Report of a clinic case of a double system ectopic ureterocele in an African infant

AbstractWe report on the observation of a 30-month-old female newborn that was treated for a urinary infection. The medical imaging revealed the existence of a right double system ureterocele with vesicorenal reflux on the ureter of the upper pyelon and a bifid left ureter. The treatment consisted in an ureterocelectomy, a reimplantation of the two right ureters and a repair of the vesical floor. The external drainage of the upper pyelon allowed us to make sure of its functionality that was about 15% of the full renal function. The post-op follow-ups have been simple and thirteen months later, the newborn is doing well and does not present any sign of urinary infection

Laparoscopic Appendectomy in Children: Preliminary Study in Pediatric Hospital Albert Royer, Dakar

Appendiceal pathology’s management has benefited in recent years from the advent of laparoscopic surgery. This study is to make a preliminary assessment of laparoscopic management of acute and complicated appendicitis in children after a few months of practice at the University Hospital Albert Royer, Dakar. This is a retrospective study of 22 cases of patients, all operated on by the same surgeon. The parameters studied were age, sex, clinical data and laboratory features, radiological data, and results of surgical treatment. The mean age of patients was 9.5 years with a male predominance. The series includes 14 cases of acute appendicitis and 8 complicated cases. Appendectomy anterograde is practiced in 81% of cases. Appendectomy was associated with peritoneal wash in 17 patients including 9 cases of acute appendicitis. Drainage of Douglas pouch is performed in 2 patients with complicated appendicitis; the average production was 300 cc of turbid liquids and any complications were not founded. An abscess of Douglas pouch is noted in 2 patients with complicated appendicitis undrained. These Douglas abscesses were treated medically. No conversion of laparotomy was performed in the series. After an average of 8 months no other problems were noted

Oesophageal atresia: Diagnosis and prognosis in Dakar, Senegal

Background: Oesophageal atresia is a neonatal emergency surgery whose prognosis has improved significantly in industrialised countries in recent decades. In sub-Saharan Africa, this malformation is still responsible for a high morbidity and mortality. The objective of this study was to analyse the diagnostic difficulties and its impact on the prognosis of this malformation in our work environment. Patients and Methods: We conducted a retrospective study over 4 years on 49 patients diagnosed with esophageal atresia in the 2 Paediatric Surgery Departments in Dakar. Results: The average age was 4 days (0-10 days), 50% of them had a severe pneumonopathy. The average time of surgical management was 27 h (6-96 h). In the series, we noted 10 preoperative deaths. The average age at surgery was 5.7 days with a range of 1-18 days. The surgery mortality rate is 28 patients (72%) including 4 late deaths. Conclusion: The causes of death were mainly sepsis, cardiac decompensation and anastomotic leaks

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