Background: Unintentional injuries are one of the most important public health problems among children in developed and some developing countries. Aim: Our purpose is to determine the prevalence of everyday life unintentional injuries among children admitted for at least 24 hours in the pediatric surgical emergencies (PSE) department, Children’s hospital of Rabat, Morocco. Methods: A cross-sectional study of unintentional injuries in children was undertaken over 4 years (2016- 2019) in the pediatric surgical emergencies (PSE) department, Children’s hospital of Rabat, Morocco. The data were analysed by statistical software Jamovi 1.6.23. Drownings and foreign bodies were excluded. Results: 1204 patients were screened, of which 545 files were studied. The median age was 8 years[4;12] with 36,5% were less than 6 years old, 70,4% were boys. The most injuries occurred mostly during winters and summers (41,6 vs 33,8%). The medical insurance plan was provided by compulsory medical insurance (AMO) and RAMED (Medical Assistance Scheme) (30,4% and 46.5% respectively). The main circumstances were accidents of everyday life (52%) with predominance of falls. For the public road accident, pedestrians were predominant. Hospital stay did not exceed 24 hours (73%) mainly in the surgical emergency department.
Neonatal testicular torsion (NTT) was first described by Taylor et al. in 1897 [1]. It can be unilateral or less frequently, bilateral. It’s a rare disease that occurs in neonate estimated at 1 in 7500 newborns [2]. Our case report is about a 9 days old male presented with a history of a swelling and irreducible inguinal hernia. Upon admission an ultrasonography was done and reported a right inguinoscrotal hernia. Surgical exploration was performed and the exploration found an extravaginally testicular torsion with a necrotic testicular associated with an inguinal hernia sac. Inside the sac we found a vermiform appendix non perforated known as amyand’s hernia.
The reverse sural artery flap (RSAF) was first described approximately four decades ago in 1983 by Donski and Fogdestam [1] and has since been used frequently for reconstruction of soft tissue defects in the distal part of the leg. Coverage of soft-tissue defects of the ankle and foot is often challenging. The distally based sural fascio-cutaneous flap is useful for reconstructing the lower leg, ankle, heel, and foot but has rarely been evaluated in paediatric patients. The objectives of this study were to assess the reliability of this flap in children, to get a global experience with the sural flap in our department of plastic and reconstructive pediatric surgery, and to describe the complications. Material and methods: A distally based sural fascio-cutaneous flap was used to cover soft-tissue defects of the ankle and foot in 5 paediatric patients between 2018 and 2021. The median age of patient at surgery was 6 years old. The most frequent mechanism of soft tissue defect was trauma caused by vehicular accident (open fractures) crush injuries, lacerated wound. Results: One of the 5 flaps was a cross leg sural flap, 4 recovered well without necrosis, only one developed partial necrosis requiring excision and skin grafting. The other complications where an early postoperative complications: partial or total necrosis of the flap late complications including impaired touch sensation over the flap and donorsite. Discussion: The distally based sural fascio-cutaneous flap is a method of choice for covering soft-tissue defects of the ankle and foot in paediatric patients. This reliable flap spares the major blood vessels and has a good blood supply. When there is exposure of a vital structure, distal sural flap is the best indication for coverage in a traumatic soft-tissue defect. The use of a distally based sural fascio cutaneous flap is not free from delayed complications most of them at the donor site.
We reviewed the charts of 136 patients treated for bladder extrophy epispadias complex, at our institution from 2000 to2019. All patients underwent Mitchell bladder Neck reconstruction technique, including Mitrofanoff's procedure in 20 patients , and bladder augmentation in 15 patients.
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