Résumé
A 30-year-old woman presented with a 5-year history of recurrent nodular lesions in the left subaxillary region,which had rapidly grown for 7 weeks.Five years prior to the presentation,she received breast conservation surgery and radiotherapy for left breast cancer,thereafter,chronic radiation dermatitis developed in the left subaxillary region.Two years after the operation,three soybean-sized bright red nodules appeared in the lesions of radiation dermatitis,and slowly enlarged.Subsequently,the nodules were resected,but a local recurrence was observed 3 weeks after the resection.The recurrent masses underwent accelerated growth during her pregnancy,and the growth was obviously inhibited after the termination of pregnancy.Physical examination revealed a quasi-elliptic,dark or bright red plaque measuring about 18 cm × 14 cm with a smooth surface in left subaxillary region,and in the center of the plaque was a bright red,hemispheric,elevated lesion measuring 10 cm × 9 cm × 5 cm with erosions or pitchy crusts on the surface.Histopathology of the lesions showed that the tumor was located in the dermis and consisted of densely packed uniform spindle-shaped cells arranged in a characteristic storiform or whirlpool pattern.Some cell nuclei showed atypia,and few mitoses were observed.In some parts of the lesion,tumor cells were arranged in a herringbone pattern.Immunohistochemistry revealed that the tumor cells stained positive for vimentin(strongly)and actin(weakly),but negative for CD34.Based on these findings,a diagnosis of postradiation dermatofibrosarcoma protuberans(fibrosarcoma type)was made.
Résumé
This paper reports 5 cases of itrogenic massive hemobilia.The bleeding of all the patients was successfully controlled via transcatheter arterial embolization. Our experience has again proved that emergency arteriography is the best method to determine the bleeding site. Transcatheter arterial embolization is easy, rapid, safe, reliable and with minor complication method, and thus should be first choice for treating hemobilia. The embolization should be contraindicated in patients with long-term shock without correction. The contraindicatious include severe hepatic cirrhosis accompanied by liver dysfunction, portal hyperfension with flow impedance.
Résumé
Transnasal endoscopical biliary catheterization was done successfully in 44 cases,23 cases with complete data were reported.These cases consisted of decompression and drainage of benign and malignant biliary obstruction (12 cases),dissolution and irrigation treatment of remnants of ascaris in the biliary tract (5 cases),dissolution of gallstone (2 cases),irrigation for biliary calculi (2 cases),hemos-tasis after endoscopic sphincterotomy (EST,1 case),and the examination and culture of the bile ( 1 case).The results were satisfactory without complication.Problems concerning EST was discussed,and endoscopic retrograde biliary drainage (ERBD) and percutaneous transhepatic biliary drainage (PTBD) were compared.