgery department of the Aristide Le Dantec University Hospital in Dakar. We were interested in epidemiological, diagnostic, therapeutic and evolutionary aspects. RESULTS: The incidence of cryptorchidism in Prune Belly syndrome was 2.4 cases per year. The average age of discovery was 1 year and the age of testicular lowering was 20 months. The bilateral form predateed with 91.7% of cases. Simple orchidopexia was practiced in 50% of cases. An orchidopexia using the Fowler-Stephens technique in one time was practiced in 45.8% of cases. A right orchidectomy was needed in 4.2% of cases. Surgical procedures were simple in 47.8% of the lowered testicles. The most common complication was testicular atrophy noted primarily in the Fowler-Stephens technique in a single time. CONCLUSION: Cryptorchidism in Prune Belly syndrome is most often bilateral and the testicle was frequently palpable. His diagnosis remains very late in our context. Given the number of testicular atrophies driven by the Fowler-Stephens technique in one time, it should be abandoned in favour of the Fowler-Stephens technique in two stages.

BUT: Analyser les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de la cryptorchidie dans le syndrome de Prune Belly. PATIENTS ET MÉTHODE: Il s'agit d'une étude rétrospective et descriptive sur une période de 11 ans portant sur 24 cas d'enfants admis pour une cryptorchidie qui entre dans le cadre du syndrome de Prune Belly au service de chirurgie pédiatrique du centre hospitalier universitaire Aristide Le Dantec de Dakar. Nous nous sommes intéressés aux aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs. RÉSULTATS: L'incidence de la cryptorchidie dans le cadre du syndrome de Prune Belly était de 2,4 cas par an. L'âge moyen de découverte était de 1 an et celui de l'abaissement testiculaire était de 20 mois. La forme bilatérale prédominait avec 91,7% de cas. Une orchidopexie simple a été pratiquée dans 50% des cas. Une orchidopexie selon la technique de Fowler-Stephens en un temps a été pratiquée dans 45,8% des cas. Une orchidectomie droite était nécessaire chez 4,2% des cas. Les suites opératoires étaient simples chez 47,8% des testicules abaissés. La complication la plus fréquente était l'atrophie testiculaire notée essentiellement dans la technique de Fowler-Stephens en un seul temps. CONCLUSION: La cryptorchidie dans le cadre du syndrome de Prune Belly est le plus souvent bilatérale et le testicule était fréquemment palpable. Son diagnostic reste très tardif dans notre contexte. Au vu du nombre d'atrophies testiculaires entraîné par la technique Fowler-Stephens en un temps, elle devrait être abandonnée au profit de la technique de Fowler-Stephens en deux temps.

Elbow floating in children: About three cases and literature review.

PURPOSE: The aim of this study was to determine the epidemiological, lesion, treatment and outcome of the 'floating elbow' in children. OBSERVATIONS: It was two boys and a girl with a mean age of 7 years. The average consultation time was 3.6 h. In two patients, the trauma had occurred during playful accident with fall from a height. Supracondylar fracture was associated with a fracture epiphyseal separation-type II distal end of the right radius in one case, a fracture of the distal quarter of the bones 2 of the forearm in the second patient and fracture quarter distal radius in the third patient. All fractures of the elbow were treated by osteosynthesis as well as a fracture of the distal radius ». The average hospital stay was 5 days. After a mean of 8 months was rated limitation of elbow flexion to 100° in a patient, an externalisation of the pins at the elbow in M3 in one patient and a limitation of elbow extension at 30° in 2 patients. One patient had a varus ulna. The pronosupination was preserved in all patients. CONCLUSION: The 'floating elbow' is unusual in children and usually occurs during a high-energy trauma. His treatment is not yet the subject of consensus. Complications often involve the elbow.

[Omphalomesenteric fistulas; epidemiological diagnostic and therapeutic features: study of four cases in the Department of Pediatric Surgery at the Aristide Le Dantec University Hospital in Dakar]. / Fistules omphalo-mésenteriques; aspects épidémio logiques, diagnostiques et thérapeutiques: à propos de quatre observations au Service de Chirurgie Pédiatrique du CHU Aristide Le Dantec de Dakar.

This study aims to determine the epidemiological, therapeutic and diagnostic features of omphalomesenteric fistulas (OMF). We conducted a study of four cases over a period of 10 years, from January 2004 to December 2013. The parameters studied were: frequency, age, sex, clinical and radiological signs, therapeutic and evolutionary features. Frequency was 0.4 cases per year. Patients were aged 11 days, 40 days, 45 days and 3 years respectively (three girls and one boy). Clinical examination showed intestinal fluid discharge from the belly button and belly button bud catheterisable in all the cases. The bud was prolapsed in the patient aged 45 days. Fistulography performed in two cases helped to confirm the diagnosis by showing a communication between the fistula and the small intestine. The assessment of malformations revealed congenital cyanogen heart disease with interventricular communication in the newborn aged 45 days, anorectal cloacal malformation associated with urachus fistula in the newborn aged 11 days. All patients underwent surgery. Semicircular periumbilical incision was performed in the absence of associated abdominopelvic malformations. A communication between the fistula and the ileum was found in the majority of cases. Bowel resection with termino-terminal anastomosis was performed in three cases. Cuneiform resection was performed in one case and was completed by complete resection of the urachal fistulous tract and bladder suture, with colostomy in newborn with urachal fistula and anorectal cloacal malformation. The postoperative course was marked by non-febrile seizures in the first child with good evolution and by superficial parietal suppuration followed by death due to cardiac decompensation in the third case. Omphalomesenteric fistula is rare. Diagnosis is based on clinical examination complemented by the fistulography. Surgical treatment using semicircular periumbilical incision gives good results. However, the assessment of malformations is necessary.

[Transanal evisceration of small bowel caused by impalement in children: about a case]. / Eviscération transanale de l´intestin grêle par empalement chez l´enfant: à propos d´un cas.

Transanal evisceration of the small intestine caused by impalement is exceptional among children. We report the case of an 11-year old girl with intestinal loops eviscerating through the anus due to a fall on a sharp piece of wood which stuck into her, occurring two hours before hospitalization. On examination, his general condition was good, with transanal evisceration of approximately 25 cm of viable small bowel through the anus and abdominal tenderness. Preoperative laboratory tests were normal and no imaging test was performed. After resuscitation, surgical exploration was performed which showed serohematic fluid collection (300 ml) and evisceration of approximately 60 cm of inflammated intestinal loops through a rupture of approximately 5 cm of the anterior wall of the rectum. Reduction of the eviscerated intestinal loops by gentle traction, repair of the rectal wall by separated sutures, wash and drainage were performed. The patient received broad-spectrum antibiotic. The operating suites were simple with a resumption of transit two days after surgery. The patient was discharged seven days after surgery. After a follow-up period of one month, the patient came for a further consultation and clinical examination was normal.

Peritoneal Tuberculosis in Infants: Diagnostic Challenges.

Abdominal tuberculosis is rare in immunocompetent infants. We report on two infants with peritoneal tuberculosis (6 and 8 months) who underwent laparotomy for suspected intussusception. In the first patient, characteristic lesions of peritoneal tuberculosis were observed intraoperatively with presence of multiple granulations. Tuberculin intradermal reaction (IDRt) was positive and tuberculous contagium could be cultured. In the second patient, the IDRt and GeneXpert tests were negative. In both patients, the histopathological examination of the biopsy specimens confirmed the diagnosis of peritoneal tuberculosis. The clinical courses under tuberculostatic therapy were favorable in both cases.

Heterotopic pancreas without Meckel's diverticulum in children as unique cause of gastrointestinal bleeding: think about it!

Ectopic pancreas also known as heterotopic pancreas (HP) is a rare congenital anomaly, mainly found as incidental finding during autopsy or abdominal exploration for an other condition. Incidence rate is probably underestimated as patients are mostly asymptomatic; otherwise, it is capable of producing symptoms depending on its location, size, often appearing in the 4th-to-6th decades. Complications such as inflammation, obstruction, bleeding, and malignancy degeneration must be considered. Pediatrics cases are very rare, generally concerning HP within Meckel's diverticulum, manifesting by gastrointestinal bleeding and intussusception. We report a rare case of jejunum bleeding, due to an isolated HP in a 15-year-old adolescent. Endoscopic and computed tomographic scan were normal, in particular did not found Meckel's diverticulum. Diagnosis and treatment have been apprehended performing a laparoscopic exploration. It is a singular location for HP, predominantly found in upper gastrointestinal tractus. So far, there have been no case reports of jejunal bleeding from ectopic pancreas without Meckel's diverticulum in children.