ABSTRACT
The treatment of perforated duodenal ulcer cannot be standardised. In emergency to treat definitively both the perforation and the peptic ulcer request selectionned patients. We think that in emergency the primary aim is the treatment of the perforation to save the patient's life. The non operative method (Taylor-Quenu) keeps reasonably its place in the treatment of perforated duodenal ulcer in spite of critical opinions. This method has not to be used in patients who are said inoperable.
Subject(s)
Peptic Ulcer Perforation/therapy , Stomach Ulcer/complications , HumansSubject(s)
Duodenum/surgery , Pancreas/injuries , Pancreatectomy/methods , Adolescent , Adult , Duodenum/injuries , Emergencies , Humans , MaleABSTRACT
Peritonitis due to Candida albicans is both rare and severe. One of the two cases reported was consecutive to subtotal pancreatectomy for necrotizing pancreatitis and the other to perforated ulcer. Genuine C. albicans peritonitis should be distinguished from ascites with superinfection. It is usually due to intra-abdominal focal infection from a perforated hollow viscus. Depending on whether the infection is systemic or localized, antifungal drugs are administered systemically or topically. The surgical treatment is that of all peritonitis and meets with the usual of re-operation in search of deep residual septic foci. Cases with extraperitoneal candidiasis have a particularly poor prognosis.
Subject(s)
Candidiasis , Peritonitis/etiology , Postoperative Complications/etiology , Aged , Antifungal Agents/administration & dosage , Ascites/complications , Candidiasis/diagnosis , Candidiasis/therapy , Female , Humans , Male , Middle Aged , Pancreatitis/surgery , Peptic Ulcer Perforation/surgery , Peritonitis/therapy , PrognosisABSTRACT
Malignant plasma cell lymphomas have rarely been studied in the literature. We report two personal cases, the first survived 9 years, in the second case, histo-immunofluorescence revealed the presence of IgA kappa immunoglobulin. 59 cases have until now been reported to the best of our knowledge. They were reported under the term plasmocytoma. Analysis of data in the literature shows that plamocytomas resemble clinically and in prognosis, non-Hodgkin malignant lymphomas, of which Lukes and Lennert have recently given a new classification. Histo-immunofluorescence will permit in the future better understanding of the immunoglobulins secreted. Treatment is not yet standard. Three methods are used, depending on the spread of the tumour (surgery, radiotherapy and chemotherapy).
Subject(s)
Plasmacytoma/pathology , Stomach Neoplasms/pathology , Female , Humans , Immunoglobulin kappa-Chains/analysis , Male , Middle Aged , Plasmacytoma/immunology , Plasmacytoma/surgery , Stomach Neoplasms/immunology , Stomach Neoplasms/surgeryABSTRACT
The authors report a case of leiomyoma of the second part of the duodenum and note in the light of 55 cases in the literature, the main characteristics of this tumour including digestive hemorrhage, especially melena, which is the commonest mode of presentation. They compare it with other muscle tumours, e.g. sarcoma and myoid tumours. A barium meal and eventually superior mesenteric arteriography are the two main aids in diagnosis which remains by chance in 15% of cases. The volume of the tumour, the intimacy of its relations with the bile ducts influence the choice of surgery. The risk of hemorrhage and the histological uncertainty almost always lead to surgical operation.
Subject(s)
Duodenal Neoplasms/diagnosis , Leiomyoma/diagnosis , Adult , Aged , Diagnosis, Differential , Duodenal Neoplasms/pathology , Duodenal Neoplasms/surgery , Female , Humans , Leiomyoma/pathology , Leiomyoma/surgery , Leiomyosarcoma/diagnosis , Male , Melena/diagnosis , Middle AgedSubject(s)
Duodenum , Echinococcosis, Hepatic/complications , Adult , Humans , Male , Rupture, SpontaneousSubject(s)
Ankle , Fibroma , Genital Neoplasms, Male , Scrotum , Spermatic Cord , Aged , Humans , Male , Middle AgedSubject(s)
Liver Abscess/diagnosis , Adult , Diagnosis, Differential , Humans , Liver Abscess/therapy , Liver Abscess, Amebic/diagnosis , Male , Middle AgedSubject(s)
Adenocarcinoma/complications , Peritonitis/etiology , Stomach Neoplasms/complications , Adult , Aged , Female , Humans , Male , Middle Aged , Stomach Rupture/complicationsABSTRACT
The authors report a stab wound of the right branch of the portal vein observed at the Lariboisière hospital, and discuss 27 published cases of traumatic lesions of the portal vein or its branches. The treatment of choice of these lesions is mainly suture, which is the best procedure when there is a frank lesion without loss of tissue. Furthermore, we have found that ligature of one branch of the portal vein is possible, even if one does not carry out removal of the liver in the corresponding area. On the other hand, in no case, in a patient without liver disease or portal hypertension, should one carry out sudden total interruption of the portal blood flow.
Subject(s)
Portal Vein/injuries , Suture Techniques , Adult , Humans , Liver/blood supply , Liver/injuries , Liver/surgery , Male , Methods , Portal Vein/surgery , Postoperative Care , Sutures , Wound HealingABSTRACT
The authors analyze 107 cases of recurrent ulcer after vagotomy. This study suggests that the most common cause is incomplete vagotomy and, more rarely, defective gastric drainage. The therapeutic deductions depend on the etiology. The most logical attitude is verification of the initial vagotomy associated with antrectomy without forgetting the successes obtained by simple thoracic vagotomy when wide gastric resection has already been carried out.
