[Gastroesophageal reflux and esophageal atresia]. / Reflux gastro-oesophagien et atrésie de l'oesophage.

In 210 surviving cases of oesophageal atresia treated by anastomosis, 34% presented a gastro-oesophageal reflux. Half of these patients needed surgical treatment of the reflux to prevent complications.

[Digestive stenosis after neonatal enterocolitis]. / Sténoses digestives après entérocolite néonatale.

Nineteen clinical cases of intestinal stricture due to neonatal necrotising enterocolitis and a review of available references are presented in this paper. Intestinal strictures are estimated to arise in 20% to 30% on neonatal enterocolitis. However the delay between the acute episode and the occurrence of the stenosis is variable; the depth and the extend, of the necrosis as well as inflammation and superinfection may contribute to the building up of the intestinal stricture. The histological aspects of the lesions are not unique, more over cases of spontaneously regressive stenosis are known. Question thus arising as to the most appropriate timing for surgery and the choice of surgical technics as a function of clinical aspects and of derivation of the disease are discussed in this paper.

Physiologic investigation of primary chronic constipation in children: comparison with the barium enema study.

Rectoanal manometry and a rectometrographic study were carried out on 31 control subjects and 63 constipated children. A single contrast barium enema was performed on all constipated children and on 20 children for whom this x-ray study (made for a reason other than constipation) was considered normal. This study allowed the determining of four manometric parameters (rectoanal inhibitory reflex threshold, rectorectal reflex threshold, conscious rectal sensitivity threshold, maximal anal resting closure pressure), of three rectometrographic parameters (maximal rectal tolerable pressure, maximal rectal tolerable volume, maximal rectal compliance), and of one radiologic parameter (rectopelvic ratio). It appeared that the barium enema study was not meaningful. The threshold of the inhibitory reflex and of the rectoanal reflex did not allow for a specific definition of abnormality in constipation. Anal closure pressure was higher in 38% of the constipated patients. The sensitivity threshold was significantly higher in the constipated group. In 79% of the patients an increase in rectal compliance was observed. Finally, in this series of constipated patients who did not have Hirschsprung's disease, organic abnormalities were demonstrated in 97% of the children.

[An unusual form of laparoschisis. Contribution to the embryological study of the umbilical region]. / Une forme particulière de laparoschisis. Contribution à l'étude embryologique de la région ombilicale.

The authors report one case of laparoschisis with special anatomic peculiarities: it was not defect on the abdominal wall, the intestinal evisceration go through a cordonnal defect who was distand of the normal abdominal wall and umbilicus. This observation re-opens the whole question of the abdominal wall deformities and all the embryologic theories are discussed.

[Cancer of the thyroid in children. 14 cases]. / Le cancer du corps thyroïde chez l'enfant. Quatorze observations.

Fourteen cases of thyroid gland carcinoma in children (mean age: 10 years) were reviewed. Scintigraphy showed a cold nodule in 10 and diffuse heterogeneous uptake indicating undifferentiated carcinoma in 3. The clinical risk of these tumours resides in alterations of the thyroid gland and in lymph node involvement. The favourable long-term prognosis in children justifies a conservative surgical treatment. Pulmonary metastases respond well to radioactive iodine. TSH secretion must be completely suppressed by continuous hormonal treatment. Anticancerous irradiation is fraught with potential dangers.

[Obstruction due to congenital tracheal and bronchial stenosis]. / Obstruction par sténoses trachéales et bronchiques congénitales.

Report of seven cases of congenital tracheal and bronchial stenosis in infants, successfully treated by endo-resection (2 cases), tracheoplasty (1 case) and resection with anastomosis (4 cases). The review of several cases of literature let to emphasize some points: the frequency of severe manifestations since neonatal period and during the first months leading to repeated hospitalisations with the treatening of broncho-pulmonar infections; the necessity of early diagnosis and complete anatomic evaluation of stenosis, which sometimes requires to be promptly treated in front of a sudden recurrence of respiratory distress; at last, improvements of reconstructive surgical technique, tracheoplasty for diffuse stenosis, endo-resection or resection with anastomosis for segmental lesions, which the results point out the possibilities and indications of that surgery in the infants.

[The place of direct reconstructive surgery in the treatment of tracheomalacia in children]. / Place de la chirurgie réparatrice directe dans le traitement de la trachéomalacie de l'enfant.

Surgical management is sometime necessary in severe case of congenital tracheomalacia, especially if airway obstruction persist after internal splinting with an endotracheal tube. Short segment tracheomalacia or bronchomalacia can be resected; but long segment of tracheal narrowing required un external airway splint using autologous tissues or prosthetic material. The initial results are encouraging.

[Primary tumors of the ribs in children and adolescents. Apropos of 15 cases]. / Les tumeurs primitives de côtes chez l'enfant et l'adolescent. A propos de 15 cas.

The authors relate 15 cases of bone tumors located on the ribs. In 5 cases the tumors were benign, 10 were malignant with 6 reticulosarcoma and 2 chondrosarcoma. This histologic type very rare in childhood has been confirmed after reexamination of the slides. Uncommon but not exceptional ribs tumors are characterized by few clinics signs 4 cases having been detected by systematic radiography whereas 2 correspond to malignant tumors. Biologics signs to, can be totally missing. Radiological analysis is misleading and rib origin of the tumor is sometime very difficult to state, usual sign of malignancy being often missing in spite of advanced lesions. Treatment, easy in benign lesion by sub or extraperiosteal bone resection, is difficult in malignant one demanding large resection of chest wall requiring delicat parietal reconstruction.

[Congenital cystic dilatation of the common bile duct and acute pancreatitis in children (author's transl)]. / Dilatation kystique congénitale du cholédoque et pancréatite aiguë chez l'enfant.

Two cases of cystic dilatation of the common bile duct associated which acute pancreatitis are presented. The correct diagnosis is not made often, because the triad of symptoms is incomplete or the recurrent abdominal pain is not attributed to pancreas, in absence of determination of serum amylase. Frequently, has been noted an anomalous formation of the pancreaticobilary ducts and always a reflux in the duct of Wirsung. Also, it is suggested, whatever the procedure of anastomosis may be, to close the inferior part of common bile duct.