Hernies Ombilicales Étranglées De L’enfant Au Centre Hospitalier Régional De Ziguinchor (Sénégal)

The umbilical hernia is a well-known pathology even though, its strangulation has been subject to much controversy. The aim of this work is to report our experience in the management of strangulated hernia of the child at the Ziguinchor regional hospital and to compare our results with those of the literature through a retrospective and descriptive study over a four years period. During the study period 24 patients with high male predominance were received. The mean age of the patients was 2.1 years. 45% of patients had a chronic cough. The average time for consultation was 27.6 hours. A notion of abdominal abrupt was found in 45% of the cases. The vast majority of patients arrived at the hospital during the dry season. Abdominal pain and vomiting were the main symptoms. An occlusive syndrome was present in about half of the patients. The diameter of the collar of the hernia varied between 1.5 and 2.5 cm and no intestinal necrosis was found during exploration. The surgery was simple in the majority of cases. Umbilical hernia is a reality in under-developed environment some factors promotes its complications

Aspects épidémiologiques, diagnostiques et thérapeutiques des ostéosarcomes de l’enfant au CHU Aristide le Dantec de Dakar: à propos de 16 cas

Le but de cette étude était de décrire les aspects épidémiologiques, diagnostiques et thérapeutiques des ostéosarcomes de l’enfant. Il s’agissait d’une étude rétrospective sur dix ans qui a colligé 16 dossiers d’ostéosarcome pris en charge au service de Chirurgie Pédiatrique de l’hôpital Aristide Le Dantec de Dakar. Les paramètres étudiés étaient le niveau d’instruction et le niveau socioprofessionnel des parents, l’origine géographique, l’âge, le sexe, les antécédents particuliers, le délai de consultation, les motifs de consultation, les signes physiques, les signes radiologiques, la biologie, les modalités thérapeutiques et l’évolution. Tous les patients avaient bénéficié d’un examen anatomopathologique qui a confirmé le diagnostic d’ostéosarcome. Pour la majeure partie de nos patients (58% des cas) les parents avaient un niveau d’instruction bas. L’âge moyen était de 11ans. Une prédominance masculine était retrouvée avec un sex-ratio de 3,25 :1. Le délai de consultation moyen était de 16 mois. Le principal motif de consultation était la tuméfaction (10 cas). Huit patients avaient bénéficié d’un traitement traditionnel. La taille de la tumeur était supérieure à 10cm dans 14 cas. La localisation la plus fréquente était le genou (14 cas). La radiographie standard retrouvait dans 15 cas des images d’ostéolyse. Le bilan d’extension n’avait pas retrouvé de métastases. Les options thérapeutiques étaient dominées par l’amputation seule (43,75% des cas). La survie à 2 ans était de 17%. L’ostéosarcome atteint le plus souvent le garçon après l’âge de 10 ans. Sa prise en charge au Sénégal se heurte à d’énormes difficultés liées au retard diagnostique. La solution repose essentiellement sur une collaboration pluridisciplinaire.Pan African Medical Journal 2013; 14: 10

Pyloric atresia: a challenge in an underdeveloped country

Pyloric atresia is a rare congenital malformation. We report a case in a 5-day newborn with pyloric atresia type C. Authors emphasize the diagnostic difficulties and therapeutic challenges in a resource-limited country.Keywords: Pyloric atresia, newborn, rare congenital malformatio

Les accidents de la vie courante chez l’enfant à Dakar: à propos de 201 cas

Les accidents de la vie courante (AcVC) sont fréquents chez l’enfant et peuvent être à l’origine de lésions handicapantes et de décès. L’objectif de notre travail était d’étudier les aspects épidémiologiques et lésionnels des AcVC à Dakar. C’est une étude transversale descriptive menée du 1er Janvier 2013 au 30 juin 2013. Les enfants victimes d’accidents domestiques, d’accidents de sport et de loisirs ou d’accidents scolaires ont été inclus. Nous avons étudié des paramètres généraux et des paramètres ayant trait à chaque type d’AcVC. Deux cent et un enfants ont été inclus, ce qui représentait 27% des consultations aux urgences. Il y avait 148 garçons et 53 filles. Les enfants de moins de 5 ans étaient les plus touchés (37,8%). Le football et le jeu de lutte étaient les grands pourvoyeurs d’AcVC. Les AcVC survenaient principalement à domicile (58,2%) et dans les aires de sport et de loisirs (31,8%). Les fractures prédominaient dans les différents types d’AcVC: 54,9% des accidents domestiques, 68,8% des accidents de sport et de loisirs et 40% des accidents scolaires. Au plan épidémiologique, nos résultats sont superposables à la littérature. Les fractures prédominent à l’opposé de la littérature où les contusions sont prépondérantes. Le jeu de lutte est le plus grand pourvoyeur de ces fractures après le football. La connaissance des aspects épidémiologiques et lésionnels permet de mener des campagnes de prévention des AcVC à Dakar

Gallstones: Management of the Sickle Cell Child

Gallstone is rare in children; however, sickle cell disease is associated with an increased risk of gallstone formation. We aimed to report particularity of diagnosis and management of gallstones in sickle cell children. We conducted a cross-sectional multicentric study in four hospitals of Dakar, in Senegal, during 18 years. We studied frequency, diagnostic particularities, management, and outcome. Among the 105 pediatric patients managed for gallstones, 87 (82.85%) had sickle cell disease. Among the latter, 18 (17.14%) were asymptomatic. Laparoscopic cholecystectomy was performed in 71 patients (67.62%). Following surgery, sickle cell patients were systematically hospitalized in the intensive care unit for 24 hours. Complications occurred in 7.6% and mortality in 1.9%. Gallstone is frequent in sickle cell children. Its management has good outcomes when taking in account particularities of these patients

Acute gastric volvulus and wandering spleen: A rare association

AbstractGastric volvulus is a rare cause of acute abdomen in pediatric practice. It is defined as the twisting of the stomach around its longitudinal or transverse axis. The symptoms are variable and not specific. It is often associated with a diaphragmatic defect or unfixed stomach. Herein we report a rare observation in a case of an 18 month old infant who presented with abdominal distension and vomiting. The insertion of a nasogastric tube was laborious and blurred the symptoms. Conventional radiography was very not contributive. The exploratory laparotomy allowed making the diagnosis of a gastric volvulus in its organo-axial form associated with wandering spleen. Untwisting associated with gastropexy seemed to be the procedure of choice for these patients

Intestinal prolapse through omphalomesenteric fistula, a rare cause of neonatal occlusion: A case report

Acute intestinal obstruction secondary to omphalomesenteric fistula is a very rare condition. Omphalomesenteric fistula is a consequence of a defect in involution of the vitelline duct between the fifth and ninth week of intrauterine development. We are reporting on a case of neonatal intestinal obstruction due to a prolapse of small bowel through an omphalomesenteric fistula. A newborn baby aged 15 days was admitted in emergency with acute intestinal obstruction lasting for two days. The physical examination found prolapse of small bowel through a persistent omphalomesenteric duct. He received surgical treatment with favorable evolution. The scarcity of the reason during the neonatal period should draw the attention of pediatric surgeons because of its potential complications

Volvulus du grêle sur paquet d’ascaris: à propos d’un cas

Nous rapportons un cas exceptionnel de volvulus nécrosé de l'intestin grêle dû à des ascaris adultes chez un enfant de 7 ans. A l'admission, l'enfant présentait le tableau d'occlusion intestinale qui évoluait depuis deux jours avec altération de l'état général. La radiographie de l'abdomen sans préparation retrouvait des niveaux hydroaériques de type grêlique et un aspect tigré évoquant le diagnostic d'une occlusion intestinale haute sur masse abdominale. Après la réanimation, le traitement chirurgical consistait en une laparotomie qui avait retrouvé un volvulus nécrosé de l'iléon terminale contenant des ascaris adultes. Une résection du grêle sur environ un mètre emportant le segment nécrosé suivie d'une iléostomie était réalisée. L'évolution a été favorable, l'anastomose iléo-colique fut réalisée quatre semaines plus tard. Au recul de deux ans l'enfant est indemne de tout symptôme. The Pan African Medical Journal 2016;2

Road traffic injuries among children in Dakar, Senegal

Background: Road traffic injuries (RTI) are a major public health problem and contribute significantly to the global burden. The aim of this study was to assess the frequency of RTIs in children and to determine their socio-demographic and lesional characteristics.Patients and methods: This was a retrospective and descriptive study over a two-year period from January 2015 to December 2016 conducted at the Department of Paediatric Surgery at the Aristide Le Dantec Hospital in Dakar. Included were all children under the age of 16 victims of a RTI. We studied various parameters relating to the victims (sex, age, education) and the accident (location andtime of occurrence of the accident, circumstances and mechanism, duration of admission to the emergency unit, localization and type of lesion). The data was entered and processed using Microsoft Office Word and Excel 2010 software.Results:Among the 425 cases received, 62.6% were boys and 37.4% girls. The average age of the children was 7.7 years. RTIs occurred mainly in pedestrian (63.8%) who wanted to cross the road. There were more accidents in the city-center area (64.9%) and during afternoons (61%). Lesions of the soft parts (wounds, contusion and decay) were predominated (89.6%) followed by fractures. Theupper limbs were the main locations of trauma.Conclusion: RTIs are common among children in Dakar. Boys crossing roads are the largest number of victims. Soft tissue trauma predominates and is mainly found on the thoracic limbs. Keywords: Road traffic injury; Boys; Lesions of the soft parts; Daka

Alarming Mortality of Biliary Atresia in Two Senegalese Tertiary Hospitals: A Plea For Early Diagnosis

Background: The management of biliary atresia is challenging in low-income countries, with delayed diagnosis and its consequences. We aimed to report its epidemiological, diagnostic, therapeutic aspects and outcomes in Dakar, Senegal. Methods: We conducted a 5-year retrospective review, which included 16 patients, admitted in the pediatric surgery services of Aristide Le Dantec University Teaching Hospital and Diamniadio Children's Hospital. Results: The mean age at admission was 105.6 (1 - 420 days), with 10 girls. Cholestatic jaundice was found in all cases, discolored stools in 43.7%, dark urine and hepatomegaly in 31.2%.  All patients had biological cholestasis and cytolysis syndromes. The ultrasound was performed in all patients with a sensitivity of 56.2%.  The mean age at the time of surgery was 145 days (22 – 540 days). The surgical exploration was conducted in 10 cases and found type IV Biliary Atresia in 50%. The Kasai procedure was performed in 4 cases and liver biopsy in 9 cases.  Mortality occurred in 75% (50% post-operatively and 25% pre-operatively). In two cases, the postoperative course was unremarkable with the success of the Kasai Procedure after a 42-months follow-up. Two patients were lost to follow-up. Conclusion: Biliary atresia still has high mortality in our context. This is mainly due to delayed diagnosis, which is common in our environment. Multidisciplinary assessment of persistent neonatal jaundice is crucial to reduce biliary atresia-related mortalit