M Belghith

Hôpital Universitaire Fattouma Bourguiba, Al Munastīr, Al Munastīr, Tunisia

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Publications (82)184.99 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Gastric volvulus is an abnormal rotation of all or a part of the stomach around one of its axes. It is a rare cause of intestinal obstruction in children. This anomaly can be primary, due to abnormalities of the gastric ligaments, or secondary to other congenital malformations. We report on the cases of five children treated between January 1994 and December 2011, four boys and one girl, with a medium age of 7 months. Diagnosis was based on clinical features, particularly in the upper gastrointestinal Rx contrast study, which confirmed the diagnosis. Four out of the five children underwent laparoscopic surgery with fixation of the stomach. A diaphragmatic hernia was associated in one case. Antireflux surgery was performed in three cases, and a diaphragmatic defect was closed in one case. The follow-up was uneventful after a medium period of 7 years. good knowledge of this anomaly is the guarantee of early diagnosis and optimum treatment to ameliorate the prognosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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    ABSTRACT: Qu’avez-vous retenu de cet article ? Testez si vous avez assimilé les points importants de cet article en répondant à ce questionnaire sous forme de QCM.
    Feuillets de Radiologie 07/2014; DOI:10.1016/j.frad.2014.06.014 · 0.05 Impact Factor
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    ABSTRACT: Background: Open surgery is the standard option for the treatment of hydatid pulmonary cysts. Surgeons are able to replicate the principles of conventional surgery using minimally invasive techniques ,in particular thoracoscopy. However, there are few reports about this subject in children. To our knowledge, this is one of the biggest pediatric series ever reported in the literature. aim: the purpose of this study was to determine the best indications of the thoracospic surgery for the treatment of the pulmonary hydatid cysts in children. methods: We report a series of 25 cases with pulmonary hydatid cysts treated using the thoracoscopic approach from 2005 to 2009. We retrospectively analyzed the patients' sex, age, symptoms, biological data, characteristics of hydatid cysts (location, number and size) and the medical treatments. Pulmonary hydatid cyst diagnosis was performed on Chest x-ray, abdominal ultrasound and biological data in all the cases. Tomography was not systematic. All patients underwent video-assisted surgery. A conversion to thoracotomy was conducteded in 2 cases. All the patients had a chest tube and received an antibio-prophylaxy , without Albendazol . A concurrent hydatid cyst at the opposite lung or in the peritoneal cavity was treated later. results: There were 25 cases with a sex ratio of 2.1 and a mean age of 8 years. All the patients underwent a video-assisted surgery. A conversion to thoracotomy was performed in 2 cases because hydatid cysts were large (size > 8 cm). The average duration of the procedure was 75 minutes. In the post-operative course, one patient presented an air leak which required a prolonged chest drainage for 16 days and a second one was treated for lung infection. In all the other cases, the follow-up was uneventful. Conclusion: The thoracoscopic approach for pulmonary hydatid cysts in children is feasible. For better results, it is recommended for cysts smaller than 5 cm.
    La Tunisie médicale 05/2014; 92(5):341-344.
  • La Tunisie médicale 05/2014; 92(5):350-351.
  • Archives de Pédiatrie 05/2014; 21(5):565. DOI:10.1016/S0929-693X(14)71825-1 · 0.41 Impact Factor
  • Archives de Pédiatrie 05/2014; 21(5):454. DOI:10.1016/S0929-693X(14)71714-2 · 0.41 Impact Factor
  • Archives de Pédiatrie 05/2014; 21(5):520. DOI:10.1016/S0929-693X(14)71780-4 · 0.41 Impact Factor
  • Archives de Pédiatrie 05/2014; 21(5):467. DOI:10.1016/S0929-693X(14)71727-0 · 0.41 Impact Factor
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    ABSTRACT: Fibroepithelial polyps of the urethra (FEPU) are rare entity in infancy. They are congenital benign tumors. Most patients present with acute retention, hematuria or intermittent bladder outlet obstruction. The treatment of choice is transurethral endoscopic resection. Histological study confirms the diagnosis and the prognosis is excellent. We retrospectively reviewed the medical records of three male patients with fibroepithelial polyps of the urethra that were diagnosed and treated in the department of pediatric surgery of Monastir. The diagnosis was based on voiding cystourethrogram and cystourethroscopy. The treatment was endoscopic resection and histology confirmed the diagnosis in all cases.
    African Journal of Urology 03/2014; 20(1). DOI:10.1016/j.afju.2013.12.001
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    ABSTRACT: Hydatid cysts are endemic in certain regions of the world. It can affect any organ. However, the primary site to the spermatic cord is an unusual location. Hydatid disease has been reported 5 times in the spermatic cord. The purpose of this study was to report a new case of a child with hydatid disease in the spermatic cord. This cyst is the first case treated successfully by Albendazole without surgery.
    African Journal of Urology 03/2014; 20(1). DOI:10.1016/j.afju.2013.09.002
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    ABSTRACT: Teratomas are unusual tumors derived from all 3 germs cells layers: endoderm, mesoderm, and ectoderm, with varying proportions. The cervical area is exceptionally affected. We report 4 cases of cervical teratoma. The clinically and radiologically suggested diagnosis was confirmed by histology. We describe herein the main clinical, radiological, and histological aspects and outcomes of this disease. Despite its most often benign histologic nature, cervical teratoma may threaten newborn infants' life due to airway compression. A multidisciplinary approach to the disease starting at delivery is required to improve the prognosis.
    Archives de Pédiatrie 09/2013; 20(10). DOI:10.1016/j.arcped.2013.07.008 · 0.41 Impact Factor
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    04/2013; 2(2):25.
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    ABSTRACT: Introduction Isolated tracheoesophageal fistula without esophageal atresia is a rare congenital malformation. Its etiology is obscure. Diagnosis is difficult but must be made early. Purpose To study the clinical, radiological, and evolutionary sights of this malformation. Patients and methods We report 4 cases of tracheoesophageal fistula, collected in the department of pediatric surgery of Monastir Hospital and in the neonatology unit of Sousse Hospital during the period between January 2001 and December 2010. Results The clinical picture consisted in a coughing bout and cyanosis after each feeding. Thoracic and abdominal imaging showed aspiration pneumonia, atelectasis, and gas within the colon. Gastrointestinal opacification demonstrated the fistula in 2 cases. Tracheoscopy visualized the tracheoesophageal fistula in the other 2 cases. Treatment was surgical and consisted in the section-ligation of the tracheoesophageal fistula with pleural interposition in all cases. The course was simple in two cases with a 3-year and 3.5-year follow up, respectively, but the infants died in the other 2 cases. Conclusion Although a rare malformation, tracheoesophageal fistula should be suggested as a diagnosis when respiratory symptoms occur during feeding starting during the neonatal period.
    Archives de Pédiatrie 02/2013; 20(2):186–191. DOI:10.1016/j.arcped.2012.11.016 · 0.41 Impact Factor
  • 01/2013; 1(1):23-25. DOI:10.1016/j.jcco.2013.02.002
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    ABSTRACT: INTRODUCTION: Isolated tracheoesophageal fistula without esophageal atresia is a rare congenital malformation. Its etiology is obscure. Diagnosis is difficult but must be made early. PURPOSE: To study the clinical, radiological, and evolutionary sights of this malformation. PATIENTS AND METHODS: We report 4 cases of tracheoesophageal fistula, collected in the department of pediatric surgery of Monastir Hospital and in the neonatology unit of Sousse Hospital during the period between January 2001 and December 2010. RESULTS: The clinical picture consisted in a coughing bout and cyanosis after each feeding. Thoracic and abdominal imaging showed aspiration pneumonia, atelectasis, and gas within the colon. Gastrointestinal opacification demonstrated the fistula in 2 cases. Tracheoscopy visualized the tracheoesophageal fistula in the other 2 cases. Treatment was surgical and consisted in the section-ligation of the tracheoesophageal fistula with pleural interposition in all cases. The course was simple in two cases with a 3-year and 3.5-year follow up, respectively, but the infants died in the other 2 cases. CONCLUSION: Although a rare malformation, tracheoesophageal fistula should be suggested as a diagnosis when respiratory symptoms occur during feeding starting during the neonatal period.
    Archives de Pédiatrie 12/2012; · 0.41 Impact Factor
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    ABSTRACT: Perinatal testicular torsion (PTT) is a rare disease. Two entities have been described: prenatal or postnatal. The aim of this study is to recall the different etiopathogenic and histological features of this disease, to highlight the difficulties of diagnosis and discuss treatment modalities and finally to establish a treatment protocol of PTT. Patients and methods This is a retrospective study through which we studied 10 patients admitted in the pediatric surgery department of Monastir hospital between 1990 and 2009. Results Seven newborns had the antenatal testicular torsion form and three had the postnatal form. The main clinical symptom was the scrotal swelling. The controlateral vaginal hydrocele was found in 50% of cases. Doppler ultrasonography was performed in five cases and found a PTT with no blood flow in four of the five cases. The no surgical treatment was opted for a single patient and semi-urgent surgical treatment by scrotal incision has been practiced for the nine other cases. The PTT was extravaginal in all the cases. The surgical procedure consisted of an ipsilateral orchiectomy in 100% of cases and we have realized a contralateral orchiopexy in six of the nine cases operated. Pathological examination found a hemorrhagic infarction in seven cases and testicular necrosis in three cases. The postoperative and subsequent evolution was favorable in all cases. Conclusion The PTT is a rare disease occurring in utero and during the first month of life. Its pathogenesis is still poorly understood and the therapeutic approach is controversial.
    Journal de Pédiatrie et de Puériculture 12/2011; DOI:10.1016/j.jpp.2011.09.002
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    ABSTRACT: ObjectifÉtudier les aspects épidémiologiques, anatomopathologiques, cliniques et évolutifs des tératomes sacrococcygiens (TSC) chez l’enfant dans le sud et le centre tunisiens. Matériel et méthodesIl s’agit d’une étude rétrospective de 24 observations d’enfants opérés pour TSC entre 1984 et 2004. Le diagnostic de TSC a été confirmé dans tous les cas par l’examen histologique de la pièce opératoire. RésultatsL’âge de nos patients a varié de la naissance à cinq ans. Des malformations associées ont été retrouvées dans 12,5% des cas. Il s’agissait d’une exstrophie vésicale associée à une ambiguïté sexuelle, d’une ectopie testiculaire bilatérale et d’un spina-bifida. Le traitement chirurgical a été entrepris de façon rapide. Il a consisté en une exérèse en monobloc de la tumeur et du coccyx. La voie d’abord était toujours périnéale associée à une voie abdominale dans deux cas. L’étude anatomopathologique a montré qu’il s’agissait d’un tératome mature dans 66,6% des cas, immature dans 16,7% et malin dans 16,7%. La mortalité a été de 16,7% et a concerné dans tous les cas des tératomes initialement malins. DiscussionLes TSC sont les plus fréquents des tératomes de l’enfant. Des malformations associées au TSC sont rapportées dans 18% des cas. Elles sont dominées par les anomalies musculo-squelet-tiques, génito-urinaires, digestives, cardiaques et chromosomiques. Le traitement du TSC est essentiellement chirurgical. Il doit être instauré le plus précocement possible et doit comporter une exérèse totale de la masse emportant le coccyx. Un complément thérapeutique par chimiothérapie est indispensable dans les formes malignes. Le pronostic des TSC est généralement bon. En effet dans les tératomes bénins, la chirurgie précoce et totale emportant le coccyx donne de bons résultats avec un taux de guérison de 90 à 100 %. ConclusionUne surveillance clinique, biologique et radiologique est indispensable et doit s’étaler sur au moins trois à cinq ans pour détecter à temps les récidives. ObjectiveThe aim of this study is to review the different aspects of sacrococcygeal teratomas (SCT) in the Tunisian south and centre. Material and MethodsThis is a retrospective study of 24 SCT observations operated between 1984 and 2004. The diagnosis of SCT was confirmed in all cases by the histological exam. ResultsThe age of our patients varied from the birth to 5 years. Associated malformations were found in 12.5% of cases and consisted on bladder exstrophy associated to a sexual ambiguity, bilateral cryptorchidism and spina bifida. The surgical treatment consisted on complete resection of the tumour and the coccyx. The approach was perineal in all cases associated to an abdominal approach in two cases. Histological study showed that the teratoma was mature in 66.6% of cases and immature in 16.7%. A yolk sac tumour was encountered in 16.7%. Mortality rate was 16.7% and concerned the cases of yolk sac tumour. DiscussionThe SCT is the most frequent of teratomas of the child. Associated malformations are reported in 18% of cases and are dominated by musculo-scrawny, genito-urinary, digestive, cardiac and chromosomic abnormalities. The SCT treatment is essentially surgical. It must be established the most prematurely and consists on a total resection of the mass taking the coccyx. A therapeutic complement by chemotherapy is indispensable for malignant teratomas and yolk sac tumour. The outcome of the SCT is generally good with a cure rate ranged from 90 to 100%. ConclusionA clinical, biologic and radiological follow-up is indispensable and has to spread out over at least 3–5 years to discover at time the recurrences.
    Oncologie 12/2008; 9(12):864-868. DOI:10.1007/s10269-007-0727-9 · 0.08 Impact Factor
  • Revue de Stomatologie et de Chirurgie Maxillo-faciale 07/2007; 108(3):243-4. · 0.39 Impact Factor
  • Revue de Stomatologie et de Chirurgie Maxillo-faciale 06/2007; 108(3):243-244. DOI:10.1016/j.stomax.2006.12.003 · 0.39 Impact Factor
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    ABSTRACT: Spontaneous perforation of the bile duct (SPBD) is a rare disease in infancy. The pathogenesis, diagnostic modalities and treatment options for this condition are reviewed and discussed. The authors report 2 new observations of SPBD in 2 male newborns aged respectively 27 and 21 days. The 2 newborns presented with cholestatic jaundice. Abdominal sonography showed an extrahepatic mass. Exploratory laparotomy revealed that the perforation was located in the cystic duct in the first case and in the common bile duct (CBD) in the second. The site of perforation was repaired and both patients underwent simple external biliary drainage. The postoperative course was uneventful for both patients with follow-up ranging from 2 to 4 years. SPBD is a rare, but important cause of surgical jaundice in infants. The pathogenesis of SPBD is unknown and multifactorial and diagnosis is often problematic. Surgical management is always required and a conservative approach is usually recommended. The prognosis is good with early surgical management.
    European Journal of Pediatric Surgery 05/2007; 17(2):132-5. DOI:10.1055/s-2007-965123 · 0.98 Impact Factor

Publication Stats

637 Citations
184.99 Total Impact Points

Institutions

  • 1991–2014
    • Hôpital Universitaire Fattouma Bourguiba
      • Intensive Care Unit
      Al Munastīr, Al Munastīr, Tunisia
  • 2001–2003
    • Centre Hôpital Universitaire Farhat Hached
      Susa, Sūsah, Tunisia
  • 1994
    • Hôpital Foch
      Lutetia Parisorum, Île-de-France, France