Oumar Ndour

Amyand's hernia with perforated appendix in a neonate.

Inguinal hernia with acute appendicitis known as Amyands hernia is uncommon. It occurs mostly in adults, older children and infants. The appendix inside the hernial sac is rarely perforated. The authors describe in a neonate aged 14 days an unusual case of inguinal hernia containing a perforated appendix that was clinically considered as a strangulated inguinal hernia. Surgery performed with an inguinal approach permitted us to remove the appendix and close the hernial sac. The postoperative course was uneventful after a follow-up of 1 year.

Isolated gallbladder perforation after blunt abdominal trauma in children

Injury of the gallbladder after blunt abdominal trauma is rare. Isolated contusion of the gallbladder is exceptional because of its anatomical localization. It is protected by the liver, intestines, the omentum, and ribs. Its clinical presentation is often insidious, the reason why the diagnosis is often made during an exploring laparotomy. The delayed diagnosis is often responsible for high morbidity and mortality. The early diagnosis is thus essential but still remains a challenge. We report a case of isolated perforation of the gallbladder after blunt abdominal trauma in a 15-years-old boy found at the stage of generalized peritonitis. The exploratory laparotomy leads to diagnosis and treating the lesion by cholecystectomy.

Aphallia: A case report and literature review

Aphallia is a complex urogenital malformation. It is rarely described in literature. Treatment calls upon feminising genitoplasty in most cases. Authors describe a case in a neonate, insisting on the sociocultural realities which guided their indications.

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.

Traumatic posterior sternoclavicular joint dislocation in a child: a case report

Sternoclavicular joint dislocation is a rare event. It occurs most often in a violent trauma. The authors report the case of a10 years old child, received at emergencies for right shoulder blunt trauma after been punched by another child. He presented with right shoulder pain, right upper limb functional impairment and right sternoclavicular joint depression. Standard chest radiographs were normal. Chest CT scan showed posterior dislocation and allowed us to determine its variety. Twelve hours after the trauma, a closed reduction has been done under general anesthesia. A control CT scan showed a restoration of normal joint anatomy. After 18 months, the shoulder was painless and mobile in all directions. It is an isolated recent posterior sternoclavicular joint dislocation in a child. With this observation the authors emphasizeon the unusual mechanism of such a dislocation occurrence, the primary role of CT scan in the diagnosis and early closed reduction.

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.

Heterotopic pancreas without Meckel’s diverticulum in children as unique cause of gastrointestinal bleeding: think about it!

Ectopic pancreas also known as heterotopic pancreas (HP) is a rare congenital anomaly, mainly found as incidental finding during autopsy or abdominal exploration for an other condition. Incidence rate is probably underestimated as patients are mostly asymptomatic; otherwise, it is capable of producing symptoms depending on its location, size, often appearing in the 4th-to-6th decades. Complications such as inflammation, obstruction, bleeding, and malignancy degeneration must be considered. Pediatrics cases are very rare, generally concerning HP within Meckel’s diverticulum, manifesting by gastrointestinal bleeding and intussusception. We report a rare case of jejunum bleeding, due to an isolated HP in a 15-year-old adolescent. Endoscopic and computed tomographic scan were normal, in particular did not found Meckel’s diverticulum. Diagnosis and treatment have been apprehended performing a laparoscopic exploration. It is a singular location for HP, predominantly found in upper gastrointestinal tractus. So far, there have been no case reports of jejunal bleeding from ectopic pancreas without Meckel’s diverticulum in children.

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.Accidents of everyday life (AcVC) are common in children and can led to disabling injuries and death. This study aimed to analyze the epidemiological aspects of AcVC and the related injury mechanisms in Dakar. We conducted a descriptive, cross-sectional study conducted from 1 January 2013 to 30 June 2013. All the children victims of domestic accidents, sport and leisure accidents or school accidents were included. We studied some general parameters and some parameters related to each type of AcVC. Two hundred and one children were included, accounting for 27% of emergency consultations. There were 148 boys and 53 girls. Children less than 5 years of age were most affected (37.8%). Football and wrestling game were the main causes of AcVC. AcVC occur mainly at home (58.2%) and in the areas of sport and recreation (31.8%). The fractures predominated in the different types of AcVC: 54.9% of domestic accidents, 68.8% of sport and recreation accidents and 40% of school accidents. From an epidemiological perspective, our results are superimposable to literature. Fractures predominated contrary to literature where bruises were preponderant. Wrestling game is the main cause of these fractures, after football. The acquisition of knowledge about the epidemiological aspects of AcVC and the related injury mechanisms will allow for prevention campaigns in Dakar.

Wrestling game injuries among children in Dakar: a report on 172 cases

Introduction The objective was to report epidemiological and lesional features among children practicing wrestling as a game in Dakar, Senegal. Methods It was a retrospective study including all patients under 16, victims of wrestling game injuries. We studied epidemiological and lesional aspects in children: frequency of wrestling game injuries among all games, age, sex, geographic origin, place of injury, parent’s socioeconomic status, nature of the injury and location. Results Wrestling game injuries represented 19.9% injuries in all games. Sex-ratio was 33.4. The most affected age group was the 6-10 years old age group. The majority of children are from suburban Dakar (64%). Injuries occurred most often at home and in the street. Most children are from low socioeconomic status (64%). Fractures predominated and were localized almost exclusively on the elbow. Conclusion Wrestling game injuries in Dakar occur among older children from the suburbs, living in the neighborhood of great wrestling champions’ districts of residence. Wrestling game cause injuries, consisting mostly of elbow fractures.

[Scooter accidents in children at Aristide Le Dantec, Unversity Hospital of Dakar: a study of 74 cases].

INTRODUCTION Scooter accidents are becoming more frequent in Dakar. The purpose of this study is to report the epidemiological and lesional aspects of these accidents on children in Dakar. MATERIALS AND METHODS A retrospective and descriptive study was conducted in Pediatric Surgery Unit of the Aristide Le Dantec Hospital in Dakar from January 1st, 2009 to December 31, 2011. Various parameters were studied. These parameters include: frequency, sociodemographic and lesional aspects. RESULTS Scooter accidents represent 12% of highway accidents. They were more frequent in the day, from 12 am to 2 pm (27%) and in the night, from 6 pm to 8 pm (28.4%). They might occur every day but were more frequent during April (17.6%) and June (13.5%). They occurred mainly in the suburban district of Dakar (78%). The age group most affected was the one from 3 to 8 years (60.8%). Male gender was predominant (sex ratio 1.5). Pedestrians are the most vulnerable (93.2%). The fall was the dominant mechanism (98.7%). Lesions affected mainly the lower limb (51.1%) and were essentially constituted by fracture. CONCLUSION The frequency of scooter accidents in children is related to the galloping urbanization and to the increase of the number of cars on the roads in the peninsula. Victims are essentially pedestrians and present most of the time fractures.