Hernie Diaphragmatique Congenitale Droite de Diagnostic Tardif. A Propos d’Une Observation et Revue de la Litterature

La hernie diaphragmatique congénitale (HDC) est une embryopathie congénitale qui se définit par l’absence de développement de tout ou d’une partie d’une coupole diaphragmatique. C’est  une pathologie rare de par le monde et trop peu documentée en Afrique. Sa fréquence dans le monde n’est pas bien connue. Sa présentation peut être précoce ou tardive. La HDC de révélation tardive représente 5 à 30% de l’ensemble des HDC. Compte tenu de la complexité de ses manifestations, les errances diagnostiques sont nombreuses et retardent la prise en charge. De ce fait, il faut toujours la suspecter devant ne détresse respiratoire et une imagerie évocatrice chez un nourrisson. La radiographie pulmonaire contribue au diagnostic. Le pronostic dépend essentiellement des malformations associées. Nous rapportons la première observation au Tchad d’un cas d’une HDC de découverte tardive. Il s’agissait d’un nourrisson de 6 mois opéré avec des suites opératoires simples. Nous discutons les difficultés diagnostiques et thérapeutiques avec la revue de la littérature.   Congenital diaphragmatic hernia (CDH) is a congenital embryopathy defined by the absence of development of all or part of a diaphragmatic dome. It is a rare condition worldwide and not well documented in Africa. Its frequency in the world is not well known. Its presentation can be early or late. Late-onset CDH represents 5 to 30% of all CDH. Given the complexity of its manifestations, there are many diagnostic errors that delay management. Therefore, it should always be suspected in the presence of respiratory distress and suggestive imaging in an infant. Chest radiography contributes to the diagnosis. The prognosis depends essentially on the associated malformations. We report the first case in Chad of HDC of late discovery. It was a 6-month-old infant operated on with simple postoperative course. We discuss the diagnostic and therapeutic difficulties with the review of the literature

Hernie Diaphragmatique Congenitale Droite de Diagnostic Tardif. A Propos d’Une Observation et Revue de la Litterature

La hernie diaphragmatique congénitale (HDC) est une embryopathie congénitale qui se définit par l’absence de développement de tout ou d’une partie d’une coupole diaphragmatique. C’est  une pathologie rare de par le monde et trop peu documentée en Afrique. Sa fréquence dans le monde n’est pas bien connue. Sa présentation peut être précoce ou tardive. La HDC de révélation tardive représente 5 à 30% de l’ensemble des HDC. Compte tenu de la complexité de ses manifestations, les errances diagnostiques sont nombreuses et retardent la prise en charge. De ce fait, il faut toujours la suspecter devant ne détresse respiratoire et une imagerie évocatrice chez un nourrisson. La radiographie pulmonaire contribue au diagnostic. Le pronostic dépend essentiellement des malformations associées. Nous rapportons la première observation au Tchad d’un cas d’une HDC de découverte tardive. Il s’agissait d’un nourrisson de 6 mois opéré avec des suites opératoires simples. Nous discutons les difficultés diagnostiques et thérapeutiques avec la revue de la littérature.   Congenital diaphragmatic hernia (CDH) is a congenital embryopathy defined by the absence of development of all or part of a diaphragmatic dome. It is a rare condition worldwide and not well documented in Africa. Its frequency in the world is not well known. Its presentation can be early or late. Late-onset CDH represents 5 to 30% of all CDH. Given the complexity of its manifestations, there are many diagnostic errors that delay management. Therefore, it should always be suspected in the presence of respiratory distress and suggestive imaging in an infant. Chest radiography contributes to the diagnosis. The prognosis depends essentially on the associated malformations. We report the first case in Chad of HDC of late discovery. It was a 6-month-old infant operated on with simple postoperative course. We discuss the diagnostic and therapeutic difficulties with the review of the literature

Hernie Diaphragmatique Congenitale Droite de Diagnostic Tardif-A Propos d’une Observation

La hernie diaphragmatique congénitale (HDC) est une embryopathie congénitale qui se définit par l’absence de développement de tout ou d’une partie d’une coupole diaphragmatique. C’est une pathologie rare de par le monde et trop peu documentée en Afrique (Benachi A,2011). Sa fréquence dans le monde n’est pas bien connue. Sa présentation peut être précoce ou tardive. La HDC de révélation tardive représente 5 à 30% de l’ensemble des HDC (Thébaud B,1998).  Compte tenu de la complexité de ses manifestations, les errances diagnostiques sont nombreuses et retardent la prise en charge. De ce fait, il faut toujours la suspecter devant ne détresse respiratoire et une imagerie évocatrice chez un nourrisson. La radiographie pulmonaire contribue au diagnostic. Le pronostic dépend essentiellement des malformations associées (Pennaforte T,2012). Nous rapportons la première observation au Tchad d’un cas d’une HDC de découverte tardive. Il s’agissait d’un nourrisson de 6 mois opéré avec des suites opératoires simples. Nous discutons les difficultés diagnostiques et thérapeutiques avec la revue de la littérature.   Congenital diaphragmatic hernia (CDH) is a congenital embryopathy defined by the absence of development of all or part of a diaphragmatic dome. It is a rare condition worldwide and not well documented in Africa (Benachi A,2011). Its frequency in the world is not well known. Its presentation can be early or late. Late-onset CDH represents 5 to 30% of all CDH (Thébaud B,1998). Given the complexity of its manifestations, there are many diagnostic errors that delay management. Therefore, it should always be suspected in the presence of respiratory distress and suggestive imaging in an infant. Chest radiography contributes to the diagnosis. The prognosis depends essentially on the associated malformations (Pennaforte T,2012). We report the first case in Chad of HDC of late discovery. It was a 6-month-old infant operated on with a simple postoperative course. We discuss the diagnostic and therapeutic difficulties with a review of the literature

Septic hip dislocations in children in a developing country

Purpose: To report on a radiological issue and therapeutic aspects encountered in septic hip dislocations in a developing country. Patients and Methods: Nineteen children among whom 11 boys and 8 girls aged on average 5.3-years old presented 7 recent and 12 late hip dislocations. Those dislocations were distributed into in category 1: dislocations without associated lesion; category 2: dislocations associated with minor lesions; category 3: dislocations associated with major lesion. Ten children who presented an elevated erythrocyte sedimentation rate (ESR) received antibiotics. An arthrotomy was performed in children with a recent dislocation. Traction was performed in all children with an average duration of 5 weeks. The results were considered good, intermediate or bad using two parameters: ESR and reduction of dislocation. Results: 2 category 1 dislocations, 6 category 2 dislocations and 11 category 3 dislocations were noted. As concerns the recent dislocations, there were 2 category 1 dislocations and 5 category 2 dislocations. For late dislocations, 1 category 2 and 11 category 3 dislocations were recorded. There were 8 good results and 11 bad results. The good results concerned 7 recent dislocations and one late dislocation. The bad results concerned exclusively late dislocations. Conclusion: In children with septic hip dislocations, the good results concern almost exclusively recent dislocations but arthrotomy and immobilization must be done early

‘PEN’ appendicitis

We report a three-year-old boy who ingested the tip of a pen and presented with signs of appendicitis. Plain abdominal radiographs showed the foreign body in the right iliac fossa. Surgical exploration revealed perforated appendix and the foreign body in its lumen. Appendectomy resulted in satisfactory recovery

Pediatric traumatic brain injury in chad: about 256 cases

Abstract Purpose Pediatric traumatic brain injury (PTBI) is a frequent pathology in the pediatric environment and remains a public health concern in the world. PTBI is the leading cause of death and severe disability in children in countries with limited pediatric trauma legislation. The objective is to report the experience of the management of PTBI in children in Chad. Methods This report is a prospective study of 256 patients admitted for PTBI over a year period. Result The incidence was 19.09%. The mean age was 6.2 years with extremes of 1 day and 15 years. The male represented 68.8% with a ratio of 2.2. The transport of the injured patients to health facilities using other means than ambulances in 87.5%. Initial loss of consciousness (IOL) accounted for 79.1% and coma seizures for 34.37%. Public road accidents accounted for 64.5% of causes. Severe traumatic brain injury (TBI) accounted for 24.2%. The cerebral scanner was performed in 37.9% of cases and had shown the association of craniocerebral lesions in 10.1% of cases. Craniocerebral wound trimming was the most common surgical procedure performed in 21.8% of cases, followed by removal of the depressed fracture of skull in 6.2% of cases. Mortality rate was 9% and sequelae 5.4%. Conclusion PTBI is a frequent neurosurgical pathology in the pediatric setting in Chad. The absence of health insurance in our context makes access to care and radiological examinations very difficult. The prognosis was conditioned by the rapidity of the management and the initial loss of consciousness