RESUMEN
The closure anomalies of the peritoneal-vaginal canal include several clinical entities, which are at the origin of various symptomatology. OBJECTIVE: To study the anatomo-clinical and therapeutic aspects of pathologies of the peritoneal-vaginal canal. MATERIALS AND METHOD: This was a prospective study from January 1st to December 31st, 2015 carried out in the pediatric surgery department of University Hospital Gabriel Touré. It covered all children aged 0-15 years old with a pathology of the peritoneal-vaginal canal operating in the department during the study period. This study did not include cases that were not operated on or not seen during the study period. RESULTS: During the study period, 2,699 children were treated in pediatric surgery, of which 150 cases of pathology of the peritoneal-vaginal canal had a hospital frequency of 5.5%. The average age was 3.25 ± 9.63 years. The sex ratio was 14. The reason for consultation was intermittent or permanent inguinal or inguino-scrotal swelling in all children. The pathology was discovered by the parents during the pushing efforts in 46.7%. Inguino-scrotal swelling was found on physical examination in 40% of cases. The right side was reached in 60% of the cases. Hernia accounted for 80.6% of these pathologies. We recorded 31 cases of strangulation and 11 cases of craze. Immediate operative follow-up was simple in 92% of patients. This rate was 96% after 6 months. CONCLUSION: Pathologies of the peritoneal-vaginal canal are very common in pediatric surgical practice. The first place of these pathologies is occupied by hernia. They preferentially affect male infants.
Les anomalies de fermeture du canal péritonéo-vaginal (CPV) regroupent plusieurs entités cliniques qui sont à l'origine d'une symptomatologie variée. OBJECTIF: étudier les aspects anatomo-cliniques et thérapeutiques des pathologies du canal péritonéo-vaginal. MATÉRIELS ET MÉTHODE: il s'agissait d'une étude prospective du 1er Janvier au 31 Décembre 2015 réalisée dans le service de chirurgie pédiatrique du CHU Gabriel Touré. Elle a porté sur tous les enfants de 0-15 ans présentant une pathologie du canal péritonéo-vaginal opérés dans le service pendant la période d'étude. N'ont pas fait partie de cette étude, les cas non opérés et ou non vus pendant la période d'études. RÉSULTATS: Durant la période d'étude 2699 enfants ont été pris en charge en chirurgie pédiatrique dont 150 cas de pathologies du canal péritonéo-vaginal soit une fréquence hospitalière de 5,5%. L'âge moyen était de 3,25± 9,63 ans. Le sexe ratio était de 14. Le motif de consultation était la tuméfaction inguinale ou inguino-scrotale intermittente ou permanente chez tous les enfants. La pathologie a été découverte par les parents lors des efforts de poussées dans 46,7%. La tuméfaction inguino-scrotale a été retrouvée à l'examen physique dans 40% des cas. Le côté droit était atteint dans 60% des cas. La hernie a représenté 80,6% de ces pathologies. Nous avons enregistré 31 cas d'étranglement et 11 cas d'engouement. Les suites opératoires immédiates ont été simples chez 92% des patients. Ce taux était de 96% après 6 mois. CONCLUSION: Les pathologies du CPV sont très fréquentes dans la pratique chirurgicale pédiatrique. La première place de ces pathologies est occupée par la hernie. Elles touchent préférentiellement les nourrissons de sexe masculin.
Asunto(s)
Hernia Inguinal/epidemiología , Conducto Inguinal/anomalías , Peritoneo/anomalías , Vagina/anomalías , Adolescente , Niño , Preescolar , Criptorquidismo/complicaciones , Femenino , Hernia Inguinal/congénito , Hernia Inguinal/etiología , Hospitales de Enseñanza , Humanos , Lactante , Recién Nacido , Masculino , Malí/epidemiología , Peritoneo/cirugía , Estudios Prospectivos , Distribución por Sexo , Hidrocele Testicular/epidemiología , Vagina/cirugíaRESUMEN
PURPOSE: Compare the position of the undescended testis at clinical examination and under general anesthesia with the patency of an open processus vaginalis. PATIENTS AND METHODS: We included children from 2 to 18 years of age operated for a unilateral or bilateral undescended testis between January 2006 and April 2014 at the Annecy Genevois hospital, France. The analysis was conducted considering that the individual was the testis. Testicular position before surgery, under general anesthesia and patency of open processus vaginalis as a surgical finding were prospectively recorded. RESULTS: Three hundred and six children were included. The analysis was conducted over 401 testes. The position at clinical examination was significantly linked to a persistent open processus vaginalis (P=0.0045). Over the 282 testes considered as candidate for Bianchi's procedure, as to say intra- or supra-scrotal under general anesthesia, 154 had a persistent processus vaginalis (55%). CONCLUSION: There is a link between a persistent processus vaginalis and the location of the undescended testis which should encourage us not to neglect the inguinal approach, and eventually to question the relevance of Bianchi's procedure. LEVEL OF EVIDENCE: 4.