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The Management of Neonatal Peritonitis in the Paediatric Surgery Department of the Donka National Hospital

Open Journal of Pediatrics 2024年第5期14卷 823-833页

作者： Mohamed Lamine Sadou Sacko Thierno Saidou Barry balla keita Mory Sangare Jacques Faya Millimono Moussa Conde Seydou keita Daniel Agbo-Panzo Pediatric Surgery Department at Conakry University Hospital Conakry Guinea Universit Gamal Abdel Nasser de Conakry Conakry Guinea General Surgery Department Ignace Deen University Hospital Conakry Guinea

Introduction: Neonatal peritonitis is a rare but serious condition requiring early diagnosis and management. The lack of antenatal diagnosis, the precariousness of neonatal intensive care, and the delay in diagnosis and treatment are the factors of poor prognosis. The objective of this study was to study the epidemiological, diagnostic and therapeutic aspects of neonatal peritonitis in order to improve its management in the pediatric surgery department of the CHU-Donka. Materials and Methods: This is a retrospective descriptive study of the records of patients treated for neonatal peritonitis from January 1, 2017 to December 31, 2022. Results: Results: We compiled 17 records of patients operated on for neonatal peritonitis, representing a frequency of 3.85% and an incidence of 2.83 cases/year. The mean age of our patients was 8.29 days, with extremes of D0 and D25. Males were more dominant, with a frequency of 71% and a sex ratio of 2.4. The average consultation time was 72 h, with extremes of 12 h and 144 h. Abdominal bloating was the main reason for consultation (100%). Fever and vomiting were frequent, at 70.59% and 82.35% respectively. PSA revealed pneumoperitoneum in 12 patients (70.59%). The colon was the most frequent site of perforation at 29.41%. ECUN was the main etiology with 35.29%. Ostomy was the main surgical procedure in 58.82% of cases, followed by suture excision in 29.41%. Postoperative follow-up was simple in 3 patients (17.65%) and complicated in 14 (82.35%). Sepsis was the main cause of death (47.59%). The mortality rate was 76.47%. Conclusion: Mortality from neonatal peritonitis remains high in developing countries. Early diagnosis, early surgical management, and the presence of well-equipped neonatal intensive care units with qualified staff are essential for an improvement in the prognosis of neonatal peritonitis.

关键词： Etiology Newborns Gastrointestinal Perforation

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Management of Acute Idiopthic Intestinal Invaginal in Infants at Conakry University Hospital

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Open Journal of Pediatrics 2024年第5期14卷 937-950页

作者： Thierno Saidou Barry Mohamed Lamine Sadou Sacko balla keita Mory Sangare Fanta Kourouma Moussa Conde Baldé Aissatou Bailo Seydou keita Daniel Agbo-Panzo Pediatric Surgery Department of the Conakry University Hospital Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea Pediatrics Department Albert Royer Childrens Hospital Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal General Surgery Department of the Ignace Deen University Hospital Conakry Guinea

Introduction: Acute intestinal intussusception (AII) has been known for a long time but its diagnosis sometimes remains difficult and its etiologies, particularly the idiopathic forms, poorly elucidated. The objective of this study was to describe the clinical and therapeutic aspects of acute intestinal intussusception in order to contribute to the improvement of the management of this condition in the pediatric surgery department of the Donka National Hospital. Materials and Methods: This is a retrospective descriptive study of patients taken in charge of acute idiopathic intestinal intussusception over a period of 7 years (January 2017 to December 31, 2023). Results: We collected 72 patients operated on for IIA, i.e. a hospital frequency of 1.1% and an incidence of 10.3 cases per year. The mean age was 16.58 months with extremes of 3 months and 28 months. The sex ratio was 12.5 in favor of the boy. The triad of ombredanne dominated the clinical picture and paroxysmal abdominal pain with period of calm represented the main reason for consultation (72 cases) i.e. 100%, followed by vomiting (62 cases) and rectal bleeding (50 cases). Ultrasound was performed in 56 patients visualizing the intussusception sausage in 54 patients or 75%. The most common anatomoclinical variety of intussusception was the ileo-caeco-colic form with 35 cases (or 38%) followed by the ileocolic form 24 cases (33%). The surgical procedure performed was a manual reduction in 54 patients or 75% and an anastomosis resection in 18 patients;the appendectomy of principle was done in 62.25%. The postoperative course was simple in 64 patients or 88.88%. The mortality rate was 6.94 %. Conclusion: AII is a common abdominal surgical emergency in infants. Recognition of the Ombredanne triad especially abdominal pain with a period of calm in children and infants in particular is an important element for vital prognosis. Early diagnosis and close interdisciplinary cooperation between pediatric, radiology an

关键词： Acute Idiopathic Intussusception Infant Intussusception Sausage Pediatric Surgery

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Solitary Osteogenic Exostosis of the Femur Revealed by Recurring Acute Distal Thigh Pain: About a Case

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Open Journal of Pediatrics 2024年第4期14卷 719-726页

作者： Thierno Saïdou Barry Mohamed Lamine Sadou Sacko balla keita Sory Sidimé Moussa Condé Daniel Agbo-Panzo Pediatric Surgery Department Donka National Hospital (HND) of the University Hospital of Conakry Gamal Abdel Nasser University of Conakry (UGANC) of Guinea Conakry Guinea Orthopedic and Trauma Surgery Department Donka National Hospital (HND) of the Conakry University Hospital Conakry Guinea

Introduction: Solitary exostoses are the most common benign tumors of the fertile metaphyses of the long bones of children. Their radiological diagnosis of metaphyseal bone growth must be confirmed on pathological examination. These tumors can remain asymptomatic for a long time and reveal themselves during a particularly vascular complication. The objective of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of these tumors. Patient and Observation: We report the case of a 15-year-old adolescent girl, with no particular pathological history, received in the pediatric surgery department of the Donka National Hospital (HND) of the Conakry University Hospital for recurrent acute painful swelling of the lower third of the left thigh in an afebrile context accompanied by lameness and stopping school for a few days (2 - 3 days). The symptoms appear to have evolved over the past 3 years and after physical activities. It regresses with rest, analgesics and non-steroidal anti-inflammatory drugs. The notion of trauma and sickle cell disease was not reported in the patient's clinical history. It is the persistence of the symptomatology which motivates the said consultation. On palpation, a small hard mass is noted at the expense of the internal metaphysis of the left distal femur. Deep palpation of this area causes a tingling sensation and during rapid mobilization of the knee. The remainder of the orthopedic examination was unremarkable. Standard x-ray of the femur shows a bony growth with a pointed tip from the distal metaphysis of the left femur. On surgical exploration, we noted a wedge-shaped exostosis oriented towards the vastus medialis muscle. Histological examination of the surgical specimen confirms osteogenic exostosis. There is no recurrence after 2 years. Conclusion: The distal femoral metaphysis is the most common location of solitary osteochondromas in children. Their definitive diagnosis requires the histology of

关键词： Osteogenic Exostosis Osteochondromas Fertile Long Bone Metaphyses Child

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Congenital Cervico-Mandibular Cystic Lymphangioma in Pediatric Surgical Setting in Guinea

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Open Journal of Pediatrics 2024年第1期14卷 164-173页

作者： Thierno Saïdou Barry Mohamed Lamine Sadou Sacko balla keita Aissatou Bailo Balde Mamadou Alpha Diallo Moussa Conde Ibrahima Kalil Dioubate Mory Sangare Salamata Sall Mariama Dalanda Diallo Daniel Agbo-Panzo Pediatric Surgery Department Donka National Hospital (HND) of Conakry University Hospital (Gamal Abdel Nasser University of Conakry (UGANC) of Guinea) Conakry Guinea Hadja Bilguissou BARRY Medical-Surgical Clinic (HBB) Conakry Guinea Albert Royer Children’s Service Cheikh Anta DIOP University (UCAD) Dakar Senegal Surgery Department of the Regional Hospital Center of Ziguinchor (CHRZ) Ziguinchor Senegal

Introduction: Cystic lymphangiomas are rare benign malformative tumors of the lymphatic system of obscure etiopathogenesis. The cervico-facial location remains the most common (75%). Although benign, these tumors remain potentially fatal, due to possible compression of the upper aero-digestive tract. The aim of this work is to study the epidemiological, diagnostic and therapeutic characteristics of cervico-mandibular congenital cystic lymphangiomas in the pediatric surgery department of the Donka National Hospital (HND) Conakry. Patients and methods: This is a retrospective and descriptive study of 13 files lasting 7 years from January 2015 to December 31, 2021. The files of children whose age is less than or equal to 15 years operated on cervical tumor with histological evidence of cystic lymphangioma were retained. The data were analyzed using SPSS statistical software 21 and anonymously. Results: The incidence of this study was 1.86 cases per year and a sex ratio of 0.62 in favor of girls. The average age was 8 months 19 days. In the antecedents, we only find poorly monitored pregnancies. The average size of the tumors was 11.85 cm. Cervical ultrasound and standard x-ray of the cervical mass were the only examinations performed. Total surgical excision of the cervical tumor was performed in all patients. The mass was polycystic on exploration. The histological examination of the surgical specimens was in favor of a cystic lymphangioma. The surgical consequences were simple in 11 patients (84.62%) and complicated by parietal suppuration in 2 cases (15.38%). There were no cases of recurrence after one year of follow-up. Conclusion: Cervico-mandibular cystic lymphangiomas are the most frequent locations of congenital lymphangiomas in children. Their severity is linked to the risk of compression of the aero-digestive tracts. Their diagnosis must be confirmed by the histology of the surgical specimen. Despite the therapeutic arsenal, excision of the cystic mass remain

关键词： Congenital Cystic Lymphangioma (LKC) Child Pediatric Surgery Guinea

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Solitary Osteogenic Exostosis of the Femur Revealed by Recurring Acute Distal Thigh Pain: About a Case

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Open Journal of Pediatrics（儿科学期刊） 2024年第4期 719页

作者： Thierno Saïdou Barry Mohamed Lamine Sadou Sacko balla keita Sory Sidimé Moussa Condé Daniel Agbo-Panzo

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Congenital Cervico-Mandibular Cystic Lymphangioma in Pediatric Surgical Setting in Guinea

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Open Journal of Pediatrics（儿科学期刊） 2024年第1期

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Successful Separation of Conjoined Twins at the Conakry University Hospital Center

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Open Journal of Pediatrics 2022年第3期12卷 514-521页

作者： Mamadou Alpha Touré balla keita balla Moussa Touré Naby Fofana Ibrahima Kalil Dioubaté Thiero Mamadou Aliou Touré Pediatric Surgery Department Donka National Hospital Conakry Guinea Pediatric Surgery Unit General Surgery Department Ignace Deen Hospital Conakry Guinea Institute of Nutrition and Health for Children Conakry Guinea

Introduction: The birth of conjoined twins is an event extremely rare that offers unique therapeutic challenges and circumstances. We must examine each situation with the many questions that arise and which sometimes require a long reflection. We report a case of separation of pygopages conjoined twins as well as a review of the literature. Patients and Observations: a pair of conjoined twins aged 11 days, weighing 3080 g between them, was referred to the neonatology department from the Faranah prefecture, 300 km from Conakry, for care. The mother, a 30-year-old housewife, multipara, eight gestures and nine parities, had not followed any prenatal consultation. The delivery took place at home in a village with the death of the mother immediately postpartum. The clinical and paraclinical investigation had concluded with the diagnosis of Siamese type pygopage. After multidisciplinary consultation, the surgical treatment by separation of the twins was carried out at the age of 50 days with success and preservation of the physiological functions. Conclusion: The birth of conjoined twins is extremely rare. Each pair of Siamese is different and the surgical strategy must be adapted according to the shared organs. The perfect multidisciplinary work of the medical staff has been the main contributor to our success.

关键词： Siamese Twins Pygopages Multidisciplinarity Separation Conakry Hospital and University Center

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Urinary Lithiasis Secondary to Urethral Duplication: A Case Report

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Open Journal of Urology 2023年第10期13卷 453-458页

作者： Mohamed Lamine Sadou Sacko balla keita Thierno Saidou Barry Mory Sangare Mamadou Madiou Barry Moussa Conde Seydou keita Daniel Agbo-Panzo Department of Pediatric Surgery CHU de Donka Conakry Guinea Gamal Abdel Nasser University Conakry Guinea General Surgery Department Ignace Deen University Hospital Conakry Guinea

Urethral duplication is a rare congenital anomaly, mainly involving boys, although cases in girls have been reported. The majority of duplications of the urethra are asymptomatic and the discovery of this malformation can be done at any age. Diagnosis and determination of its type are based on urethrocystography with mid-void images, which helps to guide the surgical approach. The treatment is not yet well codified and the therapeutic attitude varies from one author to another. We report a clinical observation of a urethral duplication with a calculus in a six-year-old boy who underwent a partial urethrectomy of the supernumerary urethra in whom a lithotomy and a urethrectomy were performed via a suspension approach. This observation illustrates the possibility of urinary stone formation after partial urethrectomy of the supernumerary urethra.

关键词： Urethra Duplication Calculus Child

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The Scrotoschisis about a Case in the Pediatric Surgery Department of the Donka National Hospital

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Open Journal of Pediatrics 2021年第2期11卷 238-242页

作者： balla keita Mamadou Alpha Touré Mamadou Madiou Barry Mohamed Lamine Sacko et Lamine Camara Pediatric Surgery Department of the Donka CHU National Hospital Conakry Guinea

Introduction: Scrotoschisis is a very rare congenital defect of the scrotum characterized by the exteriorization of one or two testes. We report a case of right scrotoschisis in a newborn as well as a review of the literature for an approach of probable etiology. Patient and Observation: A newborn baby of 8 hours of life, weighing 3200 g was referred to our department for a right scrotal defect with exteriorization of the testis associated with fluid swelling of the left bursa. The 18-year-old mother, primiparous and primigeste followed all the prenatal consultations with eutocic delivery. After clinical investigation the diagnosis of right scrotosisis and left hydrocele was retained. Surgical treatment was carried out by primary closure after orchidopexy and exploration of the contralateral bursa, the content of which was calcified meconium bathed in a yellowish liquid. The post-operative consequences were simple. Conclusion: Scrotoschisis is an extremely rare birth defect whose etiology is poorly understood. However, it could be the cause of meconium peritonitis secondary to a scarred fatal intestinal perforation.

关键词： Scrotoschisis Congenital Anomaly Etiology

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Pterygium Popliteal Syndrome Concerning a Case in the Pediatric Surgery Department of the Donka National Hospital (Conakry CHU)

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Open Journal of Pediatrics 2022年第1期12卷 162-169页

作者： balla keita Mamadou Alpha Toure Mohamed Lamie Sacko Mamadou Madiou Barry Mamadou Karamba Kaba Daniel Agbo-Panzo Pediatric Surgery Department CHU Donka Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea Plastic Surgery Department CHU Donka Conakry Guinea

Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1st Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.

关键词： Popliteal Pterygium Congenital Malformation Genetic Disease Pediatric Surgery Multidisciplinary Team

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