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.

[Tethered cord syndrome in children: about a case]. / Syndrome de la moelle attachée chez l'enfant: à propos d'un cas.

Tethered cord syndrome is a spectrum of neurological symptoms due to a constant or intermittent axial traction of the terminal cone of the spinal cord, fixed in abnormal caudal position. It is a rare congenital lesion whose symptoms can be observed only in adulthood. We report the case of a 10-year-old boy with tethered cord syndrome discovered due to bladder and anal incontinence and confirmed by lumbosacral magnetic resonance imaging. He underwent neurosurgical release of the terminal cone by posterior approach. Evolution was marked by improvement of sphincteric disorders. This case study has been followed by a literature review on this subject. This case study highlights the role of magnetic resonance imaging (MRI) in the diagnosis of this disorder.

[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.