Gallstone is rare in children; however, sickle cell disease is associated with an increased risk of gallstone formation. We aimed to report particularity of diagnosis and management of gallstones in sickle cell children. We conducted a cross-sectional multicentric study in four hospitals of Dakar, in Senegal, during 18 years. We studied frequency, diagnostic particularities, management, and outcome. Among the 105 pediatric patients managed for gallstones, 87 (82.85%) had sickle cell disease. Among the latter, 18 (17.14%) were asymptomatic. Laparoscopic cholecystectomy was performed in 71 patients (67.62%). Following surgery, sickle cell patients were systematically hospitalized in the intensive care unit for 24 hours. Complications occurred in 7.6% and mortality in 1.9%. Gallstone is frequent in sickle cell children. Its management has good outcomes when taking in account particularities of these patients.
Part of the book: Gallstone Disease
The objective of this study is to assess the frequency and the diagnostic features of complicated appendicitis in children and to search for factors that can predict the type of complication that may occur. We conducted a descriptive and analytical retrospective study over an 8-year period from July 1, 2010 to June 31, 2018, including children diagnosed and treated for the following complications. The data were collected at the pediatric surgery department of the Albert Royer Children’s Hospital of Dakar. We collected 143 cases, representing 67.77% of all appendicular pathology. Encountered complications were 47.6% of abscesses, 42.6% of peritonitis, and 9.8% of appendicular mass. Appendicular syndrome was reported in 40.1% of cases, peritoneal irritation syndrome in 27.7% of cases, and occlusive syndrome in 6.2% of cases. Abdominal ultrasonography and plain X-ray allowed the diagnosis to be made in the majority of the cases. The analytical study showed that the clinical presentation and the white cell count can indicate the type of complication, unlike age and the duration of symptoms. In our practice, appendicular pathology often presents itself in complicated form. The clinical picture and the blood investigations’ results can point to the type of complication.
Part of the book: Appendicitis - Causes and Treatments