Sana Mosbahi - Academia.edu (original) (raw)

Papers by Sana Mosbahi

Journal of neonatal surgery, Apr 13, 2024

Background: Fetus in fetu is a rare congenital malformation resulting from abnormal embryogenesis... more Background: Fetus in fetu is a rare congenital malformation resulting from abnormal embryogenesis in a monochorionic diamniotic twinning gestation. This study aimed to document our experience with this anomaly in a developing country. Methods: This retrospective analysis covers cases of fetus in fetu diagnosed at our institution between 1999 and 2023. Patients presenting with an intracorporeal mass containing a vertebral column and an appropriate arrangement of organs and limbs around the axis were included in the study. Results: Five female patients with fetus in fetu were identified. The timing of diagnosis varied from incidental antenatal ultrasound discovery to postnatal abdominal mass presentation. The initial diagnosis involved radiological and serological investigations, confirmed by histopathology after surgical excision. The mean age at the time of surgery was 44 days. All patients underwent complete excision of the fetal mass, resulting in excellent postoperative outcomes and no recurrences. Conclusion: Fetus in fetu is a pediatric rarity and must be distinguished from a teratoma mass, which carries a high malignant potential. Histological and genetic studies may contribute to understanding the pathogenesis and etiology of the disease.

Child's Nervous System

Introduction: Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative... more Introduction: Ventriculo-gallbladder shunt (VGS) has been recognized as a last-resort alternative to treat hydrocephalus when the peritoneum and/or other distal sites can no longer receive shunts. In some speci c conditions, it may be conceded as a rst-line treatment. Case presentation: We report the case of a 6-month-old girl with progressive post-hemorrhagic hydrocephalus and who presented a concomitant chronic abdominal symptom. Speci c investigations ruled out acute infection and led to the diagnosis of chronic appendicitis. Both problems were managed in a one-stage salvage procedure consisting of laparotomy sanctioning to treat the abdominal pathology and seize the opportunity to perform a VGS as a rst option since the abdomen is prone to ventriculoperitoneal shunt (VPS) failure. Conclusion: Only few cases have reported the use of VGS as the rst option to handle uncommon complex cases due to abdominal or Cerebro-Spinal Fluid (CSF) conditions. We wish to draw attention to VGS as an effective procedure not only in children with multiple shunt failures but also as rst-line management in some selected cases.

African Journal of Paediatric Surgery, 2022

Background: Trichobezoar is an uncommon clinical entity in which ingested hair mass accumulates w... more Background: Trichobezoar is an uncommon clinical entity in which ingested hair mass accumulates within the digestive tract. It is generally observed in children and young females with psychological disorders. It can either be found as an isolated mass in the stomach or may extend into the intestine. Untreated cases may lead to grave complications. Material and Methods: We retrospectively analyzed the clinical data of six patients treated for trichobezoar in Monastir pediatric surgery department during 16-year-period between 2004 and 2019. Imaging (abdominal computed tomography and upper gastroduodenal opacification) and gastroduodenal endoscopy were tools of diagnosis. Results: Our study involved 6 girls aged 4 to 12. Symptoms were epigastric pain associated with vomiting of recently ingested food in 3 cases and weight loss in one case. Physical examination found a hard epigastric mass in all cases. The trichobezoar was confined to the stomach in 4 cases. An extension into the jejunum was observed in 2 cases. Surgery was indicated in all patients. In two cases, the attempt of endoscopic extraction failed and patients were then operated on. All patients had gastrotomy to extract the whole bezoar even those with jejunal extension. Psychiatric follow-up was indicated in all cases. The six girls have evolved well and did not present any recurrence. Conclusion: open surgery still plays a crucial role in Trichobezoard management . After successful treatment, psychiatric consultation is imperative to prevent reccurrence and improve long term prognosis

EMC - Pediatría, Aug 1, 2022

Iranian Journal of Pediatric Surgery, Oct 3, 2017

Introduction: We report the case of a 4 years old girl who present a cervico-thoracic ganglioneur... more Introduction: We report the case of a 4 years old girl who present a cervico-thoracic ganglioneuroblastome with none response to chemotherapy and radiotherapy Case presentation: The girl was operated using the Cormier Dartevelle-Grünenwald incision which helped to remove the tumor completely with optimal control of noble elements. The follow up was uneventful. Conclusion: The Cormier Dartevelle-Grünenwald incision can be a good option in case of big cervico-thoracic malignant tumors.

African Journal of Urology, Sep 1, 2014

Reçu le 8 novembre 2012; reçu sous la forme révisée le 18 mars 2014; accepté le 20 mars 2014 MOTS... more Reçu le 8 novembre 2012; reçu sous la forme révisée le 18 mars 2014; accepté le 20 mars 2014 MOTS CLÉS rein; tumeur; nourrisson; nephrome mesoblastique Résumé Nous rapportons trois observations de néphrome mésoblastique chez deux nourrissons de 3 et 5 mois et chez un nouveau né de 5 jours. Le néphrome mésoblastique congénital ou tumeur de BOLANDE représente 2 à 3% des tumeurs rénales de l'enfant. elle présente des caractéristiques anatomopathologiques, thérapeutiques et pronostiques distinctes du néphroblastome. Il existe plusieurs controverses dans sa prise en charge.

PubMed, May 1, 2014

Background: Open surgery is the standard option for the treatment of hydatid pulmonary cysts. Sur... more 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.

African Journal of Urology, Dec 1, 2014

Le but de l'étude est d' analyser les caractéristiques épidémiologiques, cliniques, para clinique... more Le but de l'étude est d' analyser les caractéristiques épidémiologiques, cliniques, para cliniques, les modalités évolutives et les procédures thérapeutiques de la prise en charge du kyste hydatique du rein chez l'enfant. Patients et méthodes: Il s'agit d'une étude rétrospective de 8 cas d'enfants opérés pour kyste hydatique du rein au service de chirurgie pédiatrique de Monastir de 1995 à 2011. Résultats: L'âge des patients variait de 3 à 14 ans avec un âge moyen de 8 ans et ½. Il s'agit de 3 garçons et 5 filles soit un sex ratio de 0,6. La symptomatologie clinique révélatrice était dominée par la douleur abdominale (4 cas/8), le diagnostic positif s'est basé sur l'imagerie et la sérologie hydatique. La chirurgie était à ciel ouvert dans 4 cas et vidéo-assistée dans 4 cas dont 3 laparoscopies et une rétropéritonéoscopie. L'évolution clinique a été favorable et aucun patient ne présente de gêne fonctionnelle. Conclusion: Le traitement du kyste hydatique du rein chez l'enfant est essentiellement chirurgical et en règle conservateur. Il peut être mené par chirurgie à ciel ouvert ou par chirurgie vidéo-assistée qui a l'avantage d'être mini-invasive. Le pronostic est fréquemment favorable.

Archives De Pediatrie, Dec 1, 2014

Journal of Medical Case Reports

Background Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in... more Background Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in children. It is often misdiagnosed preoperatively as a malignant neoplasm, leading to an unnecessary nephrectomy. The challenge is to make the right diagnosis preoperatively and therefore manage it with conservative surgery. We report a case of a child with metanephric adenoma who underwent nephron-sparing surgery. Case presentation A renal tumor was discovered fortuitously in an 18-month-old Caucasian girl with several congenital malformations. Investigations showed a 28 × 27 × 27 mm left renal mass centrally located, well defined, nonvascularized, with no calcifications and which compressed the adjacent renal tissue. Furthermore, there were no signs of metastasis. The decision of a multidisciplinary meeting was to perform a computed tomography (CT)-scan-guided biopsy. Histologic examination concluded it was a metanephric adenoma. We performed a left open partial nephrectomy via a flan...

F1000Research

Introduction: The abdomen is the most prevalent site of primarily unidentified fatal injury after... more Introduction: The abdomen is the most prevalent site of primarily unidentified fatal injury after blunt trauma, and represents the third major affected part. However, follow-up strategies of intra-abdominal injuries remain controversial. The aim of this study is to describe the characteristics of children with blunt abdominal trauma (BAT) and who presented radiographic amendments in re-imaging studies and predict factors that could identify patients group requiring control in this population. Methods: A retrospective study was conducted in the department of pediatric surgery and the intensive care unit of Monastir involving all patients under the age of 14 years old who were admitted for blunt abdominal trauma between January 2010 and December 2021.An analysis of epidemiological, clinical, radiological and therapeutic management characteristics were performed. Results: A total of 151 patients were included in this study with a mean age of six years. The sex ratio (m/f) was 2.7. Mo...

Pediatric Endocrinology Diabetes and Metabolism, 2020

Pheochromocytoma is a rare tumor during childhood, originating from the chromafine tissue. The cl... more Pheochromocytoma is a rare tumor during childhood, originating from the chromafine tissue. The clinical presentation can be variable and assembling many other diseases. This tumor submits specific care problems. We report the case of a 7-year-old boy who presented with headache, fever, abdominal pain and vomiting evolving for 3 days. The physical examination revealed a painful abdomen, a high blood pressure and profuse sweating. As an acute appendicitis was suspected, abdominal ultrasound then abdominal CT were performed, revealing multiple bilateral adrenal masses. Measurement of 24-hour urinary catecholamines showed a marked increase in normetanephrines: 7,18 mg/24 h (normal range: 0.07-0.46 mg/24 h). The MIBG scintigraphy revealed a bilateral fixation in the two adrenals. During the next weeks, the patient developed close peaks of threatening hypertension, controlled with difficulty through the concomitant use of three anti hypertensive treatments. He underwent surgery two months after the first consultation, and had a total adrenalectomy on the right side and subtotal on the left side. The pathological examination concluded with multiple and bilateral pheochromocytomas with a PASS score between 2 and 6. The patient was treated with hormone replacement therapy immediately after the surgery. The subsequent course with a 10-month follow-up was favorable with disappearance of functional signs, correct blood pressure, good general condition, normal growth and a normal biological balance.

Introduction: The rectum villous tumour is an uncommon pathology in paediatrics, it represents 1%... more Introduction: The rectum villous tumour is an uncommon pathology in paediatrics, it represents 1% of all the children’s malignant tumours. Case Presentation: An eleven-year-old girl presented a rectal adenocarcinoma arising from a villous tumour. The aim of this study is to overview of the literature, asses the frequency of rectum villous tumours, specify the value of the clinical examination, of the radiologic findings in the assessment of the loco-regional extension of villous tumours and rectum adenocarcinoma and finally to discuss the treatment modalities. Conclusion: The rectum villous tumour symptomatology in children is not very specific. Therefore, a good knowledge of its clinical presentation and the predisposing pathological situations can improve the prognosis of this rare disease.

Iranian journal of pediatric hematology and oncology, 2017

Background: Ovarian masses requiring surgical intervention are uncommon in the pediatric populati... more Background: Ovarian masses requiring surgical intervention are uncommon in the pediatric population. The aim of this study was to report results of a multicentric Tunisian study concerning the clinical practice and the management of pediatric ovarian masses and to identify the factors that are associated with ovarian preservation. Materials and Methods: Between January 2000 and December 2015, 98 pediatric patients (<14 years) were surgically treated for ovarian masses at the five pediatric surgery departments in Tunisia. Results: Ninety-eight patients were included in this study. The mean age of the patients at time of surgery was 8.46±4.87 years. Sixty-three ovarian masses (64.3%) were nonneoplastic lesions, 24 (24.5%) were benign tumors, and 11 (11.2%) were malignant neoplasms. Conservative surgery (ovarian preserving surgery) was successfully performed in 72.4% of the benign lesions whereas only three patients (27.3%) with malignant tumors underwent ovary-sparing tumor resecti...

Journal of Pediatric Surgery, 2019

Background: Pulmonary hydatid disease remains an important healthcare problem. Conservative opera... more Background: Pulmonary hydatid disease remains an important healthcare problem. Conservative operative interventions including cystotomy or cystotomy with capitonnage are the two commonly used techniques. However, there is no scientific consensus over selection of these operative interventions. Aim: The aim of this study is to compare these two methods: capitonnage and uncapitonnage in the surgery of childhood pulmonary hydatid cyst in regard to the postoperative period. Methods: This is a retrospective analysis of 136 patients operated for pulmonary hydatid disease between January 2010 and July 2017 according to two techniques. Group A was cystotomy with capitonnage (n = 76), and group B was cystotomy alone (n = 60). We compared the postoperative outcomes. Results: Our data showed pneumothorax(PNO) and emphysema were seen in 30% of Group B and only in 13.2% in Group A, and the persistence of residual cavity in 23.3% in Group B and 7.9% in Group A (p = 0.014). We have not seen any case of recurrence with capitonnage. Conclusion: We conclude that capitonnage appears to prevent PNO and emphysema formation and a remaining residual cavity in the long term with a significant difference. And it prevents prolonged postoperative air leak and hospitalization with a slightly nonsignificant difference. It is difficult to say with absolute certainty that the noncapitonnage group is inferior to the capitonnage group, since several factors can influence the evolution.