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High-voltage electrical burn injuries are rare emergencies in pediatric units and always associated with a poor prognosis. Recklessness, lack of knowledge about electric currents and the lack of safety around public electricity infrastructures are the three main factors contributing to the occurrence of high-voltage electrical accidents in children. Mortality is due to acute cardiac and renal complications, and trauma associated with falls. Secondary evolution is dominated by the risk of infection and the severity of functional sequelae. Early diagnosis and prompt treatment is needed to prevent these complications. Therapeutic management is based on early resuscitation and surgical management of tissue damage. We report three cases of high-voltage electrocution in children, with electro-thermal burns associated with severe head injury in one case, and myocardial damage and a compartment syndrome with severe functional sequelae in the other two. These three case reports are an opportunity to discuss literature data.

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Perthes syndrome, or traumatic asphyxia syndrome, is a rare clinical entity, associating cyanosis, cervicofacial petechiae and subconjunctival hemorrhage. It is usually secondary to chest trauma, but can occur in any situation of abrupt rise in intrathoracic pressure with closed glottis. In this paper, we present a case of Perthes syndrome that triggered an asthma attack for a child during surgery.

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Congenital anterolateral diaphragmatic hernia is rare, with few cases reported in the literature. This anomaly is usually associated with left pulmonary hypoplasia. Treatment is surgical and prognosis depends on the presence and severity of associated malformations. We report a case of an intraoperative discovery of this unusual type of diaphragmatic hernia in an infant.

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Ingestion of a foreign body is usually accidental in children. Respiratory symptoms, often favored by the persistence of the foreign body in the esophagus, can be revealing, but rarely respiratory distress as a method telling. We report a case of unrecognized esophageal foreign body revealed by respiratory distress.

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Renal failure is a rare complication of tetanus in children. It occurs following poorly controlled muscle spasms and rigidity. We describe a severe case of tetanus complicated with rhabdomyolysis and acute renal failure in a child.

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Deficiency of coagulation factor XIII is a rare anomaly. The risk of intracranial haemorrhage is particularly high at any age, either spontaneously or during minor trauma. We report a case of spontaneous intracerebral haemorrhage in a child carrying a known deficiency of factor XIII.

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The traumatic asphyxia or Perthes' syndrome is a condition characterized by a classic triad involving head and neck cyanosis, subconjonctival bleeding, and petechiae. The pathophysiology of traumatic asphyxia is different in children compared to adults, because of the greater elasticity of the thorax in children. The purpose of this paper is to describe through two cases of traumatic asphyxia in young children the characteristics of this disease in children.

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PURPOSE: The aim of this work is to present the clinical and therapeutic aspects of pin inhalation in the airways, as well as the benefit of rigid bronchoscopy for extraction in children. MATERIALS AND METHODS: Five hundred and twenty-four cases of inhaled foreign body are identified in the multipurpose pediatric intensive care unit in the children's hospital in Rabat between January 2005 and December 2010. Thirty-six (6.8%) of them are due to pin inhalation. A retrospective study was conducted to define the epidemiological characteristics, clinical treatment and outcome of pin inhalation in the airways. RESULTS: Thirty-six cases of pin inhalation are identified, all females. The age varies from 10 to 15 years. The consultation period is 2 days. Symptoms are dominated by coughing and stinging sensation. In 61.11% (22 cases), the pin is lodged in the right airways, in 22.22% (eight cases) in the left airways and in 5.5% (two cases) at the trachea. In 63.8% (23 cases), the pin is removed at the first attempt. We did not record any severe complications. No deaths recorded. CONCLUSION: Pin inhalation is a common occurrence in young girls. The extraction can be done safely by rigid bronchoscopy under general anesthesia. Particular attention should be paid to prevention and educational programs to reduce the incidence of pin inhalation.

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The hydatid disease is common and remains endemic in Morocco. The treatment relies mainly on surgery. This may be accompanied by rare but serious complications that can certainly be life-threatening. Allergic reactions can manifest as anaphylactic shock which is characterized by its brutal onset and its severity. We stress through the pediatric case reported the exceptional occurrence of anaphylactic shock during surgery and the need for its early recognition in order to establish effective treatment. Prevention relies mainly on surgical precautions taken to avoid seeding of the abdominal cavity.

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The snakebite is the most severe form of envenomation. The aim of this retrospective study was to describe the epidemiological, diagnostic, therapeutic and evolutionary snakebites in Children in paediatric intensive care unit of the children's hospital of Rabat. The criteria of severity were studied in four grades : grade 0 (traces of hooks at the bite, no swelling or local reaction), grade 1 (local oedema, absence of constitutional symptoms), grade 2 (swelling of regional member and/or moderate symptoms), grade 3 (extensive swelling up the trunk and/or severe symptoms). The number of patients included was 17 between January 2004 and December 2009. The male predominance (59%), bites by snakes (76%), bites during the afternoons (76%) and summer (53%), bites to the lower limb (65%) were net, corroborating the data from the literature on the subject. The median period of treatment was 9.5 hours, 53% of cases of severe grade 2 and 3 versus 47% in grades 0 and 1. The median duration of hospitalization was five days. One child died (6%). No child received antivenin treatment. Our analysis calls for the availability of specific immunotherapy in local health institutions in high-risk areas, such as ours.

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