Adenocarcinoma of the colon in children with LAL: A case report.

INTRODUCTION: Colorectal cancer in children and adolescents is an exceptional condition. Its clinical symptoms are non-specific, leading to delayed diagnosis and poor prognosis. CASE PRESENTATION: The present article reports the case of a 15-year-old child followed for acute lymphoblastic leukemia with a history of a grandfather operated on and followed for colorectal cancer. The child was admitted to our department with an occlusive syndrome. Endoscopy and radiological findings suggested the diagnosis of colon adenocarcinoma (AC). The therapeutic decision was a segmental colectomy covering the right colonic angle and colostomy followed by chemotherapy. DISCUSSION: Colorectal cancer remains an exceptional pathology in children. They often include abdominal pain, nausea, vomiting and rectal discharge. Endoscopy is the key diagnostic test, enabling both distal and proximal lesions to be detected. Primary CA of the colon is rare in children, and even rarer as a second malignancy. CONCLUSION: The clinical symptoms of colorectal adenocarcinoma in children are non-specific. These cancers are little-known in pediatrics, and are often diagnosed at an advanced stage.

When Tuberculosis Defies Appearances: The Tale of a Deceptive Abdominal Mass on Imaging.

Tuberculosis poses a significant public health challenge, especially in highly endemic countries. Rarely, it appears as an abdominal mass resembling a malignant abdominal tumor and can be misleading on imaging, so early diagnosis remains a challenge, and confirmation may require invasive examinations such as laparotomy. The most characteristic radiological appearance is that of a solid, hypervascular, or peripherally enhancing mass with a hypodense center. We present a case of retroperitoneal tuberculosis that simulated a teratoma on imaging. This case highlights the diagnosis difficulties even in endemic countries, despite advances in imaging techniques such as ultrasound and computed tomography.

A Rare Case of Trichobezoar Revealing Undiagnosed Celiac Disease.

Trichobezoar is a relatively rare condition in children, mainly observed in young girls with psychiatric disorders. While documented cases of trichobezoar associated with celiac disease exist, such occurrences remain uncommon in the literature. The association between the two can be explained either by behavioral disorders resulting from a deficiency in iron and folic acid or directly by celiac disease. Treatment is predominantly surgical, and psychological support plays a crucial role in preventing the likelihood of recurrence. We present an unusual case involving the discovery of gastric trichobezoar in a 15-year-old girl who had undiagnosed celiac disease. The condition manifested after she experienced abdominal pain and pallor.

Isolated Tracheal Oesophageal Congenital Fistula: A Case Report.

Esotracheal fistula is a rare malformation represented by a thin ascending channel between the esophagus and the posterior surface of the trachea. Diagnosis is sometimes difficult due to the atypical character of the symptomatology. Diagnosis is made by a gastro-duodenal oesophageal transit (TOGD) and the treatment is surgical. We report a case of isolated congenital esotracheal fistula collected in the pediatric visceral and urogenital surgery department at the Mohammed VI University Hospital Center in Oujda, Morocco, previously not discovered, and its surgical treatment as well as an updated literature review of this entity.

Recurrent non-bilious vomiting in a child: A case report of an uncommon diagnosis.

Annular pancreas (AP) is a congenital anomaly and a recognised cause of duodenal obstruction which can affect all age groups. It may manifest early in the neonatal period, but it may also have varied and often delayed symptoms. We report the case of AP in an 18-month-old girl with a long history of recurrent post-prandial non-bilious vomiting treated for a long time with the clinical diagnosis of gastroesophageal reflux. Upper gastrointestinal study was suggestive of partial duodenal obstruction and computed tomography revealed a complete ring of pancreatic parenchyma surrounding the second part of the duodenum. Diamond-shaped duodenoduodenostomy was achieved successfully and the post-operative period was uneventful. Although rare, AP must be kept in mind of any paediatric surgeon while confronted to symptoms of partial duodenal obstruction.

Blunt renal trauma in children: the experience of Mohammed VI University Hospital of Oujda in Morocco between 2015 and 2021.

Introduction: blunt renal traumas in children are rare and their management is not suited to a very clear consensus. We sought to report our experience in managing renal injuries in children presented after blunt abdominal trauma. Methods: data of children aged less than 16 years with blunt renal injuries between January 2015 and April 2021 were retrospectively reviewed. Demographic characteristics, clinical course, biological results, radiological findings, associated injuries, management and follow up of included patients were described. Renal lesions were classified according to the American Association for the Surgery of Trauma (AAST). Results: we included a total of 20 children, of whom 70% (n=14) were males. The mean of age was 8.50 ± 3.42 years. Falls in 65% (n=13) and motor-vehicle accidents in 35% (n=7) were the two main mechanisms of injuries. Abdominal pain was the most common symptom and macroscopic hematuria was assessed in 55% of patients (n=11). Low-grade injuries (I-III) represented 40% of the cases (n=8), 60% of injuries were AAST grade IV (n=12) and none with AAST grade V was diagnosed. Spleen injuries in 25% (n=5) as well as traumatic brain injuries in 25% (n=5) were the most identified concomitant injuries followed by liver lesions in 15% (n=3). 75% of renal injuries (n=15) were managed conservatively and all cases that required an operative management were with AAST grade IV. No nephrectomy in our series was performed and the follow up was favorable with a median of 3 years. Conclusion: our data suggest that the majority of children with blunt renal injuries can be managed conservatively regardless the grade of lesions as long as no hemodynamic instability or symptomatic urinoma are identified.

Uncommon Cause of Chronic Vomiting in Children.

Gastric outlet obstruction (GOO) is unusual and must be suspected in children with chronic vomiting and abnormal weight status. The treatment depends on etiology, and surgery is not always the first remedy. Diagnosis is easily confirmed by upper gastrointestinal fibroscopy.We report the case of an 11-year-old girl, who was presented with non-bilious emesis and weight loss. Abdominal computed tomography, ultrasound, and upper gastrointestinal fibroscopy showed dilated stomach with pyloric stenosis, which was confirmed by abdominal laparoscopic exploration and cured by Heineke-Mikulicz pyloroplasty. We also compare our study to previously reported cases.

Novel homozygous inactivating mutation in the luteinizing hormone receptor gene (LHCGR) associated with 46, XY DSD in a Moroccan family.

OBJECTIVES: We present the first cases of two male brothers with Leydig cell hypoplasia secondary to a novel mutation in the LHCGR gene that has never been described before. CASE PRESENTATION: We report the case of two brothers with Leydig cell hypoplasia (LCH) type II caused by novel homozygous inactivating mutation of the LHCGR gene, located in exon 10 in c 947 position. The two patients presented at 11 years 7 months and 1 year 6 months, respectively, with abnormal sexual development, micropenis and cryptorchidism. Genetic analysis revealed a homozygous deletion of approximately 4 bp encompassing exon 10 of the LHR gene in the two brothers indicating autosomal recessive inheritance. An hCG stimulation test induced testosterone secretion within the normal range. Subsequently, a treatment with enanthate of testosterone was started, with an increase in the length of the penis. CONCLUSIONS: Leydig cell hypoplasia is a rare form of disorder of sex development. We report the occurrence of a new mutation of the LHCGR gene in two Moroccan brothers in whom the clinical features and the molecular diagnosis were correlated.

Presacral ganglioneuroma in an 8-year-old child: case report, and literature review.

Ganglioneuromas are benign tumors of the sympathetic nervous system, rarely found in the presacral region. In this study, we report the case of presacral ganglioneuroma in an 8-year-old girl, who complained of abdominal pain with diarrhea and abdominal distension. Ultrasound showed a large hypoechoic pelvic mass complicated by right ureter hydronephrosis. the CT and MRI confirm the presence of a presacral tissue mass with heterogeneous enhancement after contrast injection. The child underwent a complete surgical resection, and the anatomopathological study returned in favor of a ganglioneuroma. The presacral ganglioneuroma is an extremely rare tumor in that only twenty cases have been reported in the literature. 3 of which were less than 8-years-old. Through our case, we will review the epidemiological, clinical, radiological and therapeutic characteristics of this type of tumor.

An Unusual Presentation of Hydatid Disease in a Child: A Case Report.

The subcutaneous localization of the hydatid cyst in the abdominal wall is rarely encountered particularly in the pediatric population and is sometimes difficult to diagnose preoperatively. Here, we report the case of a 6-year-old boy who presented with two isolated episodes of low abundant hemoptysis and in whom a mass on the right lumbar region already considered as a lipoma was studied. Laboratory and radiological examinations were requested and the parietal cyst was surgically managed. The macroscopic and the pathological examination confirmed the diagnosis of the hydatid disease and helped in identifying the nature of the thoracic lesion that disappeared spontaneously after two episodes of hydatid vomiting. Hydatid cyst should be considered as a diagnosis for any masses of the abdominal wall. Moreover, biopsy and partial resection of the mass must be avoided.

Mixed ovarian germ cell tumor in a child: A case report of a rare association.

INTRODUCTION AND IMPORTANCE: ovarian tumors and especially mixed ovarian germ cell tumors are rarely seen in the paediatric population. CASE PRESENTATION: we report the case of a 13-year-old girl which was successfully treated for a mixed ovarian germ cell tumor with a favorable evolution. CLINICAL DISCUSSION: the incidence of mixed ovarian germ cell tumors, clinical manifestations, histologic distribution and prognosis are predominentely distinct in children and adolescents as compared to adult population. The diagnosis should be suspected in young girls with chronic abdominal pain and palpable swelling of the lower abdomen. Conservative surgery is the first therapeutic procedure that consists of a total resection of the mass with preservation of the reproductive function. Circulating tumor markers have the potential in diagnosis, prognostic stratification and for follow-up. CONCLUSION: mixed ovarian germ cell tumors are uncommen in children. Their management must be multidisciplinary and conservative surgery by laparotomy represent the standard of care.

Perforated gastric ulcer: An unusual cause of peritonitis in children.

Perforated gastric ulcer is a particularly rare cause of peritonitis in children. Only few cases have been reported in the literature. It is a serious emergency condition which can be overlooked leading to life-threatening consequences. We report a case of a 12-year-old girl who presented with acute abdominal pain and signs of peritonitis. Surgical exploration found a gastric perforation on the anterior side of the antrum. Primary repair of the perforation was performed after thorough decontamination and taking biopsies from its edges. The post-operative period was uneventful. Helicobacter pylori test was negative. Histopathology result was suggestive of ulceration in the gastric wall and did not isolate H. pylori. Gastro-duodenal ulcer perforation should be considered in the differential diagnosis of children presenting with acute abdomen, especially when imaging showing pneumoperitoneum.

[Cyst of the broken common bile duct: literature review]. / Kyste du cholédoque rompu: revue de la littérature.

Cystic malformations of the bile ducts are rare congenital disorders, with an incidence of 1/2000000 live births. Complication including the angiocholitis, chronic pancreatitis, progressive biliary cirrhosis, portal hypertension or gallbladder lithiases can reveal severe disorder. Spontaneous perforation is one of the rare complications described for the first time in 1934 by Weber. We report the case of an 18-month old baby admitted with subocclusive syndrome with biliary peritonitis. Ultrasound was performed showing abdominal effusion with cystic formation communicating with the bile ducts associated with subcapsular effusion of the liver confirmed by a scanner. Treatment was based on peritoneal toilet with redon drain at the level of the perforation and subhepatic drain without cyst excision. The patient was re-admitted 6 months after this incident to be definitively treated.