Riadh Mhiri

Hedi Chaker Hospital · Department of Pediatric Surgery

Introduction The aim of this observational study was to investigate the risk factors of a failed first attempt at pediatric central venous catheter (CVC) placement and its impact on CVC-related morbidity. Materials and Methods In this prospective observational study, we included 3-month-to 5-year-old children proposed for infraclavicular subclavia...

Abstract Nebulised lidocaine was previously used in infants and children undergoing flexible bronchoscopy and was safe and beneficial. The aim of this randomised controlled trial was to assess the impact of preoperative nebulised lidocaine on the incidence of perioperative respiratory adverse events in children aged 1 to 5 years proposed for ilioi...

Background: Difficult airway management is one of the main challenges in paediatric anaesthesia, particularly in low- and middle-income countries. Aims: The aim of this study was to investigate the main predictors of difficult paediatric intubation. Methods: In this observational study, we included all children aged less than 5 years undergoing int...

Constitutional Mismatch Repair Deficiency (CMMRD) is a rare childhood cancer predisposition syndrome, caused by biallelic pathogenic germline variants in the mismatch repair genes. Diagnosis and management of this syndrome is challenging, especially in low-resource settings. This study describes a patient diagnosed with colorectal cancer and grade...

Introduction: The aim of this observational study was to investigate the risk factors of a failed first attempt at pediatric central venous catheter (CVC) placement and its impact on CVC-related morbidity. Materials and Methods: In this prospective observational study, we included 3-month- to 5-year-old children proposed for infraclavicular subcla...

Background: Although ultrasound is considered the gold standard for the evaluation of children with suspected appendicitis, there is still much debate about the most accurate ultrasound findings. The purpose of this study was to define the best ultrasound signs that could ultimately improve the diagnostic accuracy of ultrasound for diagnosing pedia...

Background: Children with acute leukemia can have an increased risk of central venous catheter-related complications. The aim of this study is to assess our experience in the management of percutaneous central catheters in leukemic children and to investigate the risk of their placement in children with aplastic anemia. Materials and Methods: In th...

Background: Neonatal surgery in developing countries remains a high-risk modality p and its outcomes depend on various patient-related, system-related, and management-related factors. This study aims to describe our experience in managing newborns requiring surgical interventions and to investigate the primary predictors of postoperative mortality....

Background: Most studies have demonstrated the high accuracy of ultrasound for the diagnosis of acute appendicitis (AA) in children. However, the lack of visualization of the appendix on ultrasound is usually a challenge. The aim of this study was to identify any factors that might help the physician make the right decision when dealing with a chil...

Background Double congenital tracheoesophageal fistula (TEF) without esophageal atresia, known as double H-type fistula, is an extremely uncommon malformation. Due to its nonspecific symptoms and the small size of the fistula in infancy, H-type tracheoesophageal fistula is rarely diagnosed in the neonatal period and is also challenging to repair....

Airway management in neonates is difficult because of the risk of rapid hypoxia. It presents a challenge even for an experienced anesthesiologist. Oral tumors in neonates can obstruct the airway or feeding problems in the newborn. Surgical excision is the treatment of choice but these tumors can seriously worsen the conditions of intubation. To sur...

Purpose To identify the risk factors for adverse outcomes after pediatric pyeloplasty. Methods We conducted a retrospective review of all children under the age of 14 years who underwent primary pyeloplasty for unilateral ureteropelvic junction (UPJ) obstruction at a single teaching hospital in Tunisia between January 1, 2013, and December 31, 202...

Background: Intra-amniotic umbilical vein varices are characterized by a focal dilatation of the extra abdominal umbilical vein. Case report: We report a full-term baby female with extra-abdominal umbilical vein varices misdiagnosed clinically as an omphalocele. The umbilical vein was ligated and excised near the level of the liver. The infant died...

Background: Breast phyllodes tumor has a distinct histologic appearance. There are no pediatric phyllodes tumors of the bladder in English literature reported. Case report: A 2-year-old boy presented with a urinary infection and obstructive urinary symptoms. A 3-cm slow-growing bladder mass revealed by repeated transabdominal ultrasonography was in...

L'hyperplasie nodulaire focale (HNF) est une lésion bénigne du foie que l'on trouve généralement chez les adultes en bonne santé. Cependant, l'HNF est rare chez les enfants et ne représente que 2 % de toutes les tumeurs hépatiques pédiatriques. Nous rapportons le cas d'un enfant de 7 ans présentent une hyperplasie nodulaire focale de grande taille...

Bannayan-Zonana syndrome (BRRS) is a rare genetic disorder characterized by macrocephaly, numerous soft tissue and visceral hamartomas, and lipomas. Because of the risk of fatal bleeding and visceral neoplasia in adulthood, recognizing this disease is critical. We reported a new pediatric case of BRRS in an 18-month-old female infant with lipomas,...

Perineal burns are a rare finding in children that may cause severe complications. Vesicovaginal fistulas are an uncommon complication of a perineal burn that can be a tragedy for girls suffering from them. Fistula and/or its treatment are a socially debilitating problem with significant medicolegal implications. We present a rare case of a girl wi...

Background: Parapneumonic pleural effusion is a relatively common entity and continues to be a major cause of morbidity in children. However, managing this disease is still a matter of controversy between surgical and non-surgical options. With the advancement of mini-invasive surgery, video-assisted thoracoscopic surgery (VATS) has become a mainst...

Background: Necrotizing enterocolitis (NEC) is a serious neonatal condition. Over the last three decades, there has been progress in neonatal intensive care with an increase in the incidence of pre-term births. This has led to an increase in the incidence of NEC. However, research studies regarding NEC outcomes in low-income countries are scarce. O...

Total persistent omphalomesenteric canal as a cause of small-bowel obstruction is an exceptional finding. A neonate presented with occlusion due to volvulus of the small bowel around a total persistent omphalomesenteric canal. Remnants of the duct were successfully resected and the postoperative course was uneventful.

Background Intussusception is commonly idiopathic in children. Pathologic lead points (PLP) especially intestinal tumors (IT) are extremely rare. The diagnosis of intussusception secondary to pediatric IT is difficult due to the non-specific nature of symptoms. Its management remains a challenge. We report here four pediatric cases of intussuscepti...

Esophageal atresia (EA) is a life-threatening congenital malformation of the esophagus. Despite considerable recent advances in perinatal resuscitation and neonatal care, EA remains an important cause of mortality and morbidity, especially in low-income countries. The aim of this study was to assess risk factors for adverse outcomes following surgi...

Peutz–Jeghers syndrome is a rare but potentially life‐threating syndrome. We report here the case of a young girl who presented recurrent small bowel intussusceptions. Laparotomy exploration showed many jejunal polyps leading to jejunojejunal intussusceptions. These were removed via mini enterotomies and pathological examination concluded to Peutz–...

Background: Hickman-Broviac catheters have improved the care of young children needing frequent and prolonged venous access, but at the same times it has substantial morbidity, particularly in a resource-constrained setup. Our study aims to describe the experience of a Tunisian hospital and investigate the main risk factors for complications. Meth...

Background: Despite the high prevalence of acute appendicitis in children and substantial resource utilization associated with this condition, no consensus has been reached on optimal timing for performing appendectomies. The aim of this study was to examine the association between time to appendectomy and outcomes and assess the feasibility of del...

Peutz-Jeghers syndrome is a rare but potentially life threating syndrome. We report here the case of a young girl who presented recurrent small bowel intussusceptions. Laparotomy exploration showed many jejunal polyps leading to jejunojejunal intussusceptions. These were removed via mini enterotomies and pathological examination concluded to Peutz-...

Background Intestinal lipomas are benign, non-epithelial, intestinal tumors with an exceptionally rare localization at the ileum. Lipomas in the small intestine occur mainly in elderly patients and seldom occur in childhood. They are frequently asymptomatic, possibly due to their slow growth. These tumors may act as a lead point of intussusception....

Background Ganglioneuroma (GN) is an uncommon tumor belonging to the neuroblastic tumors group and is often localized in the posterior mediastinum, retroperitoneum, and adrenal gland. Presacral (PS) location is extremely rare. Its management remains a challenge. Case presentation A 4-year-old child presented to our department for an isolated abdom...

The article's abstract is not available.

Background Research concerning factors of death after neonatal surgery is scarce. Insight into mortality might improve perioperative care. This study aimed to identify predictive factors of mortality after neonatal surgery in a low income country (LIC). Methods Charts of all newborn patients who underwent surgical procedures under general anesthes...

A 13-year-old boy with a history of complicated pneumonia at the age of 20 months managed with antibiotics and chest drainage presented with hemoptysis. Chest radiography showed multiple small, thin-walled cavities . Chest scan showed massive necrosis of the left lung. Lung perfusion scan showed differential perfusion of left: right lungs to be 8:9...

The article's abstract is no available.

Undescended testis (UDT) is found in 3% to 5% of newborn boys. Along with the risk of infertility and germ cell tumor development, UDT is also prone to injury and appears to be at 10 times higher risk for torsion compared to the normally descended testis. The mechanism of UDT torsion is not clearly understood but it has been postulated that the lac...

A 2-month-old male child presented with multifocal liver lesions, noted by abdominal ultrasonography. The Ultrasonography was done as part of a work-up for abdominal distension. He was asymptomatic and had been previously healthy. On examination, the liver was enlarged (liver span-15 cm). Blood investigations showed abnormal liver function tests wi...

Perirenal lymphatic malformation (LM) is a rare benign lesion that often simulates as perinephric collection or parapelvic cyst. A neonate, antenatally diagnosed with a renal cystic mass, was investigated to have a perirenal LM on postnatal ultrasonography and MRI. The LM was excised successfully. Histopathologic examination of the specimen confirm...

Objectifs: Les masses rénales d’origine infectieuse sont rares chez les enfants. Le diagnostic étiologique et la prise en charge thérapeutique restent souvent un défi. Le but de cette étude est de rapporter les étiologies des masses rénales infectieuses ainsi que les moyens diagnostiques et thérapeutiques. Méthodes: Il s’agit d’une étude rétrospect...

Objectifs: Les tumeurs testiculaires représentent 1 % des tumeurs solides chez les enfants. Le but de cette étude est de décrire les caractéristiques de ces tumeurs et leur évolution chez les enfants traités pour des tumeurs testiculaires. Méthodes: Il s’agit d’une étude rétrospective des dossiers des enfants âgés de moins de 14 ans traités pour un...

A 6-year-old boy who fell to the ground from a two meter high wall presented to the emergency department for complaints of dyspnea, cough, and abdominal pain. On examination, he had fever and tachypnea. In the computed tomography evaluation, the liver had multiple unilocular hepatic cysts in segments III, V, VII, and VIII. The hydatid cyst of the h...

Introduction Bowel intussusception is an extremely rare postoperative complication of congenital diaphragmatic hernia. Any delayed diagnosis can be life-threatening. Clinician has to evoke the diagnosis every time symptoms of bowel obstruction appear after surgical repair. Methods We report the case of a newborn who presented an acute intussuscept...