Introduction: The left mesenterico-parietal hernia or left paraduodenal hernia is an anomaly of intestinal rotation which may be responsible for intestinal obstruction. It is rare. Observation: A 5-year-old boy was admitted for abdominal pain with episodes of vomiting and cessation of matters and gases. After clinical and paraclinical investigations, the diagnosis of occlusion was accepted and the child was operated. Exploration revealed a mesenterico-parietal hernia with a retrocolic sac measuring 11 cm of collar and a deep of 18 cm containing a twisted bowel. After reduction of the content, we untwisted the small intestine and released adhesions. The hernial sac was partially resected and the defect was closed. Operating outcomes were simple. Conclusion: The mesenterico-parietal hernia is a cause of organic intestinal obstruction. Although of congenital origin, it can have a late clinical manifestation. It should be considered in case of episodes of repetitive abdominal pain and vomiting to avoid complications.
Introduction: The factors of nephroblastomas' relapse are a set of elements playing a role in the reappearance of cancer cells in the same place of the kidney or in other regions of the body after a 5-year remission. Objectives: To determine the frequency and the factors of nephroblastomas' relapse in the pediatric oncology unit and pediatric surgery of the academic hospital Gabriel Touré. Materials and methods: This was a retrospective study carried out from January 1, 2005 to December 31, 2019 in all children treated for nephroblastoma relapses in the pediatric oncology unit and in the pediatric surgery service. Results: In 15 years, we have managed 182 cases of nephroblastoma, of which 128 cases were declared in complete remission after 5 years and 12 cases presented a recurrence. The relapses factors were: capsular break, intraoperative tumor rupture, presence of an associated malformation, surgery without neoadjuvant chemotherapy and tumor surgical stage (p < 0.05). Patients' age at diagnosis, sex, number of neoadjuvant and adjuvant chemotherapy sessions and histological type were not decisive (p > 0.05). Conclusion: Relapses are more and more frequent in cases of nephroblastoma. The correct use of the protocol would avoid these recurrences.
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