Are multidisciplinary consultation meetings for prenatal diagnosis achievable in a low-income country? A descriptive cross-sectional survey in Benin.

Objective: The multidisciplinary antenatal diagnosis staff bring together practitioners who are involved in the management of the antenatal period at birth. This project was designed following the French experience to institute multidisciplinary consultation meetings for prenatal diagnosis (MCMPD) in Benin. Methods: This is a descriptive cross-sectional study examining the knowledge, attitudes, and practices of Beninese practitioners in the field of MCMPD to develop the pilot phase of the project. Results: We collected 108 participants from different specialties. Pediatricians and pediatric surgeons were in the majority at 23.9% and 16.5%, respectively. Sixty-seven percent of participants were from the public sector (n=75). One practitioner felt that it was not a good idea to implement these meetings. Almost all staff (96.2%) agreed that this meeting would have a positive impact on reducing neonatal mortality. Omphalocele (58.5%), spina bifida aperta (43.6%), and gastroschisis (34%) were the most commonly diagnosed antenatal conditions in Benin. No neonatal pathology required medical termination of the pregnancy according to 35.6% of the participants. Conclusions: The objective of reducing infant mortality due to medical and surgical pathologies is a noble one and deserves to be supported. This innovative project, developed through this study, the first of its kind in the subregion, will contribute inexorably to the achievement of the third Goal Sustainable Development.

Spontaneous enteroscrotal fistula following an incarcerated inguinal hernia in a neonate: Case report and literature review.

INTRODUCTION: In Africa, frequent delays in seeking medical attention due to cultural considerations and lack of financial support could explain some particular clinical presentations. An enteroscrotal fistula following an incarcerated inguinal hernia is a rare condition in neonates. PRESENTATION OF CASE: A 21-day-old infant was brought to our consultation for persistent stool discharge from the right scrotum for three days. The parents reported an inguinoscrotal swelling that had been evolving for ten days before admission and became painful two days later. He was diagnosed with a case of enteroscrotal fistula. After correction of electrolytes disorders, a laparotomy was performed through a right lower transverse incision. Operative findings were strangulated inguinal hernia with ileal perforation. Resection and end-to-end ileo-ileal anastomosis was performed. He was discharged from the hospital on the 6th post-operative day. No recurrence within the first year of follow-up. DISCUSSION: Thirteen cases have been reported in the literature until now. Most of them were from developing countries, including ours. CONCLUSION: Early seeking medical attention of incarcerated inguinal hernias is necessary to reduce their morbidity and mortality. Paediatricians should emphasize providing adequate information, education and communication during routine examinations of neonates. We advocate the popularization of universal health insurance to facilitate health care.

[Littré's strangled umbilical hernia in children: a rare complication due to a common malformation of the small bowel]. / Hernie de Littré ombilicale étranglée chez l'enfant: complication rare d'une malformation fréquente de l'intestin grêle.

Meckel's diverticulum is the most common congenital anomaly of the small bowel. Although it is a common anomaly in the general population, its occurrence in a hernial sac, in particular at the umbilicus, is uncommon and it is known as Littré's hernia. We here report the case of a 6-month female infant, admitted with painful irreducible umbilical swelling. The diagnosis of strangled umbilical hernia was made. Meckel inflammatory diverticulum in the hernial sac was detected intraoperatively. The patient underwent wedge resection of the diverticulum followed by the closure of the intestinal gap using continuous suture and parietal repair. Clinical diagnosis of Littré's hernia is difficult and therapeutic approach varies depending on the medical team.