[Transient dilatation of the intra- and extra-hepatic bile ducts. A new aspect of bile duct involvement in scarlet fever]. / Dilatation transitoire des voies biliaires extra et intra-hépatiques. Nouvel aspect de l'atteinte des voies biliaires dans la scarlatine.

An extra- and intra-hepatic bile duct dilatation has been observed in a child in the course of scarlet fever. Manifestations of cholestasis, cytolysis and inflammation were present. Pruritus disappeared within 2 months, biological abnormalities within 3 months and ultrasonic bile duct abnormalities between 3 and 6 months, with a follow-up of 9 months. This case report suggests a relationship between a transitory obstruction, possibly toxic in origin, of the bile ducts and the scarlet fever.

[Severe, refractory neonatal inflammatory syndrome as the manifestation of a systemic multivisceral and meningeal syndrome]. / Syndrome inflammatoire néonatal grave, rebelle, d'expression systémique multiviscérale et méningée.

A neonate presented with an inflammatory syndrome with multisystemic manifestations. There was no remission until age 6 years, despite anti-inflammatory treatments. Neonatal onset and neuromeningeal manifestations identified a peculiar rare inflammatory syndrome, whose relationship with juvenile rheumatoid arthritis is discussed. In the case reported, renal, abdominal, deep lymphatic and cranial involvements were present: these have not been previously reported.

[Regressive bilocular acute pseudotumoral demyelinization. Second lesion development after 10 years of remission]. / Démyélinisation aiguë pseudo-tumorale biloculaire régressive. Seconde évolution lésionnelle à 10 ans de rémission.

The authors report what seems to be the 4th case of acute pseudotumoral demyelinating disease with regressive evolution. Onset was marked by hemiplegia with tumoral pattern on CAT-scan and pneumoencephalography and an important cystic cavity at surgery. Controlateral hemiplegia occurred 2 months later. After a period of partial recovery a long period of remission was observed, followed by a relapse 10 years after the first symptoms. This case suggests that remissions reaching 10 years are possible in such pseudotumoral demyelinating disease, but also shows that there are late secondary evolutions, as in multiple sclerosis.

[Spina ventosa, a historic disease]. / Spina ventosa, affection historique.

We report a case of tuberculous dactylitis--spina ventosa--in a 5 year-old girl from a French upper class family. Being today an unusual affection, the diagnosis of spina ventosa can be missed. Symptoms and means of diagnosis are reviewed.

[Comparative study of 4 groups of gastroduodenal ulcers in children]. / Etude comparée de 4 groupes d'ulcères gastro-duodénaux chez l'enfant.

A retrospective cooperative survey allowed analysis of 151 cases of ulcers diagnosed by endoscopy (106), surgery (40), or autopsy (5). There were 58 primary ulcers, 21 aspirin-induced ulcers, 23 steroid-induced ulcers, and 49 stress ulcers. Up to the age of 7, the majority of ulcers (80%) were secondary; after 7 years, only 47.6%. The higher incidence was found in boys of all groups, especially after 7 years of age. Only aspirin-induced ulcers were located more often in the stomach (52.3%). A family history was present in parents and siblings of children with primary ulcers (31%) and aspirin-induced ulcers (23.8%). The secondary ulcers were often complicated: hemorrhage was nearly always present with aspirin induced ulcers (95.2%); perforation occurred principally in steroid-induced ulcers (30.4%), and stress ulcers (42.8%). Death occurred only in steroid-induced ulcers (8) and stress ulcers (21). Secondary ulcers rarely became chronic.

[Hypereosinophilic syndrome with endomyocardial involvement in children. Critical analysis of the literature apropos of a case]. / Le syndrome hyperéosinophilique avec atteinte endomyocardique chez l'enfant. Analyse critique de la littérature à propos d'un cas.

A 6 years old girl presented with hypereosinophilia of 7 months duration and cardiac failure from restrictive myocardiopathy, leading to death in 3 years 6 months. Transient blast cells were found. Sixteen previously reported pediatric cases of hypereosinophilia of unknown cause with cardiac involvement are studied. The meaning of eosinophilic leukemia is discussed, the frequency of cardiac damage and the role of hypereosinophilia in the mechanism of cardiac injury are emphasized. Therapy may stabilize or reverse cardiac involvement. In the cases with intractable congestive failure, surgical treatment must be recommended.

[Intramural hematoma of the duodenum and chronic pancreatitis after jejunal biopsy]. / Hématome intramural du duodénum et pancréatite chronique après biopsie jéjunale.

A 12 year-old boy presented with duodenal hematoma in the hours following small bowel biopsy. Two years later, he presented with abdominal pain and diarrhea. Investigations allowed to find a chronic calcified pancreatitis, which is suggested to be the consequence of the previous duodenal hematoma.

[Obstruction of the celiac trunk and the superior mesenteric artery]. / Obstruction du tronc coeliaque et de l'artère mésentérique supérieure.

Pancreatic, hepatic and intestinal troubles occurred in a 8 year-old acrogeria girl who was treated for Wilm's tumor by cobalt therapy at 2 1/2 years. Complete obstruction of the coeliac trunk and proximal superior mesenteric artery was shown, associated with hypoplasia of the abdominal aorta and its collaterals in the irradiated areas. Acrogeria might enhance the toxic effects of radiotherapy on vessels.

[Primary gastroduodenal ulcers in children. A multicenter study of 58 cases of endoscopic or surgical diagnosis]. / Les ulcères gastro-duodénaux primaires de l'enfant. Etude multicentrique de 58 cas de diagnostic endoscopique ou chirurgical.

A retrospective cooperative survey allowed analysis of 58 endoscopically (56) or surgically (2) proven ulcers in children. Drugs or stress induced lesions and ulcers in neonates were excluded from the study. The distribution was as follows: 39 (67%) males, 19 (33%) females, 42 (72%) duodenal, 16 (28%) gastric; 45 children were older than 7 years; a family history of ulcer was present in parents and/or siblings of 12 patients (38%). Ulcer was diagnosed on the occasion of a complication in 39 children (67%). Endoscopy performed in 53 children first detected the ulcer in 51 (in 5 instances at the second examination only). In the remaining 5 children, ulcer was proven endoscopically after radiologic examination was performed. The endoscopic and radiologic data were compared at the time of diagnosis and during follow-up. 31 children were checked endoscopically 3 months after diagnosis and lesions were still present in 21. 10 children were operated on. In these children, evolution is unpredictable and endoscopic check-ups are necessary.

[Coffin-Siris syndrome. Critical study of the literature apropos of a case]. / Le syndrome de Coffin Siris. Etude critique de la littérature à propos d'un cas.

The authors report a case of the Coffin Siris syndrome which associates a ungueo-digital syndrome (special by the bilateral aplasia or severe hypoplasia of nails and third phalanx of fifth toes and fingers) to other anomalies: facies with thinly fine hairs contrasting with bushy and dense eyebrows and body hypertrichosis, hypotonia and mental retardation. The connections of the Coffin Siris syndrome with the trisomy 9 p+ syndrome and the fetal hydantoïn syndrome are discussed.