[Hepatic alveolar echinococcosis: a rare cause of recurrent, surgically curable abdominal pain in children]. / L'échinococcose alvéolaire hépatique : une cause exceptionnelle de douleurs abdominales récurrentes, chirurgicalement curable, chez l'enfant.

Hepatic alveolar echinococcosis is a rare parasitic zoonosis, potentially lethal in childhood. It is due to Echinococcosis multilocularis whose larva insidiously develops in the liver. We report the case of a 13-year-old girl, living in the Vosges Mountains, followed for recurrent abdominal pain, with recent worsening. Diagnosis of alveolar echinococcosis was immediately suspected based on the liver ultrasound scan and then confirmed by imaging (CT scan, NMR) and serology. A curative surgical treatment (segmentectomy) was performed 3 months after diagnosis, under oral albendazole treatment, maintained for at least 2 years. Hepatic alveolar echinococcosis usually has a negative prognosis, except if diagnosed early, which allows rapid surgical treatment, as in our patient.

[Secondary right-sided diaphragmatic hernia following neonatal group B Streptococcal septicaemia in a preterm infant]. / Hernie diaphragmatique droite à révélation secondaire et septicémie néonatale à Streptocoque B chez un prématuré.

We report on a case of a secondary right-sided diaphragmatic hernia following group B streptococcal (GBS) septicaemia in a very low birth weight infant born at 30 weeks. After initial improvement, the diagnosis of a secondary right-sided diaphragmatic hernia was suspected with the persistent radiological pulmonary right-sided image on the chest x-ray and the clinical degradation. The diagnosis was confirmed by ultrasonography on day 43. The postoperative course was simple. Persistent respiratory distress in a neonate, after a GBS septicaemia associated with a right pulmonary opacity on the chest x-ray, should prompt a careful evaluation. A secondary right-sided diaphragmatic hernia should be considered. Treatment is surgery, the prognosis is good in the absence of pulmonary hypoplasia.

[Bifocal lesion of striated muscle (hamartoma or focal myositis) in the course of Proteus syndrome]. / Lésion musculaire striée bifocale (hamartome ou myosite focale) au cours d'un syndrome de Protée.

We report a case of bifocal recurrent lesion developed in muscles of the left thigh in a 5 year-old-girl with Proteus syndrome (rare congenital hamartomatous disorder). We discuss the diagnosis of focal myositis versus hamartoma. The clinical and morphological features favour the second hypothesis.

[Inflammatory myofibroblastic tumor of the lung with endobronchial, infiltrating, multifocal and recurrent form]. / Tumeur myofibroblastique inflammatoire pulmonaire à forme endobronchique, infiltrante, multifocale et récidivante.

Pulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor, plasma cell granuloma) was reported most often as a single peripheral mass, successfully cured by surgery. A 14-year-old girl presented with a large left pulmonary mass involving and obliterating the main bronchus; there were angioinvasion and infiltration of mediastinum, hilar lymph nodes and pleura. Multiple, often tiny nodules were seen in the right lung. At microscopic examination, there were lymphocytic and plasmacytic infiltrates and borderline myofibroblastic proliferation with focal nuclear anaplasia. Smaller lesions were similar to organizing pneumonia. Disease was progressive in the remaining right lung after surgical resection and a two-month treatment with corticoids. The patient was then treated with chemotherapy. She was alive and well (twenty-month follow-up).

Neonatal necrotizing enterocolitis: a retrospective and multicentric review of 331 cases.

The authors retrospectively review 331 cases of necrotizing enterocolitis from 13 different departments of pediatric surgery; 184 cases were treated only medically at the acute stage (47 of whom developed intestinal stricture) and 147 cases were operated on at the acute stage. The different procedures of acute surgical intervention are reported and the results of two surgical procedures are compared. The first is a classical one comprising a laparotomy with exploration of the intestinal tract and resection of the necrotic segments followed by enterostomy above the resected area. The other procedure comprises a minimal laparotomy in the right lower quadrant with ileostomy above necrotic areas, without resection of necrotic segments associated with peritoneal drainage. The results are assessed using the postoperative mortality rate and the number of secondary intestinal strictures. Mortality during the first postoperative month occurred in 27.9% of cases, and intestinal strictures were noted in 31.3% of cases after acute surgical procedure.

[Post-traumatic priapism in a 11 year-old child]. / Priapisme post-traumatique chez un enfant de 11 ans.

We report on the case of a post-traumatic priapism in an 11-year-old boy. The clinical features and pathophysiological data showed that it was a high flow form with normal venous outflow; such a condition is very uncommon in the literature. Surgery aimed to perform a spongiocavernosal shunt and allowed recovery.

[Conservative surgery of the pancreas in complete traumatic sections of the Wirsung duct in children. Apropos of 2 cases]. / Chirurgie conservatrice du pancréas dans les sections traumatiques complètes du canal de Wirsung chez l'enfant. A propos de 2 observations.

A unanimous consensus has been achieved indicating the requirement of left pancreatectomy after complete ruptures of the body of the pancreas in the child. Nevertheless, exeresis of the entire left part of the pancreas has severe long-term consequences, especially if a small part of the gland is not left in place after the rupture. We report two cases of complete rupture of the isthma of the pancreas in two children who were treated by suture of the Wirsung and of the pancreas, followed by drainage. The drain dropped off early in both cases but did not hinder cicatrisation. Follow-up examinations were completely normal after a 12-year follow up in the first case and after 10 months in the second.

[Eosinophilic cystitis in children]. / La cystite à éosinophiles chez l'enfant.

In a 4-year-old boy, cystitis in a pseudotumoral form with left ureterohydronephrosis wa discovered on the occasion of repeated urinary infections. Several biopsies were required to rule out a malignant tumor, and they showed that this condition was an eosinophilic cystitis. Healing was obtained with an anti-bilharzial treatment, although this child did not suffer form bilharziasis. A few similar cases were found in the literature. We note that the diagnosis is usually not established before biopsy, but the association of repeated urinary infections and of a vesical pseudotumoral syndrome with ureteral obstruction must lead to suggesting it, especially if the first biopsy does not reveal any tumor.

[Acute pancreatitis caused by sodium valproate. Review of the literature apropos of a case in a child]. / Pancréatite aiguë au valproate de sodium. Revue de la littérature à propos d'un cas chez l'enfant.

The authors report on the case of a 12.5 and year-old epileptic boy with severe acute pancreatitis which appeared 39 months after starting treatment with sodium valproate (VAP) at a daily dosage of 26.6 mg/kg. Twelve days after hospitalization, a pseudocyst of the pancreas developed, leading to cystoduodenostomy 3 months later. Following VPA suppression, no recurrence of pancreatic symptomatology was observed. The pathophysiological mechanism of this adverse side-effect of VPA treatment remains unclear. The appearance of a painful epigastric syndrome and/or vomiting in a patient subjected to a VPA treatment indicates the possibility or acute pancreatitis, to be confirmed by blood and urinary determination of amylases and abdominal tomodensitometric examination. Finally, the fact that this side-effect may be severe even lethal, brings into question the prescription of this drug in the management of epilepsy.

[Renocolonic fistula complicating vesicorenal reflux and xanthogranulomatous pyelonephritis in a 20-month-old child]. / Fistule réno-colique compliquant un reflux vésico-rénal et une pyélonéphrite xanthogranulomateuse chez un enfant de 20 mois.

A case of vesico-renal reflux with xanthogranulomatous pyelonephritis complicated with a renocolic fistula in a 20 months old child is reported. Imaging in this case was crucial for the diagnosis and the work up; it included ASP, renal ultrasound, UIV retrograde cystography and CT. The treatment consisted in a right ureteronephrectomy after fistula's section.

[Biological effects of golytely in children]. / Etude des effets biologiques du golytely chez l'enfant.

Golytely solution is now commonly used in preoperative bowel preparation or in colonoscopy and barium enema in adults. Studies have demonstrated its effectiveness and good acceptance in regards to clinical as well as biological point of view. In children, it has been used more recently, but since 1984 several teams agree to find the method excellent. Our study aimed to confirm there was no electrolytic movement caused by golytely and that using it without reserve in children was possible, even in the very young ones. Children are generally very sensible to those movements and mainly as they have a general anaesthesia in the hours following the golytely administration for investigation or surgery. Up to now, 54 children from 4 months to 18 years aged have been studied. Besides the good quality of the preparation noted by the operator and the good clinical tolerance, no significant change of the sodium, potassium, chloride, creatinine and proteins has been noticed. Only urea has decreased very lightly but not out of norms. These results confirm that golytely is safe and effective in preparing the bowel in children.

[Complications of inguinal hernia in children]. / Les complications de la hernie inguinale chez le garçon.

From 1978 to 1985, 679 boys were operated for an inguinal hernia. 3 groups of patients must be considered. The bilateral inguinal hernias group (119 children) 73 patients were operated on both sides. 46 presented signs of hernia on the opposite side after the first operation and were operated again. In this group, there is a more important frequency of premature. But the classical notion that bilateral hernia are more common when the presenting hernia is on the left side, is not noticed. As a matter of fact, among the 46, there were 33 children operated at first on the right side. If a systematic bilateral exploration had been realised, it would here been useless in 82 per cent of the cases. The incarcerated inguinal hernia group 177 (26%) children were hospitalised for an incarcerated inguinal hernia diagnosis. 23 infants required emergency operation. Mostly, it was the first episode of a right hernia in a child under 3 months of age. 8 times a testicular infarction was noticed. The incidence of testicular lesion following incarceration of inguinal hernia is more important that the testicular atrophy after primary hernioplasty. This justify the surgical treatment for children of any age. The premature group 126 children were premature infants. In this group, a more important frequency of bilateral and incarcerated hernias are noted. 24 among these patients presented recurrent apnea episodes. To 8 of those children, the intervention was probably a benefit for the evolution of their apneas.(ABSTRACT TRUNCATED AT 250 WORDS)

[Arterial lesions in supracondylar fractures of the humerus in children. Apropos of 6 cases]. / Lésions artérielles au cours des fractures supracondyliennes de l'humérus chez l'enfant. A propos de six cas.

From six cases of brachial arterial injuries following supracondylar fractures in children, a simple management is proposed. Vascular exploration must be done in absence of radial pulse after bony reduction. If non macroscopic lesion exist, it could be a transitory spasm. On the contrary macroscopic lesion of artery point out injury of its layers that requires an arteriotomy with vascular restoration by resection anastomosis.

[Dysplasia epiphysealis hemimelica: an unusual case]. / Dysplasie épiphysaire hémimélique: un cas inhabituel.

The authors have observed an eleven-year-old boy with an unusual example of dysplasia epiphysealis hemimelica. Initially there was an intra-articular cartilaginous loose body in the knee. A discrepancy in limb length was noted, which corrected spontaneously. After an eight year follow-up, knee destruction was severe despite surgical treatment on three occasions. A tibio-tarsal arthrodesis was also performed.

[Duplication of the bladder by a frontal septum. Apropos of a case]. / Duplication vésicale par septum frontal. A propos d'un cas.

The authors report a case of total bladder duplication by frontal septum. The anterior bladder was functional. The posterior bladder was non-functional, and drained a destroyed kidney. Analysis of the rare cases reported in the literature suggests that this malformation should be differentiated from other bladder duplications, because it may be a giant ureterocele. In conclusion, the authors stress the simplicity of the management, consisting of resection of the septum and nephrectomy of the non-functional kidney.