Traumatic injuries of the upper limb quite frequently cause acromioclavicular lesions including acromioclavicular disjunction (ACD). In our context, its management is problematic regarding the indications of surgical treatment on one hand and the choice of the surgical technique on the other hand. Among the many techniques available, that of Weaver-Dunn is one of the most popular for its simplicity of realization and its efficiency. In this respect it seems the most appropriate because of the socio-economic conditions of the population because it does not require a double intervention in this case the removal of osteosynthesis equipment. In this series, we report 3 cases of at least stage 3 DACs, all treated with this technique with good functional results.

Posterior urethral valves (UPVs) are congenital obstructive membranous folds that represent the main cause of bilateral renal obstruction and dysuria in children and infants. The seriousness of this malformative uropathy lies in the importance of its impact on the upper urinary tract with a significant risk of end-stage renal failure. The objective of this work is to report our experience on the management of this pathology, for this we carried out a retrospective and descriptive study over a period of 5 years, from January 2018 to December 2022, including all hospitalized patients or seen in consultation at the pediatric surgery unit of Hôpital du Mal. The parameters studied were demographic, clinical, radiological and therapeutic variables. We collected 10 patients, an average of 2 patients per year and a frequency of 0.38%. The infant age group was the most represented, i.e. 80% of cases. The average age of our patients was 9.1 months with extremes of 2 days and 48 months. The most common reason for consultation was dysuria with 60% of cases. Overflow urination was the most frequent functional sign. Fever was present in 90% of cases. Abdominal distension was present in nearly half of our patients and acute urinary retention in 30% of cases. All our patients underwent cytobacteriological examination of urine. It was positive in 4 patients, i.e. 40% of cases. THE. Coli was the majority germ. All our patients performed retrograde urethrocystography (UCR) and objectified a dilation of the posterior urethra in all patients. Surgical treatment concerned all our patients. The FOGARTHY technique was used in 9 patients and a vesicostomy was performed in one patient. In the immediate therapeutic follow-up, 1 patient died in intensive care, 3 patients presented with sepsis, one of whom subsequently died. After an 8-month follow-up, the consequences are simple in all our patients.

The authors report on their experiences in the surgical treatment of simple umbilical hernia in African children and a focus on pathology in resource-limited settings. However, this pathology pose a real aesthetic problem especially in young girls but surgery is the salvating treatment with good results.

Sacrococcygeal teratoma (TSC) is an embryonic tumor with high potential for congenital malignant transformation. It is rare and therefore considered a neonatal surgical emergency. The authors report a case of sacrococcygeal teratoma whose mother did not follow up during pregnancy and the delivery took place at home and who comes for consultation six months after his birth. It emerges from this case that the delay in diagnosis was due to the lack of financial means in the periphery, the extreme surgery could be performed with simple post-operative follow-ups. The result of the anatomopathological examination of the surgical specimen concluded to a benign teratoma. The patient could not be reassessed in the medium and long term because he is lost of seen.

Aim: To study the epidemiological and diagnostic aspects of fractures in children before the age of 1 year and identify the place of abuse. Materiel and methods: we conducted a retrospective study in the Pediatric Surgery over a period of 2-year. We got 40 cases of fractures occurred before the age of 1 year. Results and Discussion: The main causes are the fall with 45% of cases, followed by the receipt of a load with 20% of cases, and traditional massage with 12.5% of cases. The main locations of these fractures are the femur (31.1%), humerus (20%) and the clavicle (17.8%). In applying the criteria Bayreuther, a likely accidental is retained in 67.5% of cases and abuse is suspected in 25% of cases, 7.5% of cases were not classified due to lack of clinical data and/or radiological fracture for linking to an accident or abuse. Fractures of the child before the 1st year of life are, in general, due to domestic accidents. However, a number of them may be due to intentional injuries or non-accidental injury. Conclusion: Abuse is a possible cause of fractures in children under 1-year should be systematically sought to the recurrences.

BACKGROUND:Congential diaphragmatic herniae pose serious challenges in their management in this environment.Aim & Objective: To determine the pattern, as well as the diagnostic and management challenges of congenital diaphragmatic hernia in Dakar, Senegal.PATIENTS AND METHODS:This is a retrospective review of 14 children with congenital diaphragmatic hernia (CDH) managed within eleven years in Dakar, Senegal.RESULTS:There were nine boys and five girls with the age range of one day to 22 months and a mean of 5 months. Respiratory signs (respiratory distress, cough, current pulmonary infection) were found in 13 patients and gastrointestinal symptoms (vomiting, Difficulty sucking, anorexia) in 6 patients. The thoracic-abdominal radiography was performed in all patients and revealed a Bochdalek hernia on the left in 10(71%) cases and 4(29%) were Morgagni hernia. Treatment was by repair of the diaphragmatic defect with non-absorbable sutures. The postoperative course was uneventful in 13 children while one patient died on the first postoperative day one.CONCLUSION:Congenital diaphragmatic hernia presents mainly with postnatal respiratory features in this setting. Thoracic-abdominal radiography allows for early diagnosis, prompt and effective treatment with good outcome.KEYWORDS:Congenital diaphragmatic hernia, Respiratory insufficiency, Radiological features, Good surgical outcome.