The ingestion of caustic soda is frequently a source of complications. Esophageal stenosis remains among them the most frequent complication and by far the most formidable. Pyloric stenosis remains rare following ingestion of soda. We report through this clinical case, a cicatricial pyloric stenosis after ingestion of caustic soda associated with a stenosis of the esophagus having caused vomiting with the onset of severe malnutrition. The diagnosis was confirmed by the oeso-gastro-duodenal transit (OGDT) and the child underwent under general anesthesia an enlargement pyloroplasty according to Mikulicz initially and an esophageal dilation secondly to the candle of SAVARY. The postoperative follow-up was favorable with an improvement of the signs and a progressive postoperative weight gain after a follow-up of 06 months. The evolution was favorable after the monthly dilation sessions with a good resumption of transit.
Bowel malrotation is an abnormality in the rotation of the primary intestinal loop during embryonic life. It is a severe abnormality exposing the patient to fatal complications. We report here a series of five patients presenting digestive malrotation with various malformative associations. The first three cases are multiple intestinal atresia on incomplete common mesentery. They underwent an intestinal anastomosis: end-lateral duodeno-ileal for one and end-to-end jejuno-jejunal for the other two with Ladd procedure. In the latter two cases, the omphalocele was the associated malformation; complications such as rupture of the omphalocele with intestinal perforation for one and occlusion by strangulation at the level of the neck for the other were recorded. Ileal resection removing the perforation with end-to-end ileo-ileal anastomosis was performed for the first, while reduction of strangulation at the origin of the occlusion was sufficient for the second. The LADD procedure was the complementary gesture in all cases. The outcome was favorable in 3 cases; two of the newborns who had jejunal atresia died, one on day 5 in a picture of acute respiratory distress, the other on day 6 in a picture of disseminated intravascular coagulation.
Background: There are no real comparative study between guided growth and tibial osteotomy in early stage of Blount disease. The aim of this work was to compare the results of patients treated by these two techniques. Method: We had performed a multicenter retrospective, descriptive and analytical study over a period of 05 years. All children admitted for Blount disease without medial proximal tibial epiphysiodesis and treated by one of these techniques were included. Age, sex, existence of tibial torsion, radiological stage based on Catonne's classification were studied. We also evaluated preoperatively, immediately postoperatively, and at latest follow-up tibiofemoral angle, mechanical medial proximal tibial angle, mechanical lateral distal femoral angle, and the tibial metaphyso-diaphyseal angle. Results: Seventeen (17) patients for 24 knees were included. The sex ratio was 0.54. All patients had tibial torsion. Fourteen knees (64%) were treated by guided growth at a mean age of 5.5±2.5 (range, 3-9 years). With a mean follow-up of 12 ± 3.5 months (range 6-15month); tibiofemoral, mechanical medial proximal tibial, and tibial metaphyso-diaphyseal angles were significantly corrected with normalization of the mechanical axis in 8 patients (60%). Ten patients (36%) were treated by revisited Rab osteotomy at a mean age of 7.7±4.9 years (range, 4-12 years). At a mean follow-up of 23±15 months (range, 10-48 months), only tibial metaphyso-diaphyseal angle was significantly corrected. The recurrence rate was 60%. Despite perfect correction of tibiofemoral, and mechanical medial proximal tibial angles in immediate postoperative follow-up, they gradually decrease in patients treated by Rab osteotomy, whereas they gradually increased in case of guided growth. Conclusion: Guided growth appears to be the best treatment for early stage of Blount disease. Trial registration: Retrospectively registered
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