Arthur Essomba

Depressed Skull Fractures in Children: Treatment Using an Obstetrical Vacuum Extractor

Introduction: A depressed skull fracture is an inward buckling of the skull bones. It is referred to as a ping-pong ball fracture in neonates; in older children, some fractures take a cup shape mimicking ‘ping-pong’ ball fractures. Objective and Methods: The aim of this study was to assess the use of an obstetric vacuum extractor to elevate cup-shaped depressed skull fractures in children irrespective of age. All children admitted into the Central Hospital of Yaounde between 1999 and 2004 with a cup-shaped simple depressed skull fracture and treated with the vacuum extractor were included. Results: Nine children aged from 3 months to 17 years were treated with the vacuum extractor. The cosmetic and radiographic results were satisfactory. The procedure was simple and without any complication. Conclusion: The elevation of ‘ping-pong-ball-like’ or ‘cup-shaped’ skull fractures in older children (beyond the neonatal period) is a simple, effective and safe procedure.

Strangulated or incarcerated spontaneous lumbar hernia as exceptional cause of intestinal obstruction: case report and review of the literature

Lumbar hernias are rare conditions and about 300 cases have been reported since the first description by Barbette in 1672. Therefore strangulation or incarceration are also exceptionally encountered. We present a 62 -year-old-man who had strangulated left lumbar hernia and consequent mechanical small-bowel obstruction, alongside with a non strangulated right lumbar hernia. Through a median laparotomy, an intestinal necrosis was found. A bowel resection with end to end anastomosis was performed and the lumbar hernias were repaired on both sides. The recovery was uneventfull. To the best of our knowlwdge thanks to the litterature review presented here, this is the 19th case of incarcerated or strangulated spontaneous lumbar hernia described in the surgical litterature since 1889.

Brachiocephalic A-V fistula through the median cubital vein; A reliable option to failure of forearm fistulas. A case report from CHU Yaoundé

Highlights • We describe a brachiocephalic access created with retrograde flow through the median cubital vein.• Anatomical consideration for choice of a vascular access for maintenance haemodialysis are review.• This access can be useful to avoid difficulties of venipuncture of brachiobasilic fistula and in failure of forearm fitulas.