فهرست مطالب mohamed jallouli

Over the past two decades, laparoscopy has advanced and multiple techniques for inguinal hernia repair have been established. Laparoscopic-assisted percutaneous extraperitoneal closure (LAPEC) for inguinal hernia repair in children, is one of the most simple and reliable methods. The present study aimed to assess the safety and feasibility of the LAPEC of inguinal hernia in children.
From January 2014 to January 2016, 21 conventional LAPEC procedures were performed prospectively at our center (Group 1). Over this period, 21 patients of the same age and the same gender had open inguinal herniorrhaphies (Group2). The choice of whether to perform a LAPEC procedure was made according to the surgeon preference. All operations were performed by the same surgeon. No significant differences were found between the 2 groups in terms of sex ratio, mean age, and operating time (p=0.19; student test). There were no operative complications in group 1. Two patients (9.5%) in group 2 presented inguinal hernia recurrence.
Despite a relatively high recurrence rate, LAPEC may be a practical alternative to conventional open hernioraphy. Comparative studies must be conduced to test advantages and disadvantages of this procedure in comparison with standard open herniorrhaphy and conventional laparoscopic repair techniques in a more extensive trial.

Enterobius vermicularis (EV) is the most common helminthic infection in the world. This small parasite is predominant in the pediatric population. The presence of EV in the appendix can cause or mimick appendicitis. The aim of our study was to compare patients with EV infection and those without EV infection, and to identify predictive factors that may help the diagnosis of EV infection in patients presenting with right iliac fossa pain and avoid negative appendectomy.
A retrospective analysis of all the appendices removed between January 2012 and December 2016 was conducted at the department of pediatric surgery, Hedi Chaker Hospital, Sfax, Tunisia. According to the final histopathological diagnosis, patients with EV infection were compared to those without EV infection. Data including age, sex, white blood cell (WBC) count, neutrophil count, eosinophil count, C-reactive protein, and ultrasound results for both groups were analyzed and compared. The study protocol was approved by the local hospital ethics committee. Statistical analysis was performed using IBM SPSS, version 20. Descriptive analysis in the form of mean and standard deviation was performed on demographic information. Differences between groups were assessed using the student t-test for continuous variables and the χ2 test and Fisher exact test where appropriate for categorical variables.
In total, 540 pediatric appendectomies were performed. Overall, 63.5% of patients were male and 36.5% were female. Mean age was 9.28 ± 2.77 years. 22.2% of procedures were completed laparoscopically, 76.5% were open and 1.3% were converted. The negative appendectomy rate was 11.1%. EV was present in 9.8% of cases. Comparison of clinical, biological, and ultrasound findings between two groups of patients with EV (EV) and those without EV (EV-) shows a statistical significance for pruritus ani (P EV was seen in 9.8% of pediatric appendectomies in our study. Pruritus ani, normal WBC count, normal neutrophil count, and normal CRP level at presentation could predict EV infection in children who present with right iliac fossa pain.

Splenosis is a rare condition defined as a heterotopic auto-transplantation of splenic tissue, typically after blunt abdominal trauma. It can occur anywhere in the abdominal cavity, or even the chest. Splenosis found in clinical practice is relatively rare because most patients are asymptomatic. We report a rare case of abdominal splenosis in a 7-year-old boy, 3 years after an abdominal blunt trauma.

The clinical presentation of appendicitis in the newborn is nonspecific. The diagnosis was always made after surgical exploration for acute abdominal findings mimicking necrotizing enterocolitis. We report the case of acute appendicitis in a newborn diagnosed intraoperatively after neonatal occlusion symptoms.

Ovarian masses requiring surgical intervention are uncommon in the pediatric population. The aim of this study was to report results of a multicentric Tunisian study concerning the clinical practice and the management of pediatric ovarian masses and to identify the factors that are associated with ovarian preservation.
Between January 2000 and December 2015, 98 pediatric patients ( Ninety-eight patients were included in this study. The mean age of the patients at time of surgery was 8.46±4.87 years. Sixty-three ovarian masses (64.3%) were non- neoplastic lesions, 24 (24.5%) were benign tumors, and 11 (11.2%) were malignant neoplasms. Conservative surgery (ovarian preserving surgery) was successfully performed in 72.4% of the benign lesions whereas only three patients (27.3%) with malignant tumors underwent ovary-sparing tumor resection (p In the present study, the risk factors for oophorectomy were a malignant pathology and large tumor size. In accordance with the Gynecologic Cancer Intergroup consensus, it is recommended that surgical management of ovarian masses in children should be based on ovarian preserving surgery.