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Transmesenteric hernias are extremely rare. A strangulated hernia through a mesenteric opening is a rare operative finding. Preoperative diagnosis still is difficult in spite of the imaging techniques currently available. The authors describe two cases of paediatric patients presenting with bowel obstruction resulting from a congenital mesenteric hernia. The first patient had a 3-cm wide congenital defect in the ileal mesentery through which the sigmoid colon had herniated. The second patient is a newborn infant who presented with symptoms and radiographic evidence of neonatal occlusion. At surgical exploration, a long segment of the small bowel had herniated in a defect in the ileal mesentery. A brief review of epidemiology and anatomy of transmesenteric hernias is included, along with a discussion of the difficulties in diagnosis and treatment of this condition.

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Summary: Introduction: Pancreatic pseudocyst is an uncommon disorder in children and the majority of reported cases are secondary to trauma. Aim: Treatment options range from medical management to different forms of drainage procedure. The aim of this study was to discuss therapeutic strategies. Observations: The authors report herein pancreatic pseudocyst in four children aged 7, 9, 12, and 13 years with non-resolving pancreatic pseudocyst over a 2-year period from January 2006 to July 2008. The etiology of pancreatic pseudocyst was abdominal trauma in two cases and acute pancreatitis in two cases. Ultrasound and computed tomography scans confirmed the diagnosis. Two patients had endoscopic drainage. There were no procedure-related complications, nor was there a recurrence of the cyst. In one case, the pancreatic pseudocyst resolved spontaneously. Conclusion: This report suggests that children with non-spontaneously resolving pancreatic pseudocyst can be treated successfully and safely with endoscopic drainage. Surgical treatment remains an important alternative in the therapeutic armamentarium of this affection. [ABSTRACT FROM AUTHOR]

We report a rare case of a thoracic lipoblastoma in a 7-month-old infant who presented with respiratory infection, dyspnea, and a right-sided chest wall swelling. Imaging revealed a predominantly fatty mass, and biopsy confirmed the diagnosis. A right thoracotomy was performed, resulting in subtotal excision due to the tumor's friability. Two months later, a recurrent tumor was detected and was successfully treated with total excision. This case emphasizes the importance of complete surgical resection and regular follow-up to prevent local recurrence of thoracic lipoblastoma., Competing Interests: Conflict of interestNo conflict of interest to declare., (© Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: Peritoneal dialysis (PD) is the method of choice for extra-renal replacement therapy (ERT) for children with end-stage renal disease (ESRD), because of its various advantages. However, it presents different infectious and non-infectious complications, causes of important morbidity and mortality., Aim: To determine the mechanical complications of PD in our center and to identify risk factors of their occurrence., Methods: We retrospectively collected the records of 99 patients who were treated with PD within the past eleven years in the department of pediatrics of the University Hospital Charles Nicolle of Tunis. Analysis examining possible risque factors were performed using parametric and non-parametric tests., Results: A total of 63 patients had mechanical complications with an incidence of peritoneal dialysis catheter revision of 1 procedure every 38 months. The causes were dominated by catheter migration (27.5%) and obstruction by fibrin or blood clotting (19.8%). A history of peritonitis (p=0.046) and the presence of comorbidity (p=0.008) were the two independent risk factors for catheter revision. Inguinal hernia was noted in six patients. No patient presented with a hydrothorax. Seven patients presented an episode of hemoperitoneum., Conclusion: Our results lead us to focus our efforts on preventing peritonitis and controlling morbidity. Prospective studies will enable us to confirm our results.

We report the case of a 10-year-old child who presented with a renitent lesion on the left abdominal wall. Clinical, radiological, and intraoperative findings concluded to a cutaneous fistulization of a hydatid cyst of the left lobe of the liver. The diagnosis was confirmed by histopathological examination. The child was successfully treated with acombination of medical and surgical management. Complicated hydatid disease should be considered in the differential diagnoses of patients presenting with cutaneous fistulization, particularly in regions where hydatid disease is endemic., Competing Interests: No conflict of interest to declare., (© 2023 The Authors.)

Introduction: Outcomes of orchidopexy for undescended testes may be disappointing. The aim of our study was to identify predictive factors of testicular atrophy and orchidopexy failure., Methods: It was a prospective monocentric study including all boys operated for undescended testes between January 2009 and December 2014. We have recorded for all boys: age at surgery, testes volume and position, epididymo-testicular fusion and spermatic vessels abnormalities, surgical technique, need for extensive cord dissection and tension-free orchidopexy., Results: We have included 688 boys operated for undescended testes. The whole number of undescended testes was 816. Predictive factors for postoperative testicular atrophy in univariate analysis were: testicular position in deep inguinal orifice, intra-abdominal testes, hypotrophic preoperative testes, epididymo-testicular fusion and spermatic vessels abnormalities, laparoscopic orchidopexy, complete testicular vessels skeletonization and under-tension orchidopexy. In multivariate analysis, peroperative testicular hypotrophy and testicular position in deep inguinal orifice have been identified as independent factors of postoperative atrophy. Predictive factors for testicular reascension in univariate analysis were: intra-abdominal testis position, scrotal orchidopexy and under-tension orchidopexy. In multivariate analysis, no independent factor was identified., Conclusion: Peroperative testicular hypotrophy and testicular position in deep inguinal orifice have been identified as independent factors of postoperative atrophy. There was no independent predictive factor for postoperative testicular reascension., Level of Proof: 2., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Foreign body ingestion is a frequent issue in paediatrician's practice. Foreign bodies often pass the gastro-intestinal tract spontaneously but can sometimes generate complications (1% of the cases). The migration of ingested foreign bodies is rare, but their spontaneous extrusion through the skin is even rarer and was previously described only in the neck. We report an unusual case of a spontaneous extrusion of an ingested foreign body through the skin of the lower abdomen. Observation: A 2 year-old boy, presented with a 2cm inflammatory swelling of the hypogastric region. Laboratory analysis showed hyperleukocytosis (16 7770 /mm3) and high C reactive protein level at 12mg/L. Ultrasonography and computed tomography allowed us to diagnose a parietal foreign body extruding through the skin and to eliminate associated complication (perforation, vascular fistula…). The foreign body was extracted by a surgical incision. This observation is very rare but it is also uncommon because of the nature of the ingested foreign body which was a wooden piece. Its ingestion was explained by a paediatric mental disorder.

We report a case of urethral cystic lymphangioma. Hematuria is the revealing symptom. Im our knowledge, is the third case described in literature.