[Anorectal malformations: a 6-years review at the University Clinics of Lubumbashi]. / Malformations anorectales: revue de 6 ans aux Cliniques Universitaires de Lubumbashi.

Anorectal malformations (ARM) are developmental anomalies of the genitor anal elements, they represent a wide range of anomalies. An early diagnosis allows a better management as it reduces mortality associated with ARM, especially in developing countries. A prospective cross-sectional study has been carried, including patients from 0 to one year, admitted in our service for ARM. Twenty-four (24) patients have been considered. The median age was 2 days, the sex ratio 1/3 for female. Intestinal occlusions were the most frequent circumstances of diagnosis (50%), low ARMs were the most frequent, diagnosed in 11 patients (45.7%) of which 10 did not have any fistula. The most common associated malformation was intestinal atresia (3 patients). Anoplasty was done using abdominoperineal pull-through associated to anal dilatations in 13 patients (54.1%). Six patients died from unknown etiology and 6 were lost from the follow-up. Concerning the functional outcome, 12 of the 24 patients concerned by the study attended review and 3 of them presented signs of fecal incontinence, 9 of them were continents among whom 8 were diagnosed low ARM and one with high ARM. ARMs are encountered in our environment, nonetheless, the diagnosis is still made most of the time, during an intestinal occlusion. The mortality rate is still high and measures should be taken to allow long-term reviews, which will surely reduce the number of lost patients.

[Delayed management of anorectal malformation with rectouretrobulbar fistula: a case study]. / Malformation anorectale avec fistule recto-uretro-bulbaire prise en charge tardivement: à propos d'un cas.

Ano-rectale malformations (ARM) are a spectrum of heterogeneous abnormalities in the development of the rectal canal. Its incidence is usually low and it is a little higher in some developing countries. Boys are more affected than girls and rectobulbar fistula associated with atresia of the anal canal is the most frequent disorder among them. We report the case of a 10-months old infant of male sex, whose mother lived in a mining area and had been complaining of fecaluria since the birth of her child. Physical examination showed fingerprint 1 cm below the intersection of the median raphe and the bi-ischiatic line. Paraclinical examinations showed no other associated malformation. Patient's management was based on anorectoplasty through abdominal and perineal approach with lower abdominoperineal reconstruction. In the post-operative period, the patient received antibiotic treatment and intravenous analgesia as well as dilations, which continued after discharge 2 weeks after surgery. No complications were observed and outcome was favorable.

[Intestinal occlusion due to Meckel's diverticulum: a case study]. / Occlusion intestinale sur diverticule de Meckel: à propos d'un cas.

Meckel's diverticulum is a remnant of the omphalomesenteric channel. Diverticulum may result in perforation, inflammation an even in occlusion. We here report the case of a 30-year old man, hospitalized and treated for bowel obstruction at the university clinics of Lubumbashi. Intraoperative findings showed small bowel volvulus due to Meckel's diverticulum associated with intestinal necrosis. Patient's outcome was favorable after surgery.

[Spontaneous neonatal gastric perforation: about a case]. / Perforation gastrique néonatale spontanée: à propos d'un cas.

Spontaneous neonatal gastric perforation is rare. We report the case of a full term 4-day old newborn who required resuscitation at birth. On the second day of life he had extensive abdominal distension. Abdominal x-ray without preparation showed pneumoperitoneum. Laparotomy showed a perforation at the level of the small gastric curvature, measuring 1,5 cm in diameter, treated by simple surgical suture. The patient dead on the first post-operative day.

[Lymphangioma of the breast: about a case]. / Lymphangiome du sein: à propos d'un cas.

Lymphangioma is a benign lesion of the lymphatic vessels. It is a rare paediatric condition and it is exceptional among adults. It mainly occurs in the neck, armpit and abdomen. It rarely occurs in the breast. We report the case of a 18 year-old female patient seen in consultation for a mass in her left breast, which had evolved over the last 23 months. Management was based on surgery. The patient underwent complete tumor resection. Anatomopathological examination showed lymphangioma of the breast. Patient's evolution was favorable and the patient had a median 10 months follow-up with no recurrences identified.

[A rare case of suppurative mesenteric adenitis associated with intussusception in a child: a clinical case]. / Un cas rare d'adénite mésentérique suppurée associée à une invagination intestinale chez un enfant: cas Clinique.

Some cases of suppurative mesenteric adenitis have already been described in the literature but not associated with intussusception. We describe the case of a 3-year-old boy presenting to the department of surgery at the University Hospital of Lubumbashi with bowel obstruction. He was visited elsewhere, in the previous 12 days, for diarrhea, vomiting, fever, coma and treated for cerebral malaria and blackwater fever. Surgery revealed an ileal intussusception and a suppurative mesenteric adenitis whose pyoculture revealed the presence of Enterobacter cloacae, sensitive to norfloxacin. We performed desinvagination, sucked the pus out into a syringe and excized completely the site of suppurative adenitis. The evolution of patient was good. The clinician must know that the association between suppurative mesenteric adenitis and intussusceptions exists. The diagnosis is not easy and there is the risk of developing acute peritonitis due to its fistulation in the abdominal cavity.

[Neonatal obstruction associated with duodenal diaphragm: about a case]. / Occlusion néonatale par diaphragme duodénale: à propos d'un cas.

Duodenal diaphragm is one of the rare types of duodenal atresia described, causing intestinal obstruction in the neonatal period. It is caused by embryological factors. We report the case of a 17-day-old newborn hospitalized and treated for duodenal obstruction at the University clinics in Lubumbashi and whose intraoperative finding was duodenal diaphragm. Evolution was good after surgery.