Search

Introduction: Retroperitoneal cystic immature teratoma (RCIT) is a rare disease. Its diagnosis and management are challenging. Although, the prognosis is relatively favorable, the post-operative morbidity is not rare.We hereby report a case of RCIT in an infant and describe the difficulties in diagnosis and pre-, per- and postoperative treatment. Case presentation: Our patient was a 50-day-old female born at 35 weeks of gestation without prenatal diagnosis. She was admitted for abdominal distension noticed a few days earlier. Physical examination revealed a large abdominal mass located between the right hypochondrium and the left flank. Computerized tomography showed a 10*12*11 cm heterogeneous retroperitoneal mass with fat components and calcification responsible for the compression of the right kidney. Due to the respiratory distress caused by the tumor, we decided to operate the patient urgently prior to the anatomopathological examination result. The surgical procedure consisted in a large resection of the tumor which necessitated the removal of the right kidney. Postoperatively, our patient developed chylous ascites which was managed with total parenteral nutrition and continuous intravenous infusion of Octreotide. The follow up was uneventful with no recurrence so far. Conclusion: RCIT is a clinically rare disease. The mainstay treatment remains the complete surgical resection of the tumor which could be a complicated procedure. Chylous ascites constitute a rare postoperative complication which can be managed safely by parenteral nutrition and continuous intravenous infusion of Octreotide.

Gastric duplication cysts are uncommon congenital anomaly and its association with other malformations is rarely reported. Many theories exist for the development of these lesions. This case report describes coincidental detection of perforated gastric duplication clogged by the omentum associated with anorectal malformation and agenesis of the corpus callosum.

Introduction: The rectum villous tumour is an uncommon pathology in paediatrics, it represents 1% of all the children’s malignant tumours. Case Presentation: An eleven-year-old girl presented a rectal adenocarcinoma arising from a villous tumour. The aim of this study is to overview of the literature, asses the frequency of rectum villous tumours, specify the value of the clinical examination, of the radiologic findings in the assessment of the loco-regional extension of villous tumours and rectum adenocarcinoma and finally to discuss the treatment modalities. Conclusion: The rectum villous tumour symptomatology in children is not very specific. Therefore, a good knowledge of its clinical presentation and the predisposing pathological situations can improve the prognosis of this rare disease.

Introduction: Double aortic arch (DAA) is a rare congenital malformation. Strategies for diagnosis and treatment are different. Reports of thoracoscopic treatment of DAA are rare. We report a description of our diagnostic and therapeutic approach and evaluate outcomes. Material & Methods: We reviewed charts of infants with double aortic arch who were hospitalized in our department from 2008 to 2014. Age at symptom onset, clinical presentation, diagnostic modality, operative details and post operative outcomes were retrieved. Results: We identified 7 patients presenting at a median age of 11,8 months (range: 2 months-27 months) and median weight of 10kg. Respiratory symptoms were present in all cases. Difficulties in feedings were present in 3 cases. Chest radiography, oesophagogram and Computed Tomography (CT) with three-dimentional (3D) reconstructions were performed for all patients. One patient had laryngo tracheoscopy and 3 patients echocardiography. The dominant branch was the right one in all cases. Associated cardiac anomaly was found in 1 case. Operative approach was thoracotomy in 3 cases and thoracoscopic video assisted surgery (VATS) in 4 cases. Median operative time was 132 min. Only one patient required conversion. Median hospital stay was 4,1 days. Conclusion: Double aortic arch is a rare malformation which can cause persistent non specific respiratory symptoms in infants. The use of 3D-CT scan reconstruction facilitates diagnosis and the operative approach. Thoracoscopy and thoracotomy are effective procedures even for patients with low body weight. The operative time seems similar for both approaches. Thoracoscopy offers less post-operative analgesia requirement, shorter hospital stay and good cosmetic results.