Reoperation of Anastomotic Stricture after Oesophageal Atresia Repair: An Uncommon Event.

Oesophageal atresia is a common malformation in which the survival rate in developed countries is around 90%, while its mortality remains very high in developing countries. Oesophageal stricture post-oesophageal atresia repair is traditionally treated by non-surgical approach. However, surgical resection of the oesophageal stricture may be necessary after the failure of dilations. We report one case of refractory oesophageal stricture post-EA repair in a 3-year-old girl, who underwent oesophageal atresia Type III repair at 11-day-old. We performed an end-to-end oesophageal anastomosis with tracheal oesophageal fistula closure by extra-pleural approach. The patient was lost to follow-up for 3 years. She was seen later for anastomotic oesophageal stricture with the failure of oesophageal dilatations. Surgical resection of oesophageal stricture was performed with end-to-end oesophageal anastomosis.

Ovarian tuberculosis mimicking a malignant tumour.

There has been reported increased incidence of ovarian tuberculosis in the tropics since the advent of HIV/AIDS disease. We report a case of bilateral ovarian tuberculosis associated with a single right kidney of uncertain origin in an immunocompetent 15-year-old generally healthy-looking girl. Abdominopelvic scan was equivocal about the diagnosis of the lesion as it failed to differentiate it from malignancy. Tuberculin and histopathology were necessary to confirm the diagnosis of ovarian tuberculosis. Antituberculous medical therapy successfully resolved the disease.

[Apropos of 1 Ivoirian case of osseus and cutaneous histoplasmosis by Histoplasma capsulatum var. duboisii]. / A propos d'un cas ivoirien d'histoplasmose osseuse et cutanée à Histoplasma capsulatum var. duboisii.

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.

[Acquired recto-vaginal fistula in children: is HIV infection a cause?]. / La fistule recto-vaginale acquise (FRVA) chez l'enfant: le VIH est-il en cause?

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.

[Inflammatory pseudo-tumor of the liver in a child: case report]. / Pseudo-tumeur inflammatoire du foie chez l'enfant: à propos d'un cas.

Inflammatory pseudotumor of the liver is uncommon in children. Only 14 cases have been reported in the literature. The underlying etiology is unclear but traumatic and infectious factors may be implicated. This report describes an inflammatory pseudotumor that was observed in a 9-year-old child from the Ivory Coast one year after traumatic injury of the right hypochondrium. Clinical findings were limited to non-febrile but painful hepatomegaly with weight loss. Laboratory tests were consistent with an inflammatory process. Ultrasonography revealed a poorly delimited, heterogeneous area approximately 5 cm in diameter at the level of the VI segment which had been resected. Histology documented the presence of fibro-inflammatory tissue with granulomatous inclusions. At the center of the lesion was a foreign body corresponding to a Schistosoma mansoni egg. In this case the mechanism underlying inflammatory pseudotumor could have involved either bilharziasis or trauma. A review of the literature allows the authors to enumerate the main features of this uncommon benign tumor of the liver in children.

Les séquelles de la circoncision et de l'excision traditionnelles

De 1985 a 1993; 22 enfants ages de 3 mois a 11 ans ont ete vus a notre consultation pour des sequelles de la circoncision et de l'excision traditionnelles. Parmi ces 22 enfants; on comptait 6 filles dont 4 avaient une stenose partielle du vagin et de l'uretre; une avait une stenose complete du vagin; et la derniere avait une cicatrice hypertrophique du clitoris : chez les 16 garcons; il y avait 3 cas de phimosis cicatriciels; 4 cas de fistules uretrales; 4 cas d'hypospadias iatrogenes; 3 cas d'amputations du gland; un cas d'amputation partielle du scrotum et un cas de granulome du sillon balanopreputial. Cinq filles et 11 garcons ont ete traites avec des resultats fonctionnels satisfaisants

[Pygomelus. An African surgical case report]. / La pygomélie. A propos d'un cas african opéré.

Pygomelus is a malformation characterized by the presence of one or more extra-extremities in the pelvic region. This article describes a case of pygomelus involving a child in Cote d'Ivoire. It is the tenth operated case to be reported in the literature. The malformation consisted of a well developed third lower extremity attached to the right iliac crest, without a rudimentary pelvis, and of a poorly developed upper extremity attached to the subpubic region. The two extra-extremities were removed surgically without complications. Pygomelus is an uncommon malformation whose nosologic limits are unclear since it is comparable to lower extremity duplication and dipygus. According to the authors pygomelus is a more appropriate term than caudal duplication which is widely used in English-speaking physicians.

Vesicostomy in childhood: indications and results.

The authors report their experience with 27 patients who underwent cutaneous vesicostomy (CV) diversion for either lower tract disorders or obstruction. The indications for CV included 18 cases of neurogenic bladder, 3 pseudo-prune belly syndrome, 3 bladder exstrophy, 2 vesicoureteral reflux, and 1 posterior urethral valves. A Lapides-type technique with minor changes was performed in all cases. Improvement of renal function occurred after CV in all but 3 patients (11.1%). No early surgical complications were observed. Late complications occurred in 8 patients (29.6%): 4 (14.8%) had a stomal stenosis and 4 (14.8%) urinary tract infections. The overall revision rate was 7.4%. We believe this technique is simple to perform, tubeless, easy to manage, and readly reversible. Our experience tends to confirm CV to be an easy, effective, and reversible means to treat children and infants with selected pathology of the lower urinary tract. Results and complications are discussed.