Antenatal diagnosis of extralobar pulmonar sequestration

Extralobar pulmonary sequestrations (ELS) are masses of non-functioning lung tissue that are supplied by an anomalous systemic artery and do not have a bronchial connection to the native tracheobronchial tree. On prenatal ultrasonography, an ELS appears as a well-defined echodense, homogeneous mass. Detection by color flow Doppler ultrasonography of a systemic artery from the aorta to the fetal lung lesion is a pathognomonic feature of fetal ELS. MR imaging may help in the diagnosis of pulmonary sequestration by  demonstrating a solid, well-defined mass, and the feeding artery. In this case report, we describe the sonographic and MR diagnosis of an ELS in a fetus at 22 weeks gestation with a review of the available literature.Key words: Extralobar pulmonary sequestration, antenatal diagnosis, ultrasonography, MR

Small bowel perforation secondary to accidental magnetic objects ingestion: (Two pediatric cases report)

Foreign bodies ingestion is considered as a common pediatric problem, it is mostly encountred in infants between 6months and 2 years. Ingestion of magnets was documented in only few reports. We report two uncommon cases of bowel perforations owing to magnets ingestion. Patients were respectively aged of 10 months and 20 months .they were successfully managed. Once ingested, magnetic objects would attach each other through intestinal wall leading subsequently to intestinal necrosis. Thus their surgical removal is unavoidable.

Splenogonadal Fusion Discovered by Testicular Torsion

Splenogonadal fusion, which is adherence of splenic tissue to gonads, is an uncommon congenital anomaly which mainly affects males. Herein, we report a case of splenogonadal fusion in a 20-month-old boy presenting with acute scrotal pain and inflammation. With the suspicion of left testicular torsion, an emergent left scrotal exploration was carried out. It revealed a necrotic left testicle along with a 360° rotation of the spermatic cord and three accessory structures in the lower pole of the testicle. Histology showed the presence of a splenic tissue. Splenogonadal fusion can present as an acute condition mimicking a testicular torsion. But, one should always bear in mind the possibility of this association. Splenogonadal fusion should be included in differential diagnosis of testicular mass to avoid unnecessary orchidectomy

A curious case of attempted infanticide by percutaneous needles insertion: diagnosis and laparoscopic management.

This is the case of a 6 month-old boy victim of an attempted infanticide by means of sharp long needles inserted through the abdominal wall. He was successfully managed by laparoscopic approach

Burns injury in children: Is antibiotic prophylaxis recommended?

Background: Wound infection is the most frequent complication in burn patients. There is a lack of guidelines on the use of systemic antibiotics in children to prevent this complication. Patients and Methods: A prospective study is carried out on 80 patients to evaluate the role of antibiotic prophylaxis in the control of infections. Results: The mean age was 34 months (9 months to 8 years). There was a male predominance with sex ratio of 1.66. The mean burn surface size burn was 26.5% with total burn surface area ranging from 5% to 33%, respectively. According to American Burn Association 37% (30/80) were severe burns with second and third degree burns >10% of the total surface body area in children aged <10 years old. Scalds represented 76.2% (61/80) of the burns. Burns by hot oil were 11 cases (13.7%), while 8 cases (10%) were flame burns. The random distribution of the groups was as follow: Group A (amoxicilline + clavulanic acid) = 25 cases, Group B (oxacilline) = 20 cases and Group C (no antibiotics) = 35 cases. Total infection rate was 20% (16/80), distributed as follow: 8 cases (50%) in Group C, 5 cases (31.2%) in Group A and 3 cases in Group B (18.7%). Infection rate in each individual group was: 22.9% (8 cases/35) in Group C, 20% (5 cases/25) in Group A and 15% (3 cases/20) in Group B (P = 0.7). They were distributed as follow: Septicaemia 12 cases/16 (75%), wound infection 4 cases/16 (25%). Bacteria isolated were with a decreasing order: Staphylococcus aureus (36.3%), Pseudomonas (27.2%), Escherichia coli (18.1%), Klebsiella (9%) and Enterobacteria (9%). There is a tendency to a delayed cicatrisation (P = 0.07) in case of hot oil burns (65.18 ± 120 days) than by flame (54.33 ± 19.8 days) than by hot water (29.55 ± 26.2 days). Otherwise no toxic shock syndrome was recorded in this study. Conclusion: It is concluded that adequate and careful nursing of burn wounds seems to be sufficient to prevent complications and to obtain cicatrisation. Antibiotics are indicated only to treat confirmed infections

A new operative approach for long-gap esophageal atresia

Surgical management of long-gap esophageal atresia (LGEA) remains challenging. Yet, there is a consensus among pediatric surgeons to preserve native esophagus. We used a new surgical technique to successfully manage three children diagnosed with LGEA. This technique consists of a combined thoracic and cervical approach to the EA repair using the patient's native esophagus. All patients initially had had gastrostomy and continuous upper pouch suction while awaiting surgery. This new technique has the potential to become the choice method in LGEA management

Congenital Band Compression: A Rare Cause of Small Bowel Obstruction in Newborns: Congenital Band Compression

Anomalous congenital band is a very rare cause of intestinal obstructions in newborns. It should be consideredas one of the etiologies of acute small bowel obstruction in neonatal period. We report here a retrospective study of three newborns with anomalous congenital bands who underwent surgical intervention between 2015 and 2018. There were 2 girls and 1 boy, aged respectively 1, 27 and 30 days. All the newborns were admitted with clinical diagnosis of acute small bowel obstruction. While band excision was done in all, one case received resection and anastomosis for intestinal necrosis. There are no specific signs that can help make the diagnosis of anomalous congenital band before surgical exploration

Cervicotomy and Sternotomy for Resectin of Cervicothoracic Neuroblastoma in Children

Introduction: We report the case of a 4 years old girl who presenta cervico-thoracic ganglioneuroblastome with none response tochemotherapy and radiotherapyCase presentation: The girl was operated using the CormierDartevelle-Grünenwald incision which helped to remove the tumorcompletely with optimal control of noble elements. The follow upwas uneventful.Conclusion: The Cormier Dartevelle-Grünenwald incision can be agood option in case of big cervico-thoracic malignant tumors