Introduction: Right ventricular dysfunction is a cause of morbidity and mortality after surgical correction of tetralogy of Fallot. The transatrial-transpulmonary approach allows preservation of right ventricular function. Aim: To report the immediate and long-term results of surgical treatment of tetralogy of Fallot using the transatrial-transpulmonary approach. Material and methods: This is a retrospective study including cases of tetralogy of Fallot operated on by the transatrial-transpulmonary approach between April 2009 and October 2010 in our institution. Results: There were 19 patients including 10 girls and 9 boys with a mean age of 7.4 years (extremes: 3 and 19 years). All our patients benefited from closure of the ventricular septal defect by a right atrial approach and enlargement of the pulmonary pathway. In the immediate postoperative period, the pressure gradient between the pulmonary artery and the right ventricle was 18.77 mm Hg. We had 2 deaths (10.5%). Complications were dominated by conduction disorders (100%) such as right bundle branch block and pleuropulmonary complications (41.20%). After a mean follow-up of 11.43 ±0.81 years, no patient died and all were asymptomatic, without significant residual lesion. Conclusions: Complete cure of tetralogy of Fallot by the transatrial-transpulmonary route is associated with low morbidity and mortality in our experience. The long-term results are satisfactory.

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Scrotal hematoma (SH) in newborn is a rare condition. It can occur secondary to adrenal hemorrhage which often is associated with birth trauma. Scrotal hematoma often raises the suspicion of testicular torsion leading to unnecessary surgery. We report two cases which improved our management approach.

Objective: Evaluate results of treatment of anorectal malformations (ARM).Methods: Mmulti-centric research on results of treatment of ARM in two university teaching hospital centres of Abidjan, from the period of January 2000 to December 2010. Sixty-three children operated for an anorectal malformation have been recorded. Thirty two of these children have been re-examined at an average age of 4 years old. The clinical evaluation was on anorectal function, physical condition of anorectal complex, urinary continence and quality of life according to the Ditehseim's score. Results: Sixteen patients (50%) out of the 32, had normal faecal continence; 4 had severe constipation; 10 cases (31.25%) were of complete soiling and 8 cases (25%) were of faecal incontinence. The clinical examination of anorectal complex was normal for 22 patients (68.75%). For the other 10 we could notice 5 cases of anal stricture and 2 cases of mucous ectropium. The urinary incontinence was associated with 2 cases. The low form has been observed as a factor of good prognosis for those operated of ARM (p = .04). During the evaluation of quality of life, 4 out of 12 patients aged of more than 5 years old, had a bad score in it. Conclusions: The improvement of the medium and long term results of treatment of ARM in our context requires the setting up of a multidisciplinary follow-up (paediatric surgeons, gastro-enterology paediatrics and paediatric psychologists) and raising the consciousness of parents to ensure an adapted nursing.