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Lamiri R, Habachi G, Zayani S, Salah RB, Daya A, Abdelaali M, Mekki M, Kechiche N, Sahnoun L. Staphylococcus aureus costal osteomyelitis with complicated by pleural effusion in a 7-month-old infant: A misleading clinical presentation. Radiol Case Rep 2024; 19:2362-2366. [PMID: 38559649 PMCID: PMC10979000 DOI: 10.1016/j.radcr.2024.02.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Osteomyelitis is a rare infectious disease in children, predominantly affecting long bones; however, its clinical presentation can be ambiguous if the location is atypical. Costal osteomyelitis is very rare in children and can mimic other pathologies. We present a case of a seven-month-old infant diagnosed with costal osteomyelitis complicated by rupture of a subperiosteal abscess into the pleura. His clinical condition improved with conservative treatment, which included chest drain insertion and intravenous antibiotic therapy without the need for surgical debridement. Rib osteomyelitis represents a potentially severe condition. Early detection is imperative to prevent the necessity for invasive therapies and mitigate long-term complications.
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Affiliation(s)
- Rachida Lamiri
- Pediatric surgery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Ghada Habachi
- Pediatric surgery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Seyfeddine Zayani
- Department of Pediatrics, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Radhouane Ben Salah
- Pediatric surgery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Abir Daya
- Department of Pediatrics, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Mabrouk Abdelaali
- Imagery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Mongi Mekki
- Pediatric surgery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Nahla Kechiche
- Pediatric surgery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
| | - Lassaad Sahnoun
- Pediatric surgery Department, University Hospital of Monastir, university of Monastir, Monastir, Tunisia
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Fredj MB, Messaoud M, Youssef SB, Mani S, Laaribi S, Sakka R, Hmida HB, Ksiaa A, Mekki M, Belghith M, Sahnoun L. Phenotypic variability and management of patients with mosaic monosomy X and Y chromosome material: a case series. Ital J Pediatr 2024; 50:93. [PMID: 38715086 PMCID: PMC11077738 DOI: 10.1186/s13052-024-01618-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND we aim to discuss the origin and the differences of the phenotypic features and the management care of rare form of disorder of sex development due to Mosaic monosomy X and Y chromosome materiel. METHODS We report our experience with patients harboring mosaic monosomy X and Y chromosome material diagnosed by blood cells karyotypes and cared for in our department from 2005 to 2022. RESULTS We have included five infants in our study. The current average age was 8 years. In four cases, the diagnosis was still after born and it was at the age of 15 years in one case. Physical examination revealed a variable degree of virilization, ranging from a normal male phallus with unilateral ectopic gonad to ambiguous with a genital tubercle and bilateral not palpable gonads in four cases and normal female external genitalia in patient 5. Karyotype found 45, X/46, XY mosaicism in patient 1 and 2 and 45, X/46, X, der (Y) mosaicism in patient 3, 4 and 5. Three cases were assigned to male gender and two cases were assigned to female. After radiologic and histologic exploration, four patients had been explored by laparoscopy to perform gonadectomy in two cases and Mullerian derivative resection in the other. Urethroplasty was done in two cases of posterior hypospadias. Gender identity was concordant with the sex of assignment at birth in only 3 cases. CONCLUSION Because of the phenotypic heterogeneity of this sexual disorders and the variability of its management care, then the decision should rely on a multidisciplinary team approach.
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Affiliation(s)
- Myriam Ben Fredj
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia.
| | - Marwa Messaoud
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Sabrine Ben Youssef
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Salma Mani
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Syrine Laaribi
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Rania Sakka
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Hayet Ben Hmida
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Amine Ksiaa
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Mongi Mekki
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Mohsen Belghith
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
| | - Lassaad Sahnoun
- University of Monastir Faculty of Medicine of Monastir, Université de Monastir faculté de medicine de Monastir, Monastir, Tunisia
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Mosbahi S, Ben Youssef S, Zouaoui A, Abdelali M, Ben Fredj M, Ben Abdejelil N, Belhassen S, Hidouri S, Chabchoub I, Ksia A, Sahnoun L, Mekki M, Zakhama A, Zrig A, Belghith M. Metanephric adenoma diagnosed on biopsy in an infant: a case report. J Med Case Rep 2023; 17:354. [PMID: 37550779 PMCID: PMC10408113 DOI: 10.1186/s13256-023-04046-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/19/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in children. It is often misdiagnosed preoperatively as a malignant neoplasm, leading to an unnecessary nephrectomy. The challenge is to make the right diagnosis preoperatively and therefore manage it with conservative surgery. We report a case of a child with metanephric adenoma who underwent nephron-sparing surgery. CASE PRESENTATION A renal tumor was discovered fortuitously in an 18-month-old Caucasian girl with several congenital malformations. Investigations showed a 28 × 27 × 27 mm left renal mass centrally located, well defined, nonvascularized, with no calcifications and which compressed the adjacent renal tissue. Furthermore, there were no signs of metastasis. The decision of a multidisciplinary meeting was to perform a computed tomography (CT)-scan-guided biopsy. Histologic examination concluded it was a metanephric adenoma. We performed a left open partial nephrectomy via a flank retroperitoneal incision. The final histopathological examination confirmed the diagnosis. The postoperative course was uneventful. CONCLUSION Preoperative diagnosis of metanephric adenoma is challenging. Because of the high probability of unnecessary radical nephrectomy, preoperative biopsy can be safe and determining to guide a more conservative approach so nephron-sparing surgery can be performed.
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Affiliation(s)
- S. Mosbahi
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - S. Ben Youssef
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - A. Zouaoui
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - M. Abdelali
- Department of Radiology, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - M. Ben Fredj
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - N. Ben Abdejelil
- Department of AnatomopathologyFattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - S. Belhassen
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - S. Hidouri
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - I. Chabchoub
- Department of Oncology, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - A. Ksia
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - L. Sahnoun
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - M. Mekki
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
| | - A. Zakhama
- Department of AnatomopathologyFattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - A. Zrig
- Department of Radiology, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - M. Belghith
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000 Monastir, Tunisia
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Kechiche N, Makhlouf D, Laamiri R, Zouaoui A, Mani S, Ksiaa A, Sahnoun L, Mekki M, Belguith M, Nouri A. Intussusception Caused by Heterotopic Pancreas: A Tunisian Case Series of 5 Pediatric Patients. Arch Iran Med 2022; 25:844-846. [PMID: 37543913 PMCID: PMC10685840 DOI: 10.34172/aim.2022.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/24/2021] [Indexed: 08/08/2023]
Abstract
Heterotopic pancreas (HP) is a rare congenital developmental anomaly of the gastro-intestinal tract, defined as the presence of pancreatic tissue found in ectopic sites. Intussusception caused by isolated HP is extremely rare. Pediatric reports concerning this pathology are case reports. Here, we report cases of secondary intussusception, in which conservative treatment failed and surgery was performed. The aim of this review is to study the epidemiologic and clinical aspects of HP in pediatric patients from our institution. We retrospectively collected patients who were treated in the pediatric surgery department for intussusception caused by HP, from January 1986 to November 2018. We investigated five patients, three boys and two girls, aged 5 months to 2 years. The diagnosis was made incidentally during the operation. HP was found in the jejunum in three cases and in the ileum in two cases. HP was removed. The postoperative course was uneventful. Although rare, HP should be included in the differential diagnosis of gastrointestinal diseases, causing secondary bowel intussusception.
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Affiliation(s)
- Nahla Kechiche
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Dorsaf Makhlouf
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Rachida Laamiri
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Arije Zouaoui
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Salma Mani
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Amine Ksiaa
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Lasaad Sahnoun
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mongi Mekki
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mohsen Belguith
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Abdellatif Nouri
- Pediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
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Haggui B, Hidouri S, Ksia A, Oumaya M, Mosbahi S, Messaoud M, Youssef SB, Sahnoun L, Mekki M, Belghith M, Nouri A. Management of trichobezoar: About 6 cases. Afr J Paediatr Surg 2022; 19:102-104. [PMID: 35017380 PMCID: PMC8809465 DOI: 10.4103/ajps.ajps_110_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Trichobezoar is an uncommon clinical entity in which ingested hair mass accumulates within the digestive tract. It is generally observed in children and young females with psychological disorders. It can either be found as an isolated mass in the stomach or may extend into the intestine. Untreated cases may lead to grave complications. MATERIAL AND METHODS We retrospectively analyzed the clinical data of six patients treated for trichobezoar in Monastir pediatric surgery department during 16-year-period between 2004 and 2019. Imaging (abdominal computed tomography and upper gastroduodenal opacification) and gastroduodenal endoscopy were tools of diagnosis. RESULTS Our study involved 6 girls aged 4 to 12. Symptoms were epigastric pain associated with vomiting of recently ingested food in 3 cases and weight loss in one case. Physical examination found a hard epigastric mass in all cases. The trichobezoar was confined to the stomach in 4 cases. An extension into the jejunum was observed in 2 cases. Surgery was indicated in all patients. In two cases, the attempt of endoscopic extraction failed and patients were then operated on. All patients had gastrotomy to extract the whole bezoar even those with jejunal extension. Psychiatric follow-up was indicated in all cases. The six girls have evolved well and did not present any recurrence. CONCLUSION open surgery still plays a crucial role in Trichobezoard management . After successful treatment, psychiatric consultation is imperative to prevent reccurrence and improve long term prognosis.
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Affiliation(s)
- Besma Haggui
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Saida Hidouri
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Amine Ksia
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Meriem Oumaya
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Sana Mosbahi
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Marwa Messaoud
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Sabrine Ben Youssef
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Lassaad Sahnoun
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Mongi Mekki
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Mohsen Belghith
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
| | - Abdellatif Nouri
- Department of Paediatric Surgery, Fattouma Bourguiba Hospital, Monastir Medical School, Monastir University Tunisia; Research Laboratory LR12SP13 Tunisian Ministry of Research, Tunisia
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Laamiri R, Sellami S, Kechiche N, Abdelaali M, Mekki M, Belghith M. Intrathoracic rupture of hydatid cyst of the liver in children: a report of two cases. Egypt Liver Journal 2021. [DOI: 10.1186/s43066-021-00116-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Intrathoracic rupture of hepatic hydatid cyst is a rare but dangerous complication. Its occurrence in children is exceptional as diagnosis and management constitute real challenges. We report two cases of intrathoracic rupture of hepatic hydatid cyst in children.
Case presentation
Our patients were respectively 12-year-old boy and 9-year-old girl, known cases of respiratory symptoms, diagnosed initially for pleuropneumonia. The CT scan established the diagnosis of intrathoracic rupture of hepatic hydatid cyst in the pleural cavity for the first patient and in the bronchial tree for the second. An emergency surgery was performed for both. The second patient developed broncho-biliary fistulas during the post-operative course which necessitated a re-intervention. A recurrence was noted at follow-up for the second patient.
Conclusion
Intrathoracic rupture of hepatic hydatid cyst is a serious complication which can occur even in children. Its diagnosis needs a high index of suspicion. The surgical approach remains controversial and there is a lack of consensus about the best way of management. Recurrence may occur despite appropriate treatment.
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7
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Belhassen S, Makhlouf D, Zouaoui A, Ben Youssef S, Bradai H, Mosbahi S, Kechiche N, Sahnoun L, Mekki M, Belguith M, Nouri A. Intraperitoneal Rupture of Liver Hydatid Cyst in Children. Iran J Parasitol 2021; 16:524-526. [PMID: 34630600 PMCID: PMC8476733 DOI: 10.18502/ijpa.v16i3.7108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/25/2020] [Indexed: 01/10/2023]
Abstract
The article's abstract is not available.
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Affiliation(s)
- Samia Belhassen
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Dorsaf Makhlouf
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Arije Zouaoui
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Sabrine Ben Youssef
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Haifa Bradai
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Sana Mosbahi
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Nahla Kechiche
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Lassaad Sahnoun
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mongi Mekki
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mohsen Belguith
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Abdellatif Nouri
- Research Laboratory LR12SP13, Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
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Ben Salah E, Barrera C, Sakly W, Mosbahi S, Balliau T, Franche N, Gottstein B, Ben Youssef S, Mekki M, Babba H, Millon L. Novel biomarkers for the early prediction of pediatric cystic echinococcosis post-surgical outcomes. J Infect 2021; 84:87-93. [PMID: 34614401 DOI: 10.1016/j.jinf.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study aims to search for reliable serological biomarkers allowing the early prediction of cystic echinococcosis (CE) post-operative outcomes. METHODS We applied immunoprecipitation (IP) of Echinococcus granulosus protoscolex antigens with pediatric CE patients' plasma collected at 1-month and 1-year post-surgery, followed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS). We compared IP proteomic content from relapsed patients within the first-year post-surgery (RCE) to cases with no relapses until 3 post-operative years (NRCE). Selected proteins were recombinantly synthesized and assessed for their prognostic performance by Enzyme-linked immunosorbent assay (ELISA). RESULTS A total of 305 immunoreactive parasitic proteins were identified, 59 of which were significantly more abundant in RCE than NRCE for both time-points. Four proteins showed the most promising characteristics for predicting CE outcomes: cytoplasmic malate dehydrogenase (Eg-cMDH), citrate synthase (Eg-CS), annexin A6 and severin. ELISA-IgG against the four markers were significantly lower at 1-year post-surgery than 1-month in NRCE, in contrast to RCE that displayed either stable or higher levels. The Eg-cMDH and Eg-CS showed the best prognostic performance, with respective probabilities of being "relapse-free" of 83% and 81%, if a decrease of IgG levels occurred between 1-month and 1-year post-surgery. CONCLUSION The Eg-cMDH and Eg-CS are promising biomarkers to predict early CE post-surgical outcomes.
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Affiliation(s)
- Eya Ben Salah
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia; National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Coralie Barrera
- National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Wahiba Sakly
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia.
| | - Sana Mosbahi
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Thierry Balliau
- PAPPSO, INRAE, CNRS, AgroParisTech, Université Paris-Saclay, GQE-Le Moulon, Gif-sur-Yvette 91190, France.
| | - Nathalie Franche
- Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
| | - Bruno Gottstein
- Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
| | - Sabrine Ben Youssef
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mongi Mekki
- Paediatric Surgery Department, Laboratory of Malformative and Tumor Pathology in Children (LR12SP13), Medical School, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Hamouda Babba
- Département de Biologie clinique B, Faculté de Pharmacie, Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire LR12ES08, Université de Monastir, Monastir, Tunisia.
| | - Laurence Millon
- National French Reference Centre for Echinococcosis, University Hospital, University Bourgogne Franche-Comté, Bd Fleming, Besançon F-25000, France; Department of Parasitology Mycology, University Hospital of Besançon, UMR/ CNRS 6249 Chrono-Environnement Research Team, University of Bourgogne, Franche-Comté, France.
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Abstract
BACKGROUND Femoral hernias are an uncommon groin pathology among pediatric patients. Therefore, they are frequently misdiagnosed. In the present study, we review our experience with this rare surgical entity during the past 25 years. METHODS The medical records of 19 patients who underwent 22 femoral hernia repairs between January 1994 and December 2019 were retrospectively analysed. RESULTS Patients' age ranged from 2 to 12 years (mean age was 5. 5 years) with an approximately equal sex ratio (10 girls/9 boys). There were three bilateral cases identified separately. They were discovered and managed at different times. All the children were referred with a groin lump, but the correct pre-operative diagnosis was made in only 13 cases (59%). In the remaining cases, four were identified intraoperatively following negative exploration for a supposed inguinal hernia. The other five were found to have a femoral hernia 1 month to 12 months after ipsilateral inguinal hernia repair. All patients underwent elective surgery. The femoral canal was closed using either Lytle or McVay procedure. Recurrence occurred in only one patient 2 months after initial repair. CONCLUSION Femoral hernias are often misdiagnosed. Pre-operative diagnosis can be obtained through careful clinical assessment. In equivocal cases, ultrasonography and laparoscopy could be useful. A correct pre-operative diagnosis will lead to suitable treatment, thus avoiding unnecessary reoperations and their related complications.
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Affiliation(s)
- Basma Haggui
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Saida Hidouri
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Amine Ksia
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Sana Mosbahi
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Marwa Messaoud
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Lassaad Sahnoun
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Mohsen Belghith
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
| | - Abdellatif Nouri
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba Hospital, Monastir University, Research Laboratory LR12SP13, Tunisia
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Belhassen S, Elezzi A, Hidouri S, Laamiri R, Mosbahi S, Ksiaa A, Sahnoun L, Mekki M, Belguith M, Nouri A. [Ureterocele associated with simplex ureter in children: clinical and therapeutic features]. Pan Afr Med J 2021; 38:345. [PMID: 34367424 PMCID: PMC8308876 DOI: 10.11604/pamj.2021.38.345.15142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 03/11/2019] [Indexed: 11/29/2022] Open
Abstract
L´urétérocèle est une dilatation pseudo-kystique de l´uretère terminal sous muqueux. C´est une uropathie malformative rare surtout si elle survient sur un uretère simplex. Il s´agit d´une étude rétrospective menée sur dix ans, de 12 dossiers de malades colligés au Service de Chirurgie Pédiatrique de l´Hôpital Fattouma Bourguiba de Monastir entre 2006 et 2016. L´âge moyen de nos malades est de 2,7 ans avec des limites allant de 7 jours à 11 ans, le sex-ratio est de 1. Le tableau clinique a été dominé par la fièvre en rapport avec une infection urinaire haute. Le diagnostic a été posé essentiellement par l´échographie rénale et vésicale, l´urographie intraveineuse (UIV) et l´uréthro-cystographie rétrograde (UCR). L´urétérocèle était unilatéral dans 10 cas et bilatérale dans 2 cas soit un total de 14 cas d´urétérocèles. Tous ont été sur uretère simplex et ont été opérées par voie endoscopique. Aucun incident peropératoire n´a été noté. Les suites opératoires étaient simples. Une amélioration clinique et radiologique a été obtenue dans tous les cas. L´urétérocèle sur uretère simplex est une malformation urinaire très rare. Non diagnostiquée à temps, elle peut retentir sur le haut appareil. Le traitement endoscopique est une alternative séduisante avec des résultats satisfaisants.
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Affiliation(s)
- Samia Belhassen
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Aziza Elezzi
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Saida Hidouri
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Rachida Laamiri
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Sana Mosbahi
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Amine Ksiaa
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Lassad Sahnoun
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Mongi Mekki
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Mohsen Belguith
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
| | - Abdellatif Nouri
- Service de Chirurgie Pédiatrique, Hôpital Fattouma Bourguiba de Monastir, Monastir, Tunisie.,Laboratoire de Recherche des Pathologies Malformatives et Tumorales LR12SP13, Centre Hospitalo-universitaire Fattouma-Bourguiba de Monastir, Monastir, Tunisie
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Laamiri R, Kechiche N, Hmidi N, Sahnoun L, Mekki M, Belghith M, Ksia A, Nouri A. Isolated central sterna clefts: A rare congenital malformation. Afr J Paediatr Surg 2021; 18:117-118. [PMID: 33642414 PMCID: PMC8232357 DOI: 10.4103/ajps.ajps_47_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Sternal cleft is a rare congenital anomaly which is generally observed at birth. The aetiology remains obscure. Superior clefts are more frequent than inferior ones, and isolated central clefts are extremely rare. Surgery is recommended to protect the heart and other mediastinal contents from trauma and also to improve respiratory dynamics. We present the case of a newborn with isolated central clefts and we will give a review of the literature.
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Affiliation(s)
- Rachida Laamiri
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Nahla Kechiche
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Nahla Hmidi
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Lassaad Sahnoun
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Mohsen Belghith
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Amine Ksia
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Abdellatif Nouri
- Department of Pediatric Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
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12
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Ksia A, Fredj MB, Zouaoui A, Kechiche N, Belhassen S, Mosbahi S, Ben Youssef S, Sfar S, Lamiri R, Sahnoun L, Mekki M, Belghith M, Bokhary A, Nouri A. Capitonnage seems better in childhood pulmonary hydatid cyst surgery. J Pediatr Surg 2020; 55:752-755. [PMID: 31138449 DOI: 10.1016/j.jpedsurg.2019.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/21/2019] [Accepted: 05/08/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pulmonary hydatid disease remains an important healthcare problem. Conservative operative interventions including cystotomy or cystotomy with capitonnage are the two commonly used techniques. However, there is no scientific consensus over selection of these operative interventions. AIM The aim of this study is to compare these two methods: capitonnage and uncapitonnage in the surgery of childhood pulmonary hydatid cyst in regard to the postoperative period. METHODS This is a retrospective analysis of 136 patients operated for pulmonary hydatid disease between January 2010 and July 2017 according to two techniques. Group A was cystotomy with capitonnage (n = 76), and group B was cystotomy alone (n = 60). We compared the postoperative outcomes. RESULTS Our data showed pneumothorax(PNO) and emphysema were seen in 30% of Group B and only in 13.2% in Group A, and the persistence of residual cavity in 23.3% in Group B and 7.9% in Group A (p = 0.014). We have not seen any case of recurrence with capitonnage. CONCLUSION We conclude that capitonnage appears to prevent PNO and emphysema formation and a remaining residual cavity in the long term with a significant difference. And it prevents prolonged postoperative air leak and hospitalization with a slightly nonsignificant difference. It is difficult to say with absolute certainty that the noncapitonnage group is inferior to the capitonnage group, since several factors can influence the evolution. TYPE OF STUDY Clinical research article Level of evidence III.
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Affiliation(s)
- Amine Ksia
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia.
| | - Meriem Ben Fredj
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Arije Zouaoui
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Nahla Kechiche
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Samia Belhassen
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Sana Mosbahi
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Sabrine Ben Youssef
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Sami Sfar
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Rachida Lamiri
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Lassaad Sahnoun
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Mongi Mekki
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Mohsen Belghith
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Abdulmohsen Bokhary
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
| | - Abdellatif Nouri
- Paediatric Surgery Department, Fattouma Bourguiba Hospital, Monastir, Medical School, Tunisia
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Mehmood U, Harrabi K, Hussein IA, Shanmugam N, Mekki A, Mekki M, McLachlan MA. Correction to: A study on stability of active layer of polymer solar cells: effect of UV–visible light with different conditions. Polym Bull (Berl) 2020. [DOI: 10.1007/s00289-019-02834-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Nouri A, Ksia A, Bouzaffara B, Munsterer O, Hidouri S, Chahed J, Sahnoun L, Mekki M. A New Operative Approach for Long-Gap Esophageal Atresia. J Indian Assoc Pediatr Surg 2019; 24:132-134. [PMID: 31105401 PMCID: PMC6417061 DOI: 10.4103/jiaps.jiaps_172_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
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.
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Affiliation(s)
- Abdellatif Nouri
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Amine Ksia
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Bochra Bouzaffara
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Oliver Munsterer
- Department of Pediatric Surgery, Mainz Medical School, Mainz, Germany
| | - Saida Hidouri
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Jamila Chahed
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Lassaad Sahnoun
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Monastir Medical School, Fattouma Bourguiba Teaching Hospital, Research Laboratory, Monastir, Tunisia
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15
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Nahla K, Farhani R, Lamiri R, Mekki M, Belguith M, Nouri A. Unusual Recto-colonic Tubular Duplication in a Female Neonate. J Neonatal Surg 2019. [DOI: 10.47338/jns.v8.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Complete tubular colonic duplication is exceedingly rare. A second ectopic opening in the perineum other than a normally cited anus could be an unusual presentation. We report an unusual case of recto-colonic duplication in a 16-day-old girl who presented with fecal discharge from a vestibular opening in addition to a normally situated anus. The diagnosis of total recto-colonic tubular duplication associated with a rectovestibular fistula and a normal anus was confirmed by barium enema and computed tomography scan with double contrast. At operation, we performed a long transanal incision of the common septum to create an anastomosis between the normal and duplicated colon with complete submucosal excision of the rectovestibular fistula. The patient was doing well at 3-year follow-up examination.
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16
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Youssef SB, Ksia A, Fredj MB, Messaoud M, Laamiri R, Belhassen S, Mosbahi S, Bouzzaffara B, Sahnoun L, Mekki M, Belguith M, Nouri A. Intérêt de la technique de Koyanagi dans le traitement de l’hypospadias posterieur chez l’enfant. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2017.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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17
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Kechiche N, Farhani R, Hmida B, Lamiri R, Ezzi A, Belhassen S, Mosbehi S, Ksia A, Sahnoun L, Mekki M, Belguith M, Nouri A. Congenital Complete Esophageal Diaphragm: A Rare Variant of Esophageal Stenosis. J Neonatal Surg 2018. [DOI: 10.21699/jns.v7i3.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Congenital esophageal web is a rare disorder that presents a diagnostic and management challenge. In a female infant born at 31 weeks of gestation, significant secretions and respiratory distress were noted at birth. Chest X-ray demonstrated the nasogastric tube in the esogastric junction with no distal bowel gas. Esophagogram showed a congenital web near the esogastric junction. An endoscopic examination under general anesthesia showed a complete, thick membrane on the distal esophageal lumen. Endoscopic incision and cauterization of the web through the midline were performed, improving the clinical symptoms and esophageal stenosis.
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18
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Laamiri R, Kechiche N, Braiki M, Hadhri R, Sahnoun L, Mekki M, Belghith M, Nouri A. Neonatal Solitary Intestinal Myofibromatosis. J Neonatal Surg 2018. [DOI: 10.21699/jns.v7i1.676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Solitary intestinal myofibromatosis (SIF) is a very rare condition affecting the pediatric population and carries good prognosis following adequate management based on segmental resection. We describe a rare case who presented with features of neonatal intestinal obstruction due to a solitary stenosing fibrotic lesion originating from the ileum and compatible with SIF.
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Abstract
Please see Fulltext
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20
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Ksia A, Braiki M, Ouaghnan W, Sfar S, Ammar S, Youssef SB, Boussaffara B, Sahnoun L, Mekki M, Belghith M, Nouri A. Male Gender and Prematurity are Risk Factors for Incarceration in Pediatric Inguinal Hernia: A Study of 922 Children. J Indian Assoc Pediatr Surg 2017; 22:139-143. [PMID: 28694569 PMCID: PMC5473298 DOI: 10.4103/jiaps.jiaps_166_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: The purpose of this study was to document clinical features of inguinal hernia (IH) in the pediatric population. It provides data to evaluate associated risk factors of incarcerated hernia, its recurrence as well as the occurrence of contralateral metachronous hernia. Materials and Methods: We report a retrospective analytic study including 922 children presenting with IH and operated from 2010 to 2013 in our pediatric surgery department. Results: We managed 143 girls (16%) and 779 boys (84%). The mean age was 2 years; the right side was predominantly affected (66.8%, n = 616). Incarcerated hernia was documented in 16% of cases with an incidence of 33% in neonates. The incarceration occurrence was 15.5% in males versus 2.09% in females. The surgical repair was done according to Forgue technique. Postoperatively, four cases of hernia recurrence were documented, and contralateral metachronous hernia was reported in 33 children with 7.7% females versus 2.8% males. Forty-five percent of them were infants. The mean follow-up period was 4 years. We think that incarceration can be related to several risk factors such as feminine gender, prematurity, and the initial left side surgical repair of the hernia. Conclusion: IH occurs mainly in male infants. Prematurity and male gender were identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia.
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Affiliation(s)
- Amine Ksia
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Meriem Braiki
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Wissal Ouaghnan
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Sami Sfar
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Seloua Ammar
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Sabrine Ben Youssef
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Bochra Boussaffara
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Lassaad Sahnoun
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Mohsen Belghith
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
| | - Abdellatif Nouri
- Department of Pediatric Surgery, Medical School of Monastir, Fattouma Bourguiba University Hospital, Monastir University, Tunisia Laboratory of Research, LR12SP13, Monastir, Tunisia
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Laamiri R, Kechiche N, Maatouk M, Hagui B, Mnari W, Mekki M, Nouri A. Priapism in the Newborn: Shall We Intervene? J Neonatal Surg 2017; 6:11. [PMID: 28083497 PMCID: PMC5224744 DOI: 10.21699/jns.v6i1.389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 06/08/2016] [Indexed: 11/30/2022] Open
Abstract
Idiopathic neonatal priapism is rarely published. We report the case of a newborn presenting with priapism on the first day of life and reviewed the published data on the management and the follow up of this condition.
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Affiliation(s)
- Rachida Laamiri
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Nahla Kechiche
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Mezri Maatouk
- Department of Radiology, Fattouma Bourguiba University Hospital-Monastir, Tunisia
| | - Besma Hagui
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Walid Mnari
- Department of Radiology, Fattouma Bourguiba University Hospital-Monastir, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Abdellatif Nouri
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
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22
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Oudni-M'rad M, Cabaret J, M'rad S, Chaâbane-Banaoues R, Mekki M, Zmantar S, Nouri A, Mezhoud H, Babba H. Genetic relationship between the Echinococcus granulosus sensu stricto cysts located in lung and liver of hosts. Infect Genet Evol 2016; 44:356-360. [PMID: 27456279 DOI: 10.1016/j.meegid.2016.07.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/15/2016] [Accepted: 07/20/2016] [Indexed: 11/19/2022]
Abstract
G1 genotype of Echinococcus granulosus sensu stricto is the major cause of hydatidosis in Northern Africa, Tunisia included. The genetic relationship between lung and liver localization were studied in ovine, bovine and human hydatid cysts in Tunisia. Allozyme variation and single strand conformation polymorphism were used for genetic differentiation. The first cause of genetic differentiation was the host species and the second was the localization (lung or liver). The reticulated genetic relationship between the liver or the lung human isolates and isolates from bovine lung, is indicative of recombination (sexual reproduction) or lateral genetic transfer. The idea of two specialized populations (one for the lung one for the liver) that are more or less successful according to host susceptibility is thus proposed.
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Affiliation(s)
- Myriam Oudni-M'rad
- LP3M: Laboratory of Medical and Molecular Parasitology-Mycology, LR12ES08, Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia.
| | - Jacques Cabaret
- UMR 1282, ISP INRA and F. Rabelais University, 37380 Nouzilly, France.
| | - Selim M'rad
- LP3M: Laboratory of Medical and Molecular Parasitology-Mycology, LR12ES08, Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia.
| | - Raja Chaâbane-Banaoues
- LP3M: Laboratory of Medical and Molecular Parasitology-Mycology, LR12ES08, Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia.
| | - Mongi Mekki
- Department of Paediatric Surgery and LR12SP13, University Hospital F. Bourguiba, 5000 Monastir, Tunisia.
| | | | - Abdellatif Nouri
- Department of Paediatric Surgery and LR12SP13, University Hospital F. Bourguiba, 5000 Monastir, Tunisia.
| | - Habib Mezhoud
- LP3M: Laboratory of Medical and Molecular Parasitology-Mycology, LR12ES08, Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia.
| | - Hamouda Babba
- LP3M: Laboratory of Medical and Molecular Parasitology-Mycology, LR12ES08, Faculty of Pharmacy, University of Monastir, 5000 Monastir, Tunisia; Laboratory of Parasitology, University Hospital F. Bourguiba, 5000 Monastir, Tunisia.
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Laamiri R, Belhassen S, Ksia A, Ben Salem A, Kechiche N, Mosbahi S, Sahnoun L, Mekki M, Belghith M, Nouri A. Right Congenital Diaphragmatic Hernia Associated With Hepatic Pulmonary Fusion: A Case Report. J Neonatal Surg 2016; 5:35. [PMID: 27433453 PMCID: PMC4942435 DOI: 10.21699/jns.v5i3.370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/22/2016] [Indexed: 11/11/2022] Open
Abstract
We present a case of male newborn presented with respiratory distress at 21 hours of life. The patient was operated for right congenital diaphragmatic hernia (CDH). Hepatic pulmonary fusion (HPF) was found at surgery.
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Affiliation(s)
- Rachida Laamiri
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Samia Belhassen
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Amine Ksia
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Amina Ben Salem
- Department of Radiology B, Maternal and Fetal Unit, Fattouma Bourguiba University Hospital-Monastir, Tunisia
| | - Nahla Kechiche
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Sana Mosbahi
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Lassaad Sahnoun
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Mongi Mekki
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Mohsen Belghith
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
| | - Abdellatif Nouri
- Department of Pediatric Surgery, Fattouma Bourguiba University Hospital- Monastir, Tunisia
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Kerkeni Y, Ksiaa A, Belghith M, Sahnoun L, Maazoun K, Krichene I, Mekki M, Abdellatif N. Biliary atresia: experience of a nord africain center. Tunis Med 2015; 93:683-686. [PMID: 27126424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Biliary atresia (BA) is a progressive inflammatory destructive process of the bile ducts occurring in about one of every 20.000 live births. If left untreated, biliary atresia can lead to liver failure. AIM This is the first study on biliary atresia from Africa. The Aim of our study is to describe the clinical and prognostic aspects of biliary atresia in a Tunisian medical centre, where integrated medico-surgical management of children with liver diseases is lacking and liver transplant is not available. METHODS Patients who were diagnosed with BA and underwent portoenterostomy between January 1985 and December 2010 at a tertiary regional hospital in Tunisia were included in this analysis. RESULTS 74 patients were diagnosed with BA. The patients included 34 boys (45.9%) and 40 girls (54.1%). All patients received Kasai operation as the primary treatment and the median patient age at Kasai operation was 60 days (range 3-180 days). The median followup time for the patients was 72 months (range 2 months-23 years 6 months). Out of the 74 patients who received Kasai operation, 49 patients are being followed regularly in the outpatient clinic. Eight patients died immediately after Kasai operation by either hepatocellular decompensation or by cholangitis. Seventeen patients were lost to follow-up. Fifteen out of 49 patients who underwent portoenterostomy for BA are alive at median six years following Kasai intervention. Ten patients out of the 49 who are being followed regularly were Jaundice free. Two patients had portal hypertension. All these patients had survived. Five patients survived with signs of liver failure in four cases. Two of them had received a liver transplant abroad. Survival with the native liver was 6.7 % at 5 years with Kasai operation alone. CONCLUSION BA still has a very severe prognosis in Tunisia Reducing the age at Kasai operation remains the most important target to reduce the need for LT in infancy and childhood. Centralised care will help to build surgical expertise.
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Chahed J, Mekki M, Ksia A, Kechiche N, Hidouri S, Youssef TM, Sahnoun L, Krichene I, Belghith M, Nouri A. Management of digestive lesions associated to congenital epidermolysis bullosa. Afr J Paediatr Surg 2015; 12:221-6. [PMID: 26712284 PMCID: PMC4955475 DOI: 10.4103/0189-6725.172544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Congenital epidermolysis bullosa (CEB) is a rare genodermatosis. The digestive system is very frequently associated with skin manifestations. Pyloric atresia (PA) and oesophageal stenosis (OS) are considered the most serious digestive lesions to occur.The aim of this work is to study the management and the outcome of digestive lesions associated to CEB in four children and to compare our results to the literature. PATIENTS AND METHODS A retrospective study of four observations: Two cases of PA and two cases of OS associated to CEB managed in the Paediatric Surgery Department of Fattouma Bourguiba Teaching Hospital in Monastir, Tunisia. RESULTS Four patients, two of them are 11 and 8 years old, diagnosed as having a dystrophic epidermolysis bullosa since the neonatal period. They were admitted for the investigation of progressive dysphagia. Oesophageal stenosis was confirmed by an upper contrast study. Pneumatic dilation was the advocated therapeutic method for both patients with a favourable outcome. The two other patients are newborns, diagnosed to have a CEB because of association of PA with bullous skin lesions with erosive scars. Both patients had a complete diaphragm excision with pyloroplasty. They died at the age of 4 and 3 months of severe diarrhoea resistant to medical treatment. CONCLUSION Digestive lesions associated to CEB represent an aggravating factor of a serious disease. OS complicating CEB is severe with difficult management. Pneumatic dilatation is the gold standard treatment method. However, the mortality rate in PA with CEB is high. Prenatal diagnosis of PA is possible, and it can help avoiding lethal forms.
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Affiliation(s)
- Jamila Chahed
- Department of Paediatric Surgery, School of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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Kerkeni Y, Ksia A, Zitouni H, Belghith M, Lassad S, Krichene I, Mekki M, Nouri A. [Biliary atresia and polysplenia syndrome]. Tunis Med 2015; 93:494-496. [PMID: 26815511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Polysplenia syndrome is a rare malformation characterized by the association of multiple rates and other congenital anomalies dominated by cardiac, vascular, intestinal and bile malformations. We report the observation of a patient operated in the neonatal period (3 days) for an upper intestinal obstruction with situs inversus. Surgical exploration noted the presence of multiple rates, a preduodenal vein, a biliary atresia and a duodenal atresia. The surgical procedures performed were a latero-lateral duodeno-duodenostomy and hepatoportoenterostomy of KASAI with simple immediate and delayed outcomes. The follow up was of 23 years. We recall the epidemiological characteristics of this malformative association and we discuss the role played by the prognosis of polysplenia syndrome in the evolution of biliary atresia. The diagnosis and treatment of biliary atresia are always urgent to increase the chances of success of the Kasai, and the chances of prolonged survival with native liver. However, almost all long-term survivors (even anicteric) have biliary cirrhosis, which requires lifelong follow up.
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Crochemore C, Mekki M, Corbière C, Karoui A, Noël R, Vendeville C, Vaugeois JM, Monteil C. Subsarcolemmal and interfibrillar mitochondria display distinct superoxide production profiles. Free Radic Res 2015; 49:331-7. [PMID: 25689624 DOI: 10.3109/10715762.2015.1006212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Cardiac subsarcolemmal mitochondria (SSM) and interfibrillar mitochondria (IFM) subpopulations display distinct biochemical, morphological, and functional characteristics. Moreover, they appear to be differently influenced during cardiac pathologies or toxic injuries. Although mitochondrial reactive oxygen species seem to play a critical role in cardiac function and diseases, limited information exists about the superoxide production characteristics of these mitochondrial subpopulations. In this work, using direct measurement of superoxide by electron paramagnetic resonance, we showed that differences in superoxide production profiles were present between cardiac IFM and SSM, in terms of intensity and major sites of superoxide generation. In SSM incubated with glutamate plus malate as substrates, the total observed superoxide levels were significantly higher than those observed with IFM, with an important contribution of the NADH-oxidizing site of complex I (site If) and the quinol-oxidizing site of complex III (site IIIQ0). In both IFM and SSM, succinate leads to similar rates of total superoxide levels with a substantial role for contribution of reverse electron transfer. Finally, using two spin probes with different membrane permeabilities, our data on complex III showed direct intra- and extra-mitochondrial superoxide release whereas complex I- and II-dependent superoxide were exclusively released inside the mitochondria, confirming previous studies. Feasibility of this approach to measure intra- and extra-mitochondrial superoxide levels and to characterize distinct superoxide production profiles of cardiac IFM and SSM has been demonstrated.
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Affiliation(s)
- C Crochemore
- Normandy University, Univ Rouen , ABTE EA 4651 , France
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Ksia A, Haggui B, Mosbahi S, Maazoun K, Sahnoun L, Chahed J, Krichene I, Mekki M, Belghith M, Nouri A. [Gastric volvulus in children: five case reports]. Arch Pediatr 2014; 21:1339-43. [PMID: 25449446 DOI: 10.1016/j.arcped.2014.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 05/26/2014] [Accepted: 09/21/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED Gastric volvulus is an abnormal rotation of all or a part of the stomach around one of its axes. It is a rare cause of intestinal obstruction in children. This anomaly can be primary, due to abnormalities of the gastric ligaments, or secondary to other congenital malformations. We report on the cases of five children treated between January 1994 and December 2011, four boys and one girl, with a medium age of 7 months. Diagnosis was based on clinical features, particularly in the upper gastrointestinal Rx contrast study, which confirmed the diagnosis. Four out of the five children underwent laparoscopic surgery with fixation of the stomach. A diaphragmatic hernia was associated in one case. Antireflux surgery was performed in three cases, and a diaphragmatic defect was closed in one case. The follow-up was uneventful after a medium period of 7 years. CONCLUSION good knowledge of this anomaly is the guarantee of early diagnosis and optimum treatment to ameliorate the prognosis.
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Affiliation(s)
- A Ksia
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie.
| | - B Haggui
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - S Mosbahi
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - K Maazoun
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - L Sahnoun
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - J Chahed
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - I Krichene
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - M Mekki
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - M Belghith
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
| | - A Nouri
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba de Monastir, Tunisie
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Ksia A, Hagui B, Belhassen S, Sahnoun L, Maazoun K, Mosbahi S, Hidouri S, Ben Youssef S, Ben Brahim M, Chahed J, Krichéne I, Mekki M, Belguith M, Nouri A. Kyste hydatique du rein chez l’enfant: à propos de 8 cas. African Journal of Urology 2014. [DOI: 10.1016/j.afju.2014.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Chahed J, Ksia A, Selmi W, Hidouri S, Sahnoun L, Krichene I, Mekki M, Nouri A. Burns injury in children: is antibiotic prophylaxis recommended? Afr J Paediatr Surg 2014; 11:323-5. [PMID: 25323182 DOI: 10.4103/0189-6725.143141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Jamila Chahed
- Department of Pediatric Surgery, EPS Fattouma Bouguiba, Faculty of Medicine, Monastir, CP 5000, Tunisia
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Sahnoun L, Ksia A, Mansour W, Hadhri R, Mosbahi S, Hammedi F, Maazoun K, Krichene I, Mekki M, Belguith M, Nouri A. Trois observations de néphrome mésoblastique avant l’âge de 6 mois. African Journal of Urology 2014. [DOI: 10.1016/j.afju.2014.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Sahnoun L, Ksia A, Kechich N, Sassi S, Hidouri S, Laamiri R, Belhassan S, Krichen I, Mekki M, Belghith M, Nouri A. SFCP CO-76 - Place du traitement chirurgical dans l’hyperinsulinisme congénital persistant. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71714-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hidouri S, Aloui S, Laamiri R, Ksiaa A, Chahed J, Belhassen S, Mekki M, Sahnoun L, Krichene I, Belguith M, Nouri A. SFCP CO-66 - Sténoses caustiques de l’œsophage chez l’enfant Résultats de 46 dilatations pneumatiques. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71704-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Laamiri R, Hidouri S, Aloui S, Belhassen S, Ksia A, Sahnoun L, Krichene I, Mekki M, Belghith M, Nouri A. SFCP P-110 - Ectopie testiculaire croisée. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71825-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kerkeni Y, Ksiaa A, Sahnoun L, Belghith M, Krichene I, Mekki M, Nouri A. Management of epithelial ovarian tumors in children. Tunis Med 2014; 92:350-351. [PMID: 25504399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Laamiri R, Belhassen S, Hidouri S, Aloui S, Ksia A, Sahnoun L, Krichene I, Mekki M, Belghith M, Nouri A. SFCP P-011 - Sténoses œsophagiennes de l’épidermolyse bulleuse : à propos de deux cas. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71727-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ksia A, Mosbahi S, Belhassen S, Alaya A, Sahnoun L, Sfar S, Maazoun K, Laamiri R, Chahed J, Krichene I, Mekki M, Belghith M, Nouri A. Multiple Echinococcosis with an unusual location in the spermatic cord treated successfully by Albendazole: A case report. African Journal of Urology 2014. [DOI: 10.1016/j.afju.2013.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
BACKGROUND Lipoblastoma is a rare benign mesenchymal tumour of embryonal fat that occurs almost exclusively in infants and children. This determined the epidemiological, clinical and therapeutic aspect of this disease. MATERIALS AND METHODS A total of 10 cases of pathologically proven lipoblastoma from 2003 to 2012 were reviewed. RESULTS There were six boys and four girls ranging in age from 7 months to 9 years. A soft-tissue mass was the main complain in nine patients. The various locations of the mass were mediastinal, thigh, buttock, inguino-scrotal, the greater omentum and the Latissimus dorsi. Lesions measured 5-15 cm. complete excision was done. The median time of follow-up was 42 months (ranges between 18 and 84 months). There were no recurrences. CONCLUSION It is important to consider lipoblastoma in the diagnosis of a rapidly enlarging fatty mass in children. Complete resection is the only definitive treatment and should not be delayed when impingement on surrounding structures is imminent. There is a tendency for these lesions to recur despite presumed complete excision. Therefore, follow-up for a minimum of 5 years is recommended.
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Affiliation(s)
- Yosra Kerkeni
- Department of Pediatric Surgery, Monastir Hospital, Monastir, Tunisia
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Ksia A, Yengui H, Saad MB, Sahnoun L, Maazoun K, Rachida L, Krichene I, Mekki M, Belguith M, Nouri A. Soave transanal one-stage endorectal pull-through in the treatment of Hirschsprung's disease of the child above two-year-old: a report of 20 cases. Afr J Paediatr Surg 2013; 10:362-6. [PMID: 24469488 DOI: 10.4103/0189-6725.125449] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The definitive treatment of Hirschsprung's disease is the removal of the aganglionic bowel by a pull-through surgery. In most cases, this surgery is performed in infancy or in the neonatal period as presentation in older children and adulthood is uncommon. MATERIALS AND METHODS It is a retrospective study of 20 patients above two-year-old who underwent a transanal Soave one-stage endorectal pull-through procedure for Hirschsprung's disease between January 2002 and December 2010. RESULTS Twenty patients were recruited in this study. Fourteen were males and six were females. Patient ages ranged from 2 to 14 years (median age: five years and three months). All patients presented with persistent constipation and abdominal distension. Two of them had an intestinal obstruction that required colostomy. Ten patients (50%) had a recto-sigmoid Hirschsprung's disease. All patients were operated on using a Soave one-stage endorectal pull-through procedure. The laparoscopy was necessary during the pull-through in three cases. The average duration of the intervention was 240 minutes. That represents almost the double of the duration of the same procedure in newborns and infants in our department (130 minutes). Early postoperative complications included one case of anastomosis leakage and one case of intussusception. Late postoperative complications were perineum irritation in five cases (25%), anal stenosis in four cases (20%) and enterocolitis in one case (5%). None of our patients developed fecal incontinence. Soiling was reported in four cases (20%). There was no death. CONCLUSION Soave transanal one-stage endorectal pull-through is safely feasible in children of more than two years of age. Laparoscopy may be necessary whenever there are difficulties in the pull-through.
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Affiliation(s)
- Amine Ksia
- Department of Pediatric Surgery, Hospital Fattouma Bourguiba, Monastir 5000, Tunisia
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Ksia A, Mosbahi S, Brahim MB, Sahnoun L, Haggui B, Youssef SB, Maazoun K, Krichene I, Mekki M, Belghith M, Nouri A. Recurrent intussusception in children and infants. Afr J Paediatr Surg 2013; 10:299-301. [PMID: 24469476 DOI: 10.4103/0189-6725.125414] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Recurrent intussusceptions in child and infants are problematic and there are controversies about its management. The aim of this study is to determine the details of the clinical diagnosis of recurrent intussusception and to determine the aetiology of recurrent intussusceptions. PATIENTS AND METHODS It's a retrospective study of 28 cases of recurrent intussusception treated in the paediatric surgery department of Monastir (Tunisia) between January 1998 and December 2011. RESULTS During the study period, 505 patients were treated for 544 episodes of intussusception; there were 39 episodes of recurrent intussusceptions in 28 patients; the rate of patients with recurrence was 5.5%. With comparison to the initial episode, clinical features were similar to the recurrent episode, except bloody stool that was absent in the recurrent group (P = 0,016). Only one patient had a pathologic local point. CONCLUSION In recurrent intussusception, patients are less symptomatic and consult quickly. Systematic surgical exploration is not needed as recurrent intussusceptions are easily reduced by air or hydrostatic enema and are not associated with a high rate of pathologic leading points.
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Affiliation(s)
- Amine Ksia
- Department of Paediatric Surgery, Hopital Fattouma Bourguiba, Medical School of Monastir; Monastir 5000, Tunisia
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Ksia A, Mosbahi S, Zrig A, Achour Z, Khadhar MK, Chioukh F, Sahnoun L, Krichene I, Mekki M, Belghith M, Stambouli L, Golli M, Zakhama A, Monastiri K, Nouri A. [Cervical teratoma in a child]. Arch Pediatr 2013; 20:1133-8. [PMID: 24011439 DOI: 10.1016/j.arcped.2013.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/06/2013] [Accepted: 07/13/2013] [Indexed: 11/19/2022]
Abstract
Teratomas are unusual tumors derived from all 3 germs cells layers: endoderm, mesoderm, and ectoderm, with varying proportions. The cervical area is exceptionally affected. We report 4 cases of cervical teratoma. The clinically and radiologically suggested diagnosis was confirmed by histology. We describe herein the main clinical, radiological, and histological aspects and outcomes of this disease. Despite its most often benign histologic nature, cervical teratoma may threaten newborn infants' life due to airway compression. A multidisciplinary approach to the disease starting at delivery is required to improve the prognosis.
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Affiliation(s)
- A Ksia
- Service de chirurgie pédiatrique, hôpital Fattouma-Bourguiba, Monastir, Tunisie.
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Ghribi A, Krichene I, Fekih Hassen A, Mekki M, Belghith M, Nouri A. Gastric perforation in the newborn. Tunis Med 2013; 91:464-467. [PMID: 24008879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Gastric perforation in neonates is an uncommon condition. It could be spontaneous but a contributing cause should be sought. AIM To review our experience of treating 8 neonates with gastric perforation over the past 20 years. METHODS We reviewed the records of all newborns admitted to our hospital between 1990 and 2010 with regard to gender, age at admission, contributing factors, associated anomalies, site of perforation, type of operation, and outcome. RESULTS Of the eight neonates, five were female and three male. The average weight was 2130 g. Four babies were premature. Three infants were ventilated for respiratory difficulty. Five patients had associated anomalies. Perforation occurred in the lesser curvature in 4, at the greater curvature in 3, and at the anterior antrum surface in 1. All patients were treated with gastrorrhaphy. Four neonates required additional gastrostomy. Mortality was 75% (6 infants). CONCLUSION Active perinatal management, early treatment of primary pathologies, and protection of the stomach against distension in neonates at risk are essential in the management of neonatal gastric perforation.
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MESH Headings
- Female
- Gestational Age
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/surgery
- Infant, Premature, Diseases/epidemiology
- Infant, Premature, Diseases/surgery
- Male
- Retrospective Studies
- Rupture, Spontaneous/epidemiology
- Rupture, Spontaneous/surgery
- Stomach Rupture/epidemiology
- Stomach Rupture/surgery
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43
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Ksiaa A, Zitouni H, Zrig A, Kerkeni Y, Sahnoun L, Chahed J, Laamiri R, Maazoun K, Krichéne I, Mekki M, Belguith M, Nouri A. Video-assisted surgery in the management of hydatid renal cyst in children. J Pediatr Surg 2013; 48:E17-9. [PMID: 23701802 DOI: 10.1016/j.jpedsurg.2013.02.099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 02/11/2013] [Accepted: 02/26/2013] [Indexed: 11/30/2022]
Abstract
Renal hydatid disease is rare in children. Open surgery is the traditional method of treatment, but minimally invasive techniques are being increasingly used. Herein, we report our experience with laparoscopic management of renal hydatid cyst in four children via a transperitoneal approach in three cases and a retroperitoneoscopy in one. We conclude that transperitoneal laparoscopy can be offered for the management of hydatid renal cyst associated with other intraperitoneal localizations, whereas the retroperitoneoscopy is limited for the treatment of isolated hydatid renal cysts.
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Affiliation(s)
- Amine Ksiaa
- Department of Pediatric Surgery, Fattouma bourguiba Hospital, Monastir 5000 Tunisia.
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44
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Sahnoun L, Kitar M, Maazoun K, Ksia A, Chahed J, Mekki M, Krichen I, Belghith M, Nouri A. Hirschsprung's Disease Presenting as Neonatal Appendicitis. J Neonatal Surg 2013; 2:25. [PMID: 26023445 PMCID: PMC4420371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 03/23/2013] [Indexed: 11/02/2022] Open
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45
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Ksia A, Zitouni H, Zrig A, Laamiri R, Chioukh F, Ayari E, Sahnoun L, Maazoun K, Krichene I, Mekki M, Belghith M, Nouri A. Pyloric atresia: A report of ten patients. Afr J Paediatr Surg 2013; 10:192-4. [PMID: 23860076 DOI: 10.4103/0189-6725.115054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pyloric atresia (PA) is uncommon. It occurs in 1:100000 live births. Neonates usually present soon after birth with copious non-bilious vomiting. The treatment is surgical and its prognosis is poor, especially, when it is associated with epidermolysis bullosa (EB). The aim of this study was to evaluate the clinical presentation, diagnosis, operative management, post-operative courses, and outcome in infant with PA, based in our cases and literature review. Charts of 10 patients who underwent surgery for PA in the department of paediatric surgery in a Teaching Hospital in Tunisia (Monastir) between 1990 and 2012 were reviewed. Data were analysed for demographic, clinical, therapeutic, and prognostic characteristics. The average of age at presentation was 2 days and there were six males and four females. The main presenting symptoms were non-bilious vomiting in 90% of cases. Abdominal X-ray showed gastric dilatation with an absence of gas in the rest of the intestinal tract in 90%, and a pneumoperitoneum in one. The surgical approach was laparotomy in all cases. Gastric perforation was observed in one patient and was completely repaired. The distribution of the anatomic variations was type A in nine cases and type B in one. Five patients underwent excision of the diaphragm and Heineke-Mikulicz pyloroplasty and gastroduodenostomy in the other five cases. Identified associated anomalies were Down's syndrome in one and EB in 2 (20%), one family has three affected sibling. Post-operative mortality rate was 70%. No standard surgical approach can be adopted a better management of PA or the associated anomalies depends on an early diagnosis and the availability of neonatal intensive care unit.
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Affiliation(s)
- Amine Ksia
- Department of Pediatric Surgery, Hospital Fattouma Bourguiba Monastir, Medical School of Monastir, Tunisia.
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46
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Sahnoun L, Kitar M, Maazoun K, Ksia A, Chahed J, Mekki M, Krichen I, Belghith M, Nouri A. Hirschsprung’s Disease Presenting as Neonatal Appendicitis. J Neonatal Surg 2013. [DOI: 10.47338/jns.v2.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
See Fulltext
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47
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Mekki M, Ait Belkacem F, Zobiri S, Benkaidali I. Lésions érythémateuses annulaires du visage : quel est votre diagnostic ? Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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48
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Ksia A, Mosbahi S, Ben Brahim M, Sahnoun L, Laamiri R, Maazoun K, Krichene I, Mekki M, Belguith M, Nouri A. [Esophageal strictures in children with epidermolysis bullosa]. Arch Pediatr 2012; 19:1325-9. [PMID: 23116982 DOI: 10.1016/j.arcped.2012.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/28/2012] [Accepted: 09/23/2012] [Indexed: 11/16/2022]
Abstract
UNLABELLED Esophageal stricture is a rare but often severe complication of recessive dystrophic epidermolysis bullosa in children. The purpose of the study was to review this digestive complication with emphasis on diagnostic modalities and therapeutic management. PATIENTS AND METHODS This was a retrospective study of two pediatric cases of esophageal stenosis that occurred during generalized recessive dystrophic epidermolysis bullosa of the Hallopeau-Siemens type. RESULTS The 2 patients were aged 8 years 8 months and 11 years 5 months, respectively. Dysphagia was of early onset, before the age of 10 years in both cases. Esophageal opacification led to the diagnosis of esophageal stenosis located in the upper 1/3 of the esophagus in 1 case and at the junction between the middle and the lower 1/3 of the esophagus in the other case. None of the 2 patients received medical treatment, and pneumatic dilation was the treatment method that was advocated. Esophageal endoscopy showed the stenosis and helped guide the positioning of the balloon catheter. These patients underwent 2 and 3 sessions of dilation, respectively, at intervals of 2 months and 1 year. Balloon dilation has allowed the patients to have a more comfortable life with decreased dysphagia and a substantial improvement in nutritional status. However, this improvement was transient (1 patient had symptomatic recurrence of stenosis after 3 years), which shows that monitoring of the patients and the resumption of dilatation sessions may be necessary. CONCLUSION Esophageal strictures in dystrophic epidermolysis bullosa of the Hallopeau-Simens type are severe and difficult to support. Pneumatic dilatation is the treatment of choice for the fragile esophagus. It gives satisfactory results and can be repeated without significant risk.
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Affiliation(s)
- A Ksia
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba, 5000 Monastir, Tunisie.
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49
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Lehtihet Y, Ouhadj O, Djidi L, Mekki M. Étude comparative prospective : cône aprismatique jetable/cône biprismatique, à propos de 100 mesures de la PIO. J Fr Ophtalmol 2012; 35:690-4. [DOI: 10.1016/j.jfo.2012.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 02/17/2012] [Accepted: 05/24/2012] [Indexed: 10/27/2022]
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50
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Jellali MA, Mekki M, Saad J, Zrig A, Elanes I, Mnari W, Maatouk M, Harzallah W, Toumi S, Krichène I, Salem R, Nouri A, Golli M. Perinatally discovered complete tubular colonic duplication associated with anal atresia. J Pediatr Surg 2012; 47:e19-23. [PMID: 22703820 DOI: 10.1016/j.jpedsurg.2012.01.082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 01/17/2012] [Accepted: 01/24/2012] [Indexed: 12/18/2022]
Abstract
Complete tubular colonic duplication (CTCD) is exceedingly rare. The association of CTCD with an anorectal malformation is unusual. This malformation may be found unexpectedly at laparotomy. We present 3 cases of surgically proven neonate CTCD discovered at laparotomy for anal atresia. We reviewed the mode of clinical presentation, the imaging, and laparotomy findings. Our series illustrates that this rare disease presents perinatally in association with anal atresia, with or without other associated anomalies.
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Affiliation(s)
- Mohamed A Jellali
- Department of Radiology, CHU Fattouma-Bourguiba, 1st JUNE Street, Monastir 5000, Tunisia.
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