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Background: Esophageal atresia (EA) is one of the most common congenital anatomical malformations that affect the alimentary tract and might be associated with the presence of tracheoesophageal fistula (TEF), and both occurs in about 1/2500 to 1/4000 live births. Depending on the anatomical description it is classifies into subtypes and there are many reported variants other than those subtypes like esophageal webs and congenital esophageal stenosis (CES). Case presentation: Here we report a rare variant of EA with proximal TEF which although presented clinically and radiologically as type C (EA) with (TEF) but at thoracotomy it is proved to be a different rare anatomical variant were the esophagus is found to be continuous down to the stomach with no gap resembling a type E (TEF) but there is an atretic segment just 1 cm above a (TEF).This is the first Case described in the literature. Conclusions: The knowledge and the anticipation of such types of variations remains the cornerstone for proper management and a high index of suspicion is needed to aid not to miss such rare anomalies.

Background: Intestinal volvulus (IV) can occur at various sites of the gastrointestinal tract. In Europe, IV in children is most frequently due to malrotation but in Asia Ascaris infestation is a common cause. This report reviews the experience with IV in children in Tunisia; analyzes the aetiologies as well as the clinical presentations and the benefits of the Ladd′s procedure in the treatment of the IV. Patients and Methods: The authors retrospectively reviewed the case records of all children with IV from January 2000 to December 2009 at the Tunis Children′s Hospital. Results: There were 22 boys and nine girls with an age range of one day to four years. Twenty-five (80%) patients presented during the neonatal period. The most common presentation was bilious vomiting and dehydration. The aetiology was identified in all patients: Anomalies in rotation (n=22), omphalo-mesenteric duct (n=3), internal hernia (n=3), cystic lymphangioma (n=2), caocal volvulus (n=1). The bowel resection rate for gangrene was 16%. All patients with malrotation had Ladd′s procedure performed. Five patients (19%) developed wound infections. One patient presented with adhesive small bowel obstruction. There were no recurrences following Ladd′s procedure for malrotation. Two neonates (6%) died from overwhelming infections. Intestinal volvulus in our environment differs in aetiology from other reports. The resection rates are not similar, however. Conclusion: Early diagnosis reduced the high morbidity and mortality in our study.

Background: To analyze the spectrum of testicular tumors in prepubertal children and the therapeutic resultants in an unselected population. Materials and Methods: Our hospital database was analyzed for testicular tumors from January 1995 to December 2010 concerning clinical presentation, treatment and therapeutic results. Results: Eight patients were operated on because of testicular tumors. In six cases (75%) the tumor was benign: benign teratoma (four cases), epidermoid cyst (one case) and immature teratoma (one case). Two patients (25%) had a malignant tumour: yolk-sac tumour (two cases). All this children underwent surgery. Radical inguinal orchidectomy was performed in six cases and conservative surgery was performed in two cases. One patient has received adjuvant chemotherapy. Followup was uneventfully three years after primary surgery. Conclusion: In prepubertal children, most testicular tumours are benign. If tumour markers were negative testis-preserving surgery can be proposed, complete excision of the tumour should be ascertained. In the case of testicular teratoma, the possibility of contralateral tumour should be considered in the follow-up. [ABSTRACT FROM AUTHOR]