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Background Esophageal perforation is a rare surgical pathology in children. Thoracic esophageal perforation is more severe than cervical esophageal perforation. Iatrogenic cause, mainly by endoscopy, is the most common in esophageal perforation. However, perforation induced by “Magill forceps” is exceptional. Case presentation A systematic physical examination revealed pyrexia severe respiratory distress and right-sided pleural effusion. We report the success of non-operative treatment applied to thoracic esophageal perforation due to Magill forceps in a 24-month-old male infant. The immediate and short-term outcomes were excellent. Conclusions Non-operative treatment is possible in iatrogenic perforation of thoracic esophageal in infants. This treatment delivers excellent outcome in carefully selected patients.

L´agénésie sternale comme l´ectopia cordis sont des malformations congénitales extrêmement rares. Nous rapportons l´unique cas pris en charge dans un service de chirurgie pédiatrique au Bénin. Il s´agissait d´une fillette de 3 ans ayant présenté depuis sa naissance une agénésie sternale avec ectopia cordis. Elle avait bénéficié initialement d´une cicatrisation dirigée puis secondairement d´une thoracoplastie avec succès. Les résultats à long terme sont bons. Elle est aujourd´hui âgée de 13 ans, scolarisée et présente un état clinique satisfaisant. Il s´agit d´un des rares cas rapportés dans la littérature et maintenu en vie par une gestion thérapeutique optimale dans un contexte ouest africain.

Fetus in fetus (FIF) is an extremely rare congenital condition characterized by the parasitic development of a malformed fetal twin within a normal second twin’s body. The localization is mostly abdominal in the retroperitoneum. Thoracic localization is extremely rare. In this clinical case, a 5 month old female infant weighing 5 kg presented with a chest mass causing respiratory distress. We realized a chest CT-Scan; the latter revealed a heterogeneous mass, completely occupying the left hemithorax. Imaging studies confirmed the presence of the fetus in fetus occupying the entire left hemithorax and mediastinum, pushing the heart to the right. A complete resection of the mass could be performed under general anesthesia and orotracheal intubation (GA + OTI). The monitoring involved ECG, SpO2, NIBP, PR, T°, and Capnometry. The ventilation was first mechanical and secondarily manual. The patient did not receive unipulmonary ventilation nor central IV line. Postoperative period marked by volume overload, anemia, cardiac arrest, with successful resuscitation. Histopathology studies and imaging confirmed the diagnosis. On D9, she was discharged from pediatric critical care and from hospital on day ten postoperative. She presented in good clinical condition after a 3-month follow-up. We report this case in order to show how we took care of this FIF case in the precarious conditions.