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Biomedical subjects

M Ndoye

Publications and source records attributed to M Ndoye.

At least 19 recordsLinked to original sources

Strangulated umbilical hernias in children.

Umbilical hernia is a frequent pathology of the anterior abdominal wall in children. The hernia ring closes usually before 4 years, but a strangulation can occur. It is an exceptional complication according to the literature data. Since this complication is rare, we undertook a retrospective study of these strangulations in a 5-year period from January 1997 to December 2001 at Aristide Le Dantec hospital. We collected 41 cases that underwent emergency surgery operations for strangulated umbilical hernias, which represent about 15% of umbilical hernias operated during the same period. The age range was 8 months to 10 years and the average age was 14 months. All the children were examined within 24 h after the onset of the disease and the surgery was immediately performed. In five cases the bowel was necrosed and perforated and we performed a resection followed immediately by an anastomosis. In the follow up, two children presented wound infections and a hernia recurred in one child. There was no mortality. This study conducts us to question western reports which recommend conservative therapy for umbilical hernia in children.

Child↗

[Umbilical reconstruction in children. Prospective report of 77 cases].

Umbilical hernia is as frequent pathology in our country. The skin excess is a real problem for the surgeon because it is inesthetical. We report 77 cases of children with umbilical hernia who we operated between 1999 and 2000. Fifty-five of them have a umbilical plasty. For this, we used three surgical techniques: lateral left plasty, "horseshoe" plasty and umbilical graft. We classed our results into three groups: 40 good results, seven middle results and three bad results. Twenty-seven patients are lost. These three surgical techniques are a simple and safe solution to this problem of skin excess in the umbilical hernia.

Adolescent↗

[Evaluation of the management of femoral shaft fractures in children by flexible intramedullary nailing].

The purpose of this study was to evaluate the morphological and functional outcomes of femoral shaft fractures of the child using a centromedullary elastic nailing. We led a retrospective study including 22 children operated from January 1997 to December 2000 at the surgical emergency department of "Hôpital Aristide Le Dantec". The follow-up was made in the department of paediatric surgery. The patients included 16 boys and 6 girls presenting a total of 23 femoral shaft fractures. The main circumstance was traffic accident(15 cases). All the children underwent an ascending centromedullary elastic nailing controlled by a C-arm after a period of traction. The outcomes were appreciated after a period of 10 months. We observed: A union in all cases, four infections well managed by antibiotics, one vicious callus of 15 degrees, a mobility limitation of knee in two cases (45 degrees and 100 degrees), an inferior limb length inequality in one case, scabs in one patient who died at the 3rd month of a septicopyohemia. The functional evaluation of the outcomes (flexion, extension, limb length inequality) and morphological outcomes (axis, consolidation) showed 21 good results and one bad result. The centromedullary elastic nailing is a safe procedure owing to the low complication rates and the rapid consolidation allowing an early walk in femoral shaft fractures, compared with the orthopaedic treatment.

Accidents, Traffic↗

[Evaluation of the management of omphalocele at Dakar].

Omphalocele is a congenital malformation of the abdominal wall of children, characterized by an ombilical defect living the abdominal organ visible through a translucent amniotic membrana. The goals of this study were to describe the epidemiological, clinical and therapeutic characteristics at the University Teaching Hospital of Dakar. We conducted a retrospective study at the UniversityTeaching Hospital of Dakar from January 1997 to December 2002. Fifty cases of Omphalocele diagnosed at the Unit of Paediatric Surgery of the Department of General Surgery at Aristide Le Dantec Hospital, were included in this study. We described the epidemiological, clinical and therapeutic characteristics of omphalocele. Omphalocele is a condition diagnosed late in boys from poor sphere. The study revealed that weight from birth, omphalocele size, local state, and existance of associated malformation correlated with death rate. The treatment option was a spontaneous epidermisation as described by Grob in the absence of omphalocele rupture wich imposed a primary closure of abdominal wall. The overall death rate was 42%. The improvement of results will need an antenative diagnosis, paediatric reanimation unit wich will notably reduce death rate.

Birth Weight↗

[The ovarian tumors in children. A report of 12 cases].

The objectives emphasize the diagnosis and therapical problems concerning the child's ovary tumors for a better care in our conditions of work. We collected in a retrospective study 12 cases of ovarian tumors during 30 years. The middle age of the patients was of 11 years with extremes of 2 years and 15. The circumstances of discovery of the tumor were represented by order of frequency by an abdominal tumor (10 cases), an abdominal pain (8 cases) and of the compression signs digestive or urinary (6 cases). The medical imagery (echography, intravenous urography, Chest X-ray) permitted to evoke in the majority of the cases the ovarian origin of the mass. The surgical treatment consisted in an ovariectomy (5 times), an salpingo - ovariectomy (6 times) and a surgery of partial exeresis associated to a chemotherapy. The operative continuations were simple. A patient died of intercurrentes complications. The histological exam of the operative piece showed that it was about benign tumors. However a brought closer surveillance proves to be necessary had consideration to the two noted recidivisms.

Adolescent↗

[Trichobezoard revealed by intestinal perforation. A case report].

This paper presents a case of gastric and ileal trichobézoard on a 12 years-old girl. It was revealeds by ileal perforation which was confirmed by abdominal X-ray. Trichobézoard diagnosis was not performed before surgery despite two contradictory/abdominal ultrasound scans. The trichobézoard was removed surgicaly by ileotomy and gastrotomy. The patient had an satisfactory post-operative convalescence after a follow-up of six months.

Bezoars↗

[Ectopia testicular in child: about 3 cases].

The authors report 3 cases of testicular ectopia. Of these 3 cases, two proved tobe cases of penial ectopia whose diagnosis was mentionned before the intervention. One case proved tobe a case of tranverse testicular ectopia diagnosed as an inguino-scrotal hernia. Surgical exploration has always allowed to reach a correct diagnosis. In all three cases the testicle was of normal size and the cord long enough to lower the testicle between the skin an the dartos Surraco's procedure. The authors discuss the pathogenis of this affection, echography contribution in the diagnosis, and the therapeutics aspects.

Congenital Abnormalities↗

[Intussusception in children: about 20 cases].

The authors report on a retrospective study 20 cases of intussusception in senegalese children. The diagnosis is essentially clinical. In difficult cases plane abdominal X-rays, barium meal and echography are indispensable exams. In our context the diagnosis is most of the time late and it is due to the unknown nature of the affection and early consultation to the traditional practitionners. The lateness of the diagnosis leads to the lateness of the management. This explains the importance of intestinal necrosis noticed in our serie and the high mortality rate which is 10%. The authors suggest recommendations to ameliorate the prognosis of this ailment which is good elsewhere.

Child↗

[Fractures of the medial humeral epicondyle in child: preliminary study about 18 cases].

The aim of this work is to study the epidemiological, radiological, clinical views of fractures of the medial humeral epicondyle in child and mainly to appreciate the results of surgical treatment. For this, we looked at again in a retrospective study eighteen (18) files of children with fracture of the medial humeral epicondyle. The average age of children was eleven (11) and the male sex most represented (16 boys versus 2 girls). Medial humeral epicondyle's fracture often occurs by accident in playing (15 cases). Accurate diagnostic of the fracture of the medial humeral epicondyle was rarely formulated on the clinical plan. It's the radiography who shown the fracture of the medial humeral epicondyle and permitted to specially the type in accordance with Marion's and Faysse's classifications and also Lechevallier. It was always surgical and consisted on a open reduction and fixation by pins or a periostee's stich. With ten (10) months of background, we assessed our results either on morphological plan than the functional plan. 1/ On morphological plan: an hypertrophy of the medial humeral epicondyle is 3-fold mentioned. Others children have not presented a morphological animaly. 2/ On functional plan: Ten children had an elbow's mobility considered as normal after self reeducation at home. Six enjoyed physical therapy in a specialized department. Two of the children had an extension gap from 30 degrees to 35 degrees respectively. We obtained thirsteen (13) good results in general, three (3) means results and two (2) bad results. In conclusion, the fracture of medial humeral epicondyle occurs around ten (10) years old in boy victim in playing. Diagnostic is sometimes difficult. Surgical treatment gives good results. However, it can be the origin of sequellaes which can justify correct previous refunding.

Adolescent↗

[Burn-induced contraction cicatrix in children. Review of 79 cases].

Post-burn flexion contractures of the hands are evaluated in this retrospective study concerning eighty-six hands of seventy-nine children in the pediatric surgery unit of the University hospital of Dakar from 1971 to 1995. A peak frequency was found among 2-months-old males. Fire (flames or embers) is the most frequent etiology (49.5%). The initial treatment of these burns is more often inadequate because it is performed in dispensaries (small clinics) or at home and then causes severe sequelae. Among the methods of treatment, excision with graft gives the best results in short flexion contractures. Isolated Z plasty can be used successfully. Our follow-up is short (6 months) but the results are relatively good. Among the factors influencing the results, the seriousness of the lesions, the type of surgical treatment, immobilization and physiotherapy are the most significant.

Adolescent↗

[Cervical teratomas in the child (apropos of 8 cases)].

Eight cases of cervical teratomas in children are reported including 4 boys and 4 girls. Six patients presented within the first 10 days of life. The tumor was congenital in 7 cases. In 3 neonates it produced severe respiratory distress. Neural and chondral tissues were predominant but all three germ layers were represented. All patients were operated upon, with a 2/8 mortality. The main clinical and histopathological features of these rare tumors are reviewed. Early total surgical removal is the cornerstone of treatment.

Airway Obstruction↗

[Gastric volvulus in the infant. Clinical and radiological diagnosis].

The authors reported two cases of gastric volvulus in female and male babies respectively 5 and 3 months old. Patients presented functional symptoms as vomiting, regurgitation. Baryum meal X ray allows to make diagnosis in meso-axial and organoxial varieties. They showed the interest to evocate this diagnosis related to an infant vomiting's diagnosis and discussed about therapeutic modality.

Female↗

[Pelvic ring fractures in children. Apropos of 47 cases].

PURPOSE OF THE STUDY: The aim of this study was to report the different anatomical types, associated injuries, morbidity and mortality of pelvic ring disruption in child in Dakar traumatological centers. MATERIAL AND METHODS: [corrected] Forty seven children were admitted in two of three traumatology centers in Dakar between 1968 and 1992. This retrospective and intermittent study excluded tendon-bone avulsions and acetabular fractures. Twenty eight boys and nineteen girls presented a fracture with or without ring disruption according to Ducloyer and Filipe classification. In this first group, they make difference between an isolated or combined fracture and distinguished an anterior and a posterior one. Forty five children were treated by a non-operative methods. RESULTS: Forty three boys and girls sustained their injuries in a pedestrian-motor vehicle accidents and 4 among were struck by a truck. A massive fracture-dislocation with complete pelvic disruption was found in 70.3 per cent. Half of them (34.4 per cent) presented an anterior isolated anatomic type. In the other group the high energy forces caused major pelvic instability and also various associated soft-tissue injuries. The majority of complications were open pelvic fractures (21.1 per cent), genito-urinary (34.4 per cent), vascular (16.6 per cent), neurological and perineo-rectal injuries. Four children (8.4 per cent) died. At the last review others presented orthopaedic, genito-urinary, neurological or perineo-rectal sequelae. DISCUSSION: The frequency of pelvic fractures in child present a peak between 6 and 12 years old. These types of fractures are the results of a high energy injury in pedestrian motor vehicle accidents in Dakar suburbs. The anatomo-radiographic types had an interesting bimodal pattern: Among the benign types: a double fracture of the iliopubic ramus is dangerous for the bladder (1 case), and leads to a dysplastic acetabulum with time (1 case). Unstable fractures (70.3 per cent): some of them (23.3 per cent) present a complex dislocation of the pelvis. The present review focuses on double urethral injuries (2 cases), open pelvic fractures (10 cases) and mortal hemorrhagic shock (4 cases). The morbidity rate is high (38.4 per cent) caused by skeletal and soft-tissue sequelae and also management difficulties. CONCLUSION: Pelvic fracture in children requires early diagnosis and management. In our countries, morbidity and mortality of these injuries must decrease with the popularization of road safety, multidisciplinary management and improvement of working conditions.

Accidents, Traffic↗

[Hypertrophic pyloric stenosis of the infant. Apropos of 8 cases].

Eight cases of Infantile Hypertrophic Pyloric Stenosis collected in 10 years (1980-1989) in the Pediatric Surgery Unit of the Surgical Clinic of Dakar are reported. The rarity of this pathology among Blacks and a male predominance are noted. The clinical onset occurred after an average period of 3,25 weeks marked by food vomiting. At the start of the surgical management the age of patients was 6 weeks. X-ray examination following a barium meal showed no passage of contrast in 3 cases. However a narrowed and elongated pyloric canal was noted in 5 cases. Abdominal sonography was used in 3 cases and showed gastric stasis with a hypertrophy of pyloric muscle. A rammstedt pyloromyotomy was performed after a period of few hours to 13 days of resuscitation. A duodenal perforation complicated the operation twice and was subsequently repaired. In the post operative period, two patients died within 2-3 days. One of them had duodenal perforation. Six patients made a good recovery.

Female↗

[Ureteral-pelvic junction syndrome in the child. Apropos of 8 cases].

Eight cases of uretero-pelvic junction syndrom collected in the ten past years are reported. They are 4 males and 4 females ranged from 18 months to 15 years with a mean age of 4.5 years. This age too late is probably due to the misknowlege but also to the lack of information about the pathology. The main characteristics of this syndrome are analysed according to the literature. All patients except one underwent nephrectomy because the irreverible lesions of the kidney. The authors emphasize the importance of early diagnosis done by antenatal echography but it can be made with a good clinical examination followed by the results of I.V.P. It is necessary for them to make parents, general practitioners and paediatricians sensitive to that pathology to avoid such operating act whose consequence are very serious where as it is benign.

Adolescent↗

[Posterior urethral valves in Senegalese children. Fourteen cases].

Fourteen pediatric cases of posterior urethral valves in patients aged 6 months to 14 years (with four infants and ten older children) are reported. The main symptoms were vesical, including dysuria, acute urinary retention and dribbling. One patient presented with diarrhea, vomiting and dribbling. Urethral valves were looked for as part of the evaluation for urinary lithiasis in one patient, and in another urinary lithiasis developed following the diagnosis of urethral valves. In half the cases, onset of symptoms occurred within one year of birth. Urethrocystography allowed to evidence the valves and to evaluate repercussions on the bladder including hyperplasia (7 cases) and diverticula (2 cases). The intravenous urogram disclosed bilateral ureterohydronephrosis in eight cases. Pathogens recovered from the urine included Klebsiella (3 patients), Pseudomonas (4 patients), Proteus (one patient), and E. coli (one patient). Most patients were treated by catheter lamination under antimicrobial therapy. Two patients died from renal failure. Results were considered satisfactory in nine cases with follow-ups ranging from 1 month to 4 years. Three patients were lost to follow-up. Early diagnosis is essential and management should rely mainly on endoscopic resection which reduces the length of the hospital stay and the risk of infection.

Adolescent↗

Partial splenectomy for benign cystic lesions of the spleen.

Cystic lesions of the spleen are uncommon, about 600 cases being reported in the world literature. This report concerns three pediatric patients treated by partial splenectomy for benign cyst. In the world literature most of the cystic lesions of the spleen are treated by splenectomy and more recently by partial splenectomy. The infected lesions are treated by splenectomy or by incision and drainage only. Partial splenectomy has evident advantage over splenectomy. Although in the world literature we have not found a single case of infected splenic benign cyst treated by partial splenectomy, we believe that this procedure also has an advantage over drainage as the infected and necrotic part of the cyst is removed, thereby reducing morbidity and further possible complications.

Adolescent↗