Rupture of a superior mesenteric artery aneurysm in a child.

A 13-year-old child presented with a ruptured aneurysm of the trunk of the superior mesenteric artery most likely due to incipient fibromuscular disease localized in the adventitia. The aneurysm was resected and replaced by an autologous saphenous vein graft. The postoperative course was uneventful. Diagnosis and operative strategy are discussed.

Identification of Campylobacter pylori in gastric biopsy smears.

The use of gastric biopsy imprint smears to diagnose Campylobacter pylori was compared with the use of tissue sections and cultures. Multiple gastric biopsies were taken from the mucosa of 42 patients during endoscopy. Imprint smears were prepared from the samples used to make tissue sections; other samples were used for microbiologic culture. There was a good concordance (93%) between the morphologic diagnosis of C pylori in the air-dried, Giemsa-stained smears and the tissue sections; the cytologic preparations were clearly positive in six cases (14%) whose sections contained low numbers of the organisms. There was a concordance of 83% between the combined morphologic techniques and the bacteriologic culture. Six positive cases were detected only by the morphologic techniques while one positive case was detected only by bacteriologic culture. C pylori was identified in one or more preparations of the antral biopsy specimens in 23 (55%) of the 42 cases, including 23 (74%) of the 31 cases with a final diagnosis of gastritis or ulcer. These results show the usefulness of the cytologic study of gastric biopsy smears in diagnosing C pylori infections.

[Endoscopy and histology in the diagnosis of inflammatory intestinal diseases]. / Apports de l'endoscopie et de l'histologie dans le diagnostic des maladies inflammatoires intestinales (M.I.I.).

Colonoscopy is now a routine examination in the diagnosis and the follow-up of I.B.D. The most typical aspects of endoscopic and histological lesions are described. Colonoscopy and histological study of endoscopic biopsies permit a differential diagnosis of Crohn's disease and ulcerative colitis in 90% of the cases. Certain cases remain indeterminate even after colectomy.

Prolonged catheterization. A rare cause of pulmonary atheroma.

At post-mortem examination of a 75-year-old man, a fragment of polyethylene catheter placed several years previously was discovered in the right pulmonary artery. It was embedded in a vessel wall and caused an atheromatous plaque, a rare complication in human pathology.

Granulomatous synovitis and Crohn's disease.

A case of Crohn's disease of the colon, diagnosed after the discovery of a granulomatous synovitis of the wrist in a 40-year-old woman is described. The clinical and histological features of the articular and extraarticular inflammatory lesions of Crohn's disease are reviewed.

High-output right ventricular failure secondary to hepatic arteriovenous microfistulae. Selective arterial embolization treatment.

A patient with diffuse hepatic arteriovenous microfistulae suffered from secondary high-output right ventricular failure, pulmonary hypertension, and ascites, all of which could be managed by selective embolization of the hepatic artery. The vascular lesion of the liver seems to be essential, although hemorrhagic hereditary telangiectasia , perhaps aggravated by administration of oral contraceptives, may be considered contributory factors in this case.

[Balloon cell melanoma of the skin. Review of the literature. Apropos of 1 case]. / Le mélanome cutané à cellules claires. Revue de la littérature. A propos d'un cas.

The clinical and pathological features of the fifteen balloon cell melanomas found in the literature are reviewed. Conclusions are that despite early nodal metastases, the median survival time (6,3 years), is rather long, and this diagnosis can be very difficult on the lymph nodes metastases.

Fibromuscular dysplasia of arteries: a spastic phenomenon?

Arterial fibrodysplasia is principally observed in renal and carotid arteries: the disease is a systemic, acquired one related to ischemia of the muscular cell of the media, by obstruction of the vasa-vasorum. Its histological identification in very rare cases of spastic arteries in cases of chronic ergotamine or methysergide intoxication lead me to consider that fibrodysplasia could be due to chronic, repeated, discontinuous and subobstructing spasms, favoured by the various etiological co-factors already known.

[Malignant melanoma of the gallbladder]. / Le mélanome malin de la vésicule biliaire.

The authors present a case of secondary melanoma of the gallbladder, surgically discovered during a laparotomy for assumed biliary tract pathology. The primary tumor was a cutaneous melanoma at the right leg treated by surgery, four years before. At the laparotomy, the pancreas and the omentum contained also metastases. After cholecystectomy the cancerous evolution quickened and led to death after one year. The exceptional character of this observation lead the authors to review the literature.

[Malignant mesenchymatous hamartoma of the liver in adults. Apropos of a case]. / Hamartome mésenchymateux malin du foie chez l'adulte. A propos d'une observation.

Clinical and pathological findings in a forty-eight-year-old woman with malignant mesenchymatous hamartoma of the liver (embryonic sarcoma) are reported. Special emphasis is put on the monomorphic leiomyosarcomatous aspect of the peritoneal metastases, and on the presence of pseudo-tumorous foci abounding in plasmocytes and centered by recent phlebitis.

[Surgical experience in 48 cases of early gastric carcinoma]. / Expérience chirurgicale de 48 cas de "early gastric carcinoma".

The authors are reporting their surgical experience of the early gastric carcinoma (EGC). In the last twenty-one years, 48 patients with 54 EGC were operated on: 30 men and 18 women. The proportion of early gastric carcinoma (EGC) among treated gastric carcinoma which was 8% during the first period has risen to 12.5% during the last six years and to 30% during the last year. The average age was 59 years. Symptoms and means of diagnose are analysed. Gastroscopy with multiple biopsies is the most important method of diagnose. The EGC were limited to the mucosa in 27 cases, in another 27 lesions the submucosa was invaded. Most lesions were type II c and III. There were five associations with another cancer. Distal gastric resection (subtotal) was employed in all cases except in one case of total resection. The over all operative mortality rate (30 days) was 6%. The five years survival rate (excluding operative mortality) is 85% (corrected 93%). The ten years survival rate is 75% (corrected 92%).

Prospective evaluation of the diagnostic accuracy of liver ultrasonography.

Liver ultrasound was prospectively evaluated in 104 subjects who underwent liver biopsy, including 24 patients without evidence of liver disease (controls), and 80 with a broad spectrum of liver pathology. Ultrasonography was very specific (100%) and moderately sensitive (70%) in the detection of liver pathology, and hepatic neoplasms, steatosis, and fibrosis were detected by ultrasound in 80%, 80%, and 67% of cases respectively. In addition, ultrasonography diagnosed other pathologies--mainly biliary tract disease and abdominal neoplasms--in 26% of the patients.