EUS-BD for calibration of benign stenosis of the bile duct in patients with altered anatomy or inaccessible papilla.

In cases of inaccessible papilla, EUS-guided biliary drainage (EUS-BD) has been described as an alternative to calibrate benign biliary stenosis. However, few studies are available. This tw-center, retrospective study was designed to evaluate technical success and clinical success at 1 year.

[Surgical complications of intestinal ascariasis].

Ascaridiosis is a usually benign disease caused by the parasite Ascaris lumbricoides. Medical treatment is usually sufficient. Prevalence in tropical zones is high, sometimes leading to severe surgical complications requiring treatment and having a high morbidity and mortality.

[Treatment of the dislocated hip in older children].

Between 1976 and 1987, 85 cases of CDH occurring after walking age were followed in the department. Eighteen children aged 5 years or older were reviewed. In 11 children the dislocation was unilateral and in 7 bilateral; out of these 25 hips, 20 were high luxations and 5 occurred at a lower level.

[Neonatal treatment of congenital hip dislocation using an abduction pillow].

Numerous and various devices are being used in the treatment of congenital dislocation of the hip before the age of 1 year. We prefer the abduction pillow of Becker, owing to the simple design and use; there is also an economical factor: everybody can afford it. The abduction pillow can in no way be used for prevention.

[Caustic esophageal stenosis in children: report and prevention].

From 1976 to 1988, 22 caustic burns of the esophagus in children were treated by retrograde dilatations (21 cases), by surgical resection and end-to-end anastomosis (2 cases) and by myotomy of the residual stricture after 12 to 18 months retrograde dilatations (4 cases). 3 deaths are recorded which might have been avoided; the treatment was successful in 11 cases and failed in 4 cases which led to the replacement of the esophagus; dilatations are being continued in 4 cases. In view of these results, the choice of the treatment should not be restricted either to conservative treatment continued in spite of poor results or systematic surgical replacement of the esophagus at an early stage.

[Rectal prolapse in children. Review of 260 cases].

Rectal prolapse is mostly seen in constipated children after prolonged straining at stool. In Morocco, it will occur in children suffering from digestive parasitosis or hypotrophic children following episodes of acute diarrhea. In order to evaluate the respective role of these factors and consequently adapt the management of this condition, a prospective study of 260 cases was conducted between 1979 and 1986 bearing on etiologic factors on the one hand and with a view to assessing the efficacy of medical treatment and of sclerosing injections on the other hand.

[The treatment of Pott's disease in children. Apropos of 100 cases].

Between 1976 and 1984, 100 children aged 13 months to 15 years were treated for tuberculosis of the spine. 29 patients seen at an early stage and presenting limited lesions healed completely with mild or moderate residual kyphosis after orthopaedic treatment associating antibiotherapy and strict immobilization in plaster shells. 71 patients having extensive vertebral destruction or after failure of the orthopaedic treatment underwent surgery for excision and anterior spine fusion.

[Prevention of caustic stenoses of the esophagus with an intraesophageal mold].

The various methods for the management of full-thickness caustic burns of the esophagus, whether by early bougienage or by corticosteroïd treatment and/or use of an intraluminal catheter, have proved unsuccessful to this date. The use of an intraluminal splint kept in place during 3 weeks, as advocated by Reyes, slows down the growth of exuberant granulation tissue and prevents the formation of synechia and stricture during the healing process. Reyes's method was modified as follows: after a delay of 4 or 5 days, an esophagoscopy is performed along with a histologic study in order to ascertain the extent of the burn.

[Atlanto-axial dislocations in children].

A series of 9 cases of atlanto-axial dislocation observed between 1976 and 1982 illustrates the wide range of etiologic factors as well as their possible implication. The findings were as follows: 3 congenital anomalies of the odontoid process, 2 luxations resulting from trauma, 1 spine infection, 2 Grisel syndromes, 1 psoriatic rheumatism. Among them 3 children had incomplete tetraplegia.

[Esophagus ligation on murphy button in the management of bleeding esophageal varices in children (author's transl)].

Bleeding esophageal varices in 9 children (among whom 5 with extra-hepatic and 4 with intra-hepatic obstruction) were treated by ligation of the esophagus on an anastomotic button. Two patients died, one presenting mesenteric infarction following splenectomy, the other due to mismanagement of postoperative esophagus stenosis. In the patients with extra-hepatic obstruction, no recurrent bleeding was noted and the varices have completely disappeared on X-Ray and endoscopy with nearly 5 years follow-up, which proves the efficiency of the method.

[Treatment of hematologic disorders in children by splenic artery ligation (author's transl)].

Because of the risk of overwhelming sepsis following splenectomy, and since it is possible to reduce the splenic function while preserving the spleen, the treatment of various hematologic disorders by splenic artery ligation has been attempted in 11 children, among whom 3 under 5 years of age. 3 patients had thalassemia, 4 had hereditary spherocytosis and 4 others suffered from secondary hypersplenism. One patient died of overlooked splenic necrosis.

[New approach to the management of caustic esophageal stricture in children (author's transl)].

The management of long segment esophageal stenosis following chemical burns in children remains a difficult problem although various kinds of treatment have been proposed. The surgical treatment, consisting in replacing the injured segment, is mutilating and always performed at some risks. On the other hand dilatations must be carried on over several years in order to produce results and are not compatible with normal life.

[Treatment of esophageal varices using Murphy device (author's transl)].

Bleeding esophageal varices in 7 children (5 with extra-hepatic obstruction and 2 with intra-hepatic obstruction) were treated by ligation of the esophagus on a Murphy button. Two patients died, one presenting mesenteric infarction following splenectomy, the other due to mismanagement of post-operative esophagus stenosis. Among the 5 surviving patients, the fact that no recurrent bleeding was noted and the complete disappearance of varices on X ray and endoscopy with a 2-6/12 year follow up demonstrate the efficiency of this treatment.

[Livaditis procedure used for repair of esophageal atresia type I (author's transl)].

The livaditis procedure and the prognosis of post-operative leakage being now improved, it is tempting to perform an early repair of esophageal atresia type I. The authors report the successful treatment of esophageal atresia performed at the age of 7 weeks, despite a gap of 5 vertebrae between both segments and an anastomotic leak.

Intestinal calcium-binding protein 3 months after massive small bowel resection in the piglet.

Changes in intestinal calcium-binding protein and calcium binding activity were studied at resection and 3 months after 90% small bowel resection in piglets and one adult pig. A calcium-binding protein (MW congruent to 11.000) with calcium-dependent eletrophoretic mobility was partially purified from mucosal extract of proximal jejunum, mid-gut, and ileum.

[Vascular and infectious enteropathy in newborn infants. Reflections on pathogeny; clinical and therapeutic deductions. Apropos of 45 cases].

Necrotizing enterocolitis of the new-born has an anatomical definition: lesions discovered during surgery or on post-mortem examination. Progress in neanatal shock reveals facts already known in the adult and in experimental medicine: concept of preferential and circulatory by-pass. A considerable decrease in blood flow is seen in the latter during shock; this shock is sometimes not important.