Place of Laparoscopy in Peritoneal Tuberculosis.

Peritoneal tuberculosis (PT) is a rare form of extrapulmonary tuberculosis in children. The diagnosis is difficult because of its clinical polymorphism. Laparoscopy is the gold standard to make the diagnosis by exploring and performing peritoneal biopsies.

Primary hydatid cyst of the small intestine masquerading as intestinal duplication in a child.

Hydatid disease or hydatidosis is a worldwide zoonosis disease caused by the tapeworm of and still widely endemic in Tunisia especially in rural areas where the sheep-dog cycle is dominant. It is an important public health problem in the pediatric age group causing significant morbidity and mortality. We report a case of primary hydatid cyst of the small intestine in a child and we want to highlight the difficulty that we meet in the diagnosis despite the contribution of imaging.

[Clinical and biological study of the 31 cases of gallstones].

This study reports the clinical and biological signs, as well as the morphological aspect and the chemical composition of the calculus during the biliary stones. The study population consisted of 31 patients with an average age of 49 years (30 women and one man) with biliary lithiasis and who had cholecystectomy. Hepatic colic and epigastralgia were the most evocative clinical signs.

Alimentary tract duplications in children: report of 16 years' experience.

Background: Alimentary tract duplications (ATDs) are a rare condition in children, characterised by a large pathogenic, clinical, and histological polymorphism. Surgical observation and pathologic evaluation of the resected specimens are the only way to confirm the diagnosis. In this study, we want to analyse the anatomical, clinical and therapeutic aspects of this entity.

Duodenal adenocarcinoma in a 10-year-old boy.

Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours.

Peptic oesophageal stricture in children: management problems.

Background: Peptic oesophageal stricture (PES) is a serious complication of gastroesophageal reflux disease (GERD) in childhood. The treatment of PES is still controversial, ranging from simple oesophageal dilations to resection/anastomosis of the stenotic portion of the oesophagus. In this study, we want to share our experience with 11 children with GERD and PES.

Ureterocele containing a stone in a duplex system.

The formation of calcified stone in the ureterocele, a frequent event in adults, is very uncommon in a pediatric age. We present a case of a ureterocele containing a calcified stone in an 8-year-old girl. The diagnosis was made with radiological investigations (intravenous pyelogram, ultrasonography and, eventually, voiding cystourethrogram).

[Congenital pulmonary malformations: clinical, radiological and treatment features].

Background: Congenital broncho-pulmonary malformations (CBM) are rare, essentially presented by congenital lobar emphysema, bronchogenic cysts, pulmonary sequestrations and cystic adenomatoid malformations. The diagnosis can be in prenatal. In postnatal, symptoms are variable.

[Primary psoas abscesses of the psoas muscle in children].

Background: Primary psoas abscesses of the psoas muscle are relatively rare in childhood and can determine problems of diagnosis and therapeutic assumption.

Aim: To demonstrate that ultrasonography is an excellent means in diagnosis and treatment of psoas abscess in children limiting the use of CT more costly and radiant and the surgery that is decaying.

Methods: Over a 15 years period (January 1995-december 2009), 16 children with psoas abscess were studied retrospectively.

Primary hyperoxaluria type 1 in Tunisian children.

To determine the clinical, biological, and radiological futures of primary hyper-oxaluria type 1 in Tunisian children, we retrospectively studied 44 children with primary hyper-oxaluria type 1 who were treated in our center from 1995 to 2009. The diagnosis was established by quantitative urinary oxalate excretion. In patients with renal impairment, the diagnosis was made by infrared spectroscopy of stones or kidney biopsies.

Primary hyperoxaluria type 1 in Tunisian children.

Background: Primary hyperoxaliuria type 1 is an autosomal recessive disorder characterized by increasing urinary excretion of calcium oxalate, recurrent urolithiasis, nephrocalcinosis, and accumulation of insoluble oxalate throughout the body. This inborn error of metabolism appears to be a common cause of end stage renal disease in Tunisia.

Aims: To review the clinical, biological and radiological futures of primary hyperoxaluria type 1 and to correlate these aspects with the development of end-stage renal disease.

[Uropathies and nephropathies of Bardet-Biedl syndrome in children].

Background: The Bardet-Biedl syndrome is an autosomal recessive disease, characterised by obesity, retinal degeneration, hypogenitalism in men, polydactylism and an often moderate mental retardation. With these cardinal features, others clinical findings (secondary features) including diabetes, congenital heart defects, hypertension or syndactyly can be seen. Renal involvement is almost constant, but varies from a moderate impairment of the tubular functions to chronic renal failure caused by malformative uropathy or glomerulopathy.

Reversible nephrotic syndrome secondary to pulmonary hydatid disease.

Most patients with pulmonary hydatidosis are children. The disease may be asymptomatic or revealed by unusual events such as a glomerulopathy. An 8-year-old boy from a rural part of Tunisia presented with generalised oedema and macroscopic haematuria.

[Urinary tract infections in children following renal transplantation: a single-center experience].

Background: Urinary tract infection (UTI) is the most common complication after kidney transplantation and represents a potential life-threatening risk for the immunocompromised child.

Aim: The aim of this report is to determinate incidence, risk factors, microbiologic features and evaluate the impact of this complication on graft outcome and patient mortality.

Methods: We performed a retrospective cohort study reviewing the medical records of 17 children from 38 who received a renal transplant in our center between January 1992 and june 2008 and who present an urinary tract infection.

[Posterior uretral valves. About a series of 44 cases].

Objective: To explore the physical symptoms and radiological findings for the diagnosis of posterior urethral valves (PUV), to point of the therapeutic snags depending on gravity and delay of lesions.

Methods: We reviewed the records of 44 patients with PUV. Mean age: 2 years 1/2 (range 1 day-13 years).

Compound heterozygosity of novel missense mutations in the gamma-glutamyl-carboxylase gene causes hereditary combined vitamin K-dependent coagulation factor deficiency.

Hereditary combined vitamin K-dependent (VKD) coagulation factor deficiency is an autosomal recessive bleeding disorder associated with defects in either the gamma-carboxylase, which carboxylates VKD proteins to render them active, or the vitamin K epoxide reductase (VKORC1), which supplies the reduced vitamin K cofactor required for carboxylation. Such deficiencies are rare, and we report the fourth case resulting from mutations in the carboxylase gene, identified in a Tunisian girl who exhibited impaired function in hemostatic VKD factors that was not restored by vitamin K administration. Sequence analysis of the proposita did not identify any mutations in the VKORC1 gene but, remarkably, revealed 3 heterozygous mutations in the carboxylase gene that caused the substitutions Asp31Asn, Trp157Arg, and Thr591Lys.

[Angiomatoid fibrous histiocytoma: rare tumor of intermediate malignancy].

Angiomatoid fibrous histiocytoma is a rare tumour affecting young adults. Unlike conventional malignant fibrous histiocytoma, its extension is only local thus giving a good prognosis. We report the cases of a 9 year-old girl and a 16 year-old boy presenting respectively, with an axillary tumour 5 cm of diameter and a paravertebral subcutaneous tumour 1.