[Children and adolescents at risk. A Study by the Child Psychiatry Department of Armand Trousseau hospital in Paris]

Along the 12 months of 2002, our Child Psychiatry Department received 109 young patients "at risk", under 17 years old. A detailed study of 103 files evaluates the danger they ran in three fields, suicide, abuse and neglect, and psychiatric pathology. With an original "danger scale", the multidisciplinary team completes three assessments: the danger before hospitalisation (background), the present professional action (diagnosis, care, police and justice connections...), estimation of the risk after treatment. In most cases, patients situations are severe, they have lasted for a long time (more than 6 months), and they were already taken on charge. The hospital psychiatric intervention, even for a short time, means to us to interfere whatever the proceedings: medical care, institutions, justice...

[Esophageal atresia, brachio-cephalic arterial trunk and tracheomalacia (author's transl)]

The case of 6 children operated for type III esophageal atresia with re-establishment of continuity is reported owing to the association with anterior tracheal compression by the brachio-cephalic arterial trunk. In the 5 cases, control radiography after the intervention showed a tracheotomy opposite the superior esophageal pouch and sometimes a notch in the anterior trachea. In all of the cases, endoscopy confirmed the presence of compression of the anterior aspect of the trachea by the brachio-cephalic arterial trunk. In 2 cases, esophageal transit was normal, the signs of tracheal compression disappeared after section-reimplantation of the brachio-cephalic trunk. In the other cases esophageal complications existed: stenosis, choking during swallowing, reflux. The surgical treatment of these complications led to the disappearance of the respiratory disorders.