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Background: Simultaneous occurrence of duodenal atresia, annular pancreas, and situs inversus totalis is an exceedingly rare clinical condition. This may pose management-related challenges to the treating surgeon. Case Presentation: We report a case with a preoperative diagnosis of duodenal atresia and situs inversus. Intraoperatively, an annular pancreas encircling the duodenum was found. Instead of duodenoduodenostomy, a duodenojejunal anastomosis was performed. The postoperative course remained uneventful. The patient is doing fine on a 6-month follow-up. Conclusion: The simultaneous presence of multiple anomalies in this patient prompted us to utilize an alternative approach to relieve the duodenal obstruction. This report highlights the importance of tailoring surgical decisions based on the individualized needs of the patient.

Background: The management of neglected forms of Blount's disease is a challenge in developing countries. Both progressive and acute correction can be performed with a significant risk of compartment syndrome. Very few cases of this complication have been reported in the literature. We report a rare case of compartment syndrome after acute correction for neglected Blount's syndrome in a teenager and the lessons learned in the management of this complex case. Case description: A 16-year-old girl was admitted to our unit with a severe bilateral genu varum since childhood. The deformities were classified as Langeskiold Stage VI. Considering the complexity of the case, we treated the limbs in different operating times. We started with the left side. Under general anesthesia with a caudal block, a tibial valgization osteotomy with elevation of the tibial plateau, a fibular subtraction osteotomy and a fasciotomy were performed. Postoperative course was negative with a compartment syndrome and dry gangrene. An amputation was performed with no specific follow-up. On the right side, the same procedure was performed 45 days after the first one, this time with an initial minimal correction of the varus with a bivalved cruro pedal cast for better monitoring, and local care and we used to carry out a secondary valgization by external manipulations before obtaining the bone callus. The postoperative course was simple. Conclusion: Compartment syndrome remains a potential complication of surgical treatment of neglected forms of Blount's disease. Clinical diagnosis is difficult with signs that may be masked by locoregional anesthesia. Progressive correction, preventive fasciotomy, opening and monitoring of the cast may prevent its occurrence.

Background: Gastroschisis often has a fatal outcome in developing countries. Its outcome is taken as an indicator of the level of healthcare in a particular healthcare facility. The aim was to study the outcome of the management of gastroschisis and to identify the main challenges of its treatment in a country with limited resources. Methods: This is a prospective and descriptive study conducted over a period of 4 years (2016-2020). It included all the neonates admitted to the two referral hospitals of our country with the diagnosis of gastroschisis. Each of the university hospitals had a neonatology unit. Parenteral nutrition and assisted ventilation were not available. Results: Twenty patients were admitted to our hospitals with an annual frequency of five cases. The sex ratio (M:F) was 1.5. Only one of the 20 mothers (5%) of the patients had an antenatal diagnosis and was the only one born in a university hospital. The remaining (19-95%) were referred to a university hospital after their birth. None of the 20 patients had received parenteral nutrition. Surgically, seven babies (35%) had benefited from the placement of a silo with progressive reduction of the bowels. The mortality of gastroschisis was 100% and the average life span of the patients was 4.5 days [1-20 days]. Conclusion: It is important to act appropriately on the whole chain of management of gastroschisis from antenatal diagnosis to treatment so that this pathology is no longer fatal for newborns in countries with limited resources.

Congenital diaphragmatic hernia is a common cause of neonatal respiratory distress. The right or left diaphragmatic cupola hernia is most often involved. Rarely, a retro-costo-xiphoidian or Larrey or Morgagni hernia is diagnosed as part of respiratory distress. We present a case of congenital retro-costo-xiphoid diaphragmatic hernia in a midline situation, involving the sternal portion and extending to the diaphragmatic domes on each side. The discovery was made antenatal by obstetric ultrasound from 21 weeks. At birth, there was minor respiratory distress. The management consisted of a reduction and placement of a polypropylene plate in the natal post by abdominal approach.

Gastrointestinal perforations (GIP) in newborns are serious neonatal conditions that have significant morbidity and mortality, especially in resource constrained setups. This study was done to describe our experience of GIP in neonates and identify the factors leading to high mortality in our setup. We collected 18 cases with GIP in neonates. The average age was 5.7 days (range, 1-7 days). The sex ratio was 0.64. The average time to treatment was 3.3 days (range, 1-10 days). The etiology of GIP was perforated necrotizing enterocolitis (13 patients), spontaneous gastric perforation (2 patients), perforated ileal atresia (1 patient), ileal perforation complicating a strangulated inguinoscrotal hernia (1 patient), and peritonitis after colostomy (1 patient). Mortality was 77.8% (n=14), among which 9 newborns (64.3%) died preoperatively. Prematurity, management delay, and lack of a neonatal intensive care unit were the main poor prognostic factors. Mortality from GIP is still high in our context due to several factors, especially prematurity, management delay, and lack of a neonatal intensive care unit.

Le syndrome de la moelle attachée est un ensemble de symptômes neurologiques dû à une traction axiale constante ou intermittente du cône terminal de la moelle spinale, fixé en position caudale anormale. Il s'agit d'une lésion congénitale rare dont les symptômes peuvent s'exprimer qu'à l'âge adulte. Nous rapportons un cas clinique chez un garçon de 10 ans découvert à la suite d'une incontinence vésicale et anale qui a été confirmé par une imagerie par résonnance magnétique lombo-sacrée. Il a bénéficié d'une libération neurochirurgicale du cône terminal par un abord postérieur. L'évolution a été marquée par une amélioration des troubles sphinctériens. Ce cas est suivi d'une revue de littérature sur le sujet. Ce cas met l'accent sur l'intérêt de l' imagerie par résonance magnétique (IRM) dans le diagnostic de cette affection.

Le diverticule de Meckel est l'anomalie congénitale la plus fréquente de l'intestin grêle. Bien qu'il s'agisse d'une anomalie courante dans la population générale, sa présence dans un sac herniaire, en particulier au niveau ombilical est une situation peu fréquente et constitue la hernie de Littré. Nous rapportons le cas d'un nourrisson de 6 mois de sexe féminin, admis pour une tuméfaction ombilicale douloureuse et irréductible. Le diagnostic de hernie ombilicale étranglée a été posé. En per opératoire, il était découvert dans le sac herniaire un diverticule de Meckel inflammatoire. On procéda à une résection cunéiforme du diverticule suivie de la fermeture de la brèche intestinale par une suture en surjet et de la réfection pariétale. Le diagnostic clinique de la hernie de Littré est difficile et l'attitude thérapeutique varie selon les équipes.

Background: Urological pathologies of children are dominated by congenital malformations of the kidneys and urinary tract. Their management is often surgical. The objective of this survey was to study etiological and therapeutic aspects of urological presentations in children. Patients and Methods: Data for aetiology, treatment, and results in children hospitalized at the Paediatric Surgery service of National Teaching Hospital (CNHU) in Cotonou were retrospectively analyzed from January 1999 to December 2008. Results: A total of 214 patients with complete data were evaluated. Urological pathologies represented 4.8% of the hospitalizations in paediatric surgery, with an incidence of 21 cases per year. The mean age was 4.9 ± 3.2 years (age 1 week to 14 years). The male to female ratio was 14:14. Cryptorchidism, hydrocele, nephroblastoma, the posterior urethral valves, ureteropelvic junction obstructions, post-circumcision haemorrhage and hypospadias were the most frequent pathologies. Congenital urological malformations represented 81.3%, followed neoplastic pathologies (7.9%), traumatic pathologies (6.1%) and others (4.7%). The disorders of male genitalia were more frequent and constituted 68.2% of the cases. The anomalies of the urinary tract were 30.8% and intersex disorders were 0.9%. The average age of the children urological pathologies at the time of consultation was 8.85 ± 4.6 years. The treatment was often surgical with a mortality of 2.8%.

INTRODUCTION: Le mobilier scolaire et la posture assise en classe sont souvent impliqués dans l'apparition des douleurs rachidiennes, influant de fait sur la qualité des tâches réalisées par les apprenants. Aucune étude n'a encore vérifié le degré d'adéquation entre les caractéristiques du mobilier et celles des écoliers au Bénin. L'objectif de cette étude transversale est donc de déterminer la relation entre les dimensions des table-bancs utilisées en classe et les mesures anthropométriques des écoliers au Bénin. METHODS: Elle a été réalisée avec un échantillon probabiliste de 678 écoliers, âgés de 4 à 17 ans. Les mesures anthropométriques des écoliers et les mensurations relatives aux longueurs, largeurs et hauteurs des table-bancs ont été mesurées, puis intégrées aux équations proposées dans la littérature. Les pourcentages des valeurs situées hors des limitesacceptables, dérivées de l'application des équations ont été calculés. RESULTS: La largeur et la hauteur des table-bancs utilisées par les écoliers étaient plus élevées (p = 0,05) que les valeurs de référence recommandées par les structures officielles de contrôle et de production des mobiliers scolaires au Bénin. Quel que soit le sexe, il y avait une inadéquation entre la largeur du banc et la longueur fesse-poplité, puis entre la hauteur de la table et la distance coude-bancdes écoliers. CONCLUSION: Les résultats suggèrent de prendre en compte l'évolution des mesures anthropométriques des écoliers dans la confection des table-bancs, afin de promouvoir de bonnes postures assises en classe et de réduire le risque de troubles du rachis.