ABSTRACT
The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year-old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy. An early recurrence required a second disobstruction with surgical then endoscopic insertion of a drain, with 23 months of satisfactory survival. The discussion is focused on hilar fungating cholangiocarcinoma. The extrahepatic (Klatskin tumor) or intrahepatic origin of these lesions, the circumstances and morphological investigations for the diagnosis are discussed. Particularities of the treatment are mentioned, with emphasis on the possible participation of the endoscopist for choledocho or hepaticoduodenostomy.
Subject(s)
Adenoma, Bile Duct/diagnostic imaging , Bile Duct Neoplasms/diagnostic imaging , Adenoma, Bile Duct/pathology , Adenoma, Bile Duct/surgery , Aged , Anastomosis, Surgical , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/surgery , Drainage , Female , Humans , Neoplasm Recurrence, Local , Prostheses and Implants , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year- old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy. An early recurrence required a second disobstruction with surgical then endoscopic insertion of a drain, with 23 months of satisfactory survival. The discussion is focused on hilar fungating cholangiocarcinoma. The extrahepatic (Klatskin tumor) or intrahepatic origin of these lesions, the circumstances and morphological investigations for the diagnosis are discussed. Particularities of the treatment are mentioned, with emphasis on the possible participation of the endoscopist for choledocho or hepaticoduodenostomy.
Subject(s)
Adenoma, Bile Duct/diagnostic imaging , Bile Duct Neoplasms/diagnostic imaging , Cholestasis, Intrahepatic/etiology , Adenoma, Bile Duct/complications , Adenoma, Bile Duct/pathology , Adenoma, Bile Duct/surgery , Aged , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/surgery , Cholestasis, Intrahepatic/surgery , Female , Humans , Neoplasm Recurrence, Local , Reoperation , Tomography, X-Ray Computed , UltrasonographySubject(s)
Appendectomy/methods , Appendicitis/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Suture Techniques/instrumentationABSTRACT
A case of mesenteric cystic lymphangioma revealed by hypochromic anemia and abdominal pain, secondary to an intracystic hemorrhage is reported in a 4-year old child. Etiology, pathology, diagnosis, treatment and prognosis of mesenteric lymphangioma in children are reviewed.
Subject(s)
Lymphangioma/complications , Mesenteric Cyst/complications , Mesentery , Peritoneal Neoplasms/complications , Child, Preschool , Female , Humans , Lymphangioma/diagnostic imaging , Lymphangioma/surgery , Mesenteric Cyst/diagnostic imaging , Mesenteric Cyst/surgery , Peritoneal Neoplasms/diagnostic imaging , Peritoneal Neoplasms/surgery , Prognosis , Tomography, X-Ray Computed , UltrasonographyABSTRACT
A case of mesenteric cystic lymphangioma revealed by hypochromic anemia and abdominal pain, secondary to an intracystic hemorrhage is reported in a 4-year old child. Etiology, pathology, diagnosis, treatment and prognosis of mesenteric lymphangioma in children are reviewed.
Subject(s)
Anemia, Hypochromic/etiology , Lymphangioma/surgery , Peritoneal Neoplasms/surgery , Child, Preschool , Female , Humans , Lymphangioma/blood , Lymphangioma/complications , Lymphangioma/diagnosis , Peritoneal Neoplasms/blood , Peritoneal Neoplasms/complications , Peritoneal Neoplasms/diagnosis , Prognosis , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Two cases of squamous carcinoma of the anus developing from condylomata acuminata are reported. The general characteristics of condylomata acuminata are reviewed: viral etiology due to HPV virus, histological appearance and role in the the genesis of certain cancers. The association of condylomata acuminata and cancer of the anus is more particularly studied in a review of the literature: etiology, anatomoclinical aspects, treatment and current state of knowledge concerning the oncogenic role of HPV virus at this site.
Subject(s)
Anus Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Condylomata Acuminata/pathology , Neoplasms, Multiple Primary/pathology , Adult , Aged , Anus Neoplasms/etiology , Anus Neoplasms/therapy , Brachytherapy , Condylomata Acuminata/complications , Condylomata Acuminata/therapy , Female , Follow-Up Studies , Humans , Male , Middle AgedABSTRACT
Quality of care has been evaluated in this study by the criterion of mortality in a Digestive and Vascular Surgery unit. The analysis over a one-year period concerned 34 dead patients among 1298 entered and 1,108 operated patients who underwent 1,248 operations. The causes of death have been studied in the 3 groups: non operated (5 patients), digestive (20 patients), vascular (9 patients), with distinction of emergency surgery. Therapeutic habits have been systematically reexamined and considered either adapted or to be modified. Punctual conclusions of such a study are interesting for the medico-surgical team but also for the nursing team. Transparency of mortality for a whole team is a factor of progress by the periodical reappraisal of the therapeutic habits based upon accurate data, and by the better collaboration in the team.
