[A case study of post-traumatic common bile duct injury: an unusual lesion]. / Plaie isolée du cholédoque post traumatique, lésion inhabituelle: à propos d'un cas.

Traumatic injury of the common bile duct is extremely rare, especially when it is isolated. It usually occurs after laparoscopic biliary tract surgery. This lesion is often associated with one or multiple lesions of the neighborhood organs. We report a case of isolated injury of the common bile duct following abdominal trauma in a 5-year old child treated in our Department at the Mother-Child Hospital in Nouakchott. Radiological exploration didn't provide a conclusive diagnosis. Exploratory laparoscopy was performed because surgery had revealed diffuse biliary peritonitis secondary to a lesion at the bottom of the common bile duct. Emergency treatment was based on lavage with external biliary drainage followed, after a month, by bilio-digestive anastomosis. Life-threatening complication of common bile duct injuries is biliary peritonitis. In the literature, early postoperative morbidity is 20-30% while mortality rate is 0-2%. Isolated traumatic injury of the common bile duct in children is a lesion whose clinical course and therapy should be known in order to decrease morbi-mortality. Treatment is based on a multidisciplinary approach involving the pediatric surgeon, the radiologist and the resuscitating anaesthesiologist.

[Congenital mega urethra complicated by stones: about a case]. / Méga-urètre congénital compliqué de calculs: à propos d'un cas.

Congenital mega-urethra is a rare malformation causing micturition disturbance sometimes associated with upper urinary tract impairment. Despite the frequent association with other urinary and non-urinary abnormalities in children, stone-related complication has been reported only once in the literature. We report a case of congenital mega urethra complicated by stasis and stone formation in a 3 year old child successfully treated in the Department of Paediatric Surgery at the Mother-Child Hospital in Nouakchott. This study highlights the epidemiological clinical and therapeutic features of this association between congenital mega-urethra and urinary stones.

[Clubfoot in adult patients treated with tibiocalcaneal arthrodesis: about two cases (3 feet)]. / Pied varus équin de l'adulte traité par arthrodèse tibiocalcanéenne: à propos de deux cas (3 pieds).

Inveterate clubfoot (inveterate talipes equinovarus, ITEV) is a vicious attitude of the foot which doesn't rest on the floor through its normal base of support but weight is thrown to the outer side of the foot and to the foot point. When this vicious attitude persists a long time, it results in severe osteoarticular deformities in adults. Fixed ITEV is a good indication for tibiocalcaneal arthrodesis. In the majority of cases this provides painless and stable plantigrade foot. This study aims to assess the clinical and radiological outcomes of astragalectomy with tibiocalcaneal fusion. This case series involves 2 adult patients undergoing tibiocalcaneal arthrodesis due to severe and annoying equinovarus rearfoot deformity. Outcome was satisfactory with painless and stable plantigrade foot. At 90-day follow-up the patient with bilateral clubfoot had no inequality while the patient with unilateral clubfoot had a shortening of 2 cm compensated by right sole. In the majority of cases with severe and fixed deformities of the ankle and of the ITEV, tibiocalcaneal arthrodesis allows for painless and stable plantigrade foot, without vascular or cutaneous risk.