[Surgical pathology costs more in emergencies: a bias in the clinical scoring index]. / La pathologie chirurgicale coûte plus cher en urgence: un biais des points ISA.

A retrospective study of all records of patients operated on for biliary lithiasis during the years 1995, 1996 and 1997 was performed in a general hospital setting to compare the costs of management according to presentation. This study shows that acute and chronic cholecystitis have statistically significantly different costs. The reimbursement plans, base on diagnostic related groups do not take this into account. This system disadvantages those centers which preferentially treat acute pathologies.

[The place of anatomo-pathological study in the diagnosis of enterocolitis complicated by Yersinia pseudo-tuberculosis]. / Place de l'examen anatomo-pathologique dans le diagnostic des entérocolites compliquées à Yersinia pseudo-tuberculosis.

Over a period of 3 months, 3 patients were operated on for subacute enterocolitis. The first case was a 3 years old boy with a transverse colonic perforation near the right angle and gross lymphadenopathy. The second case was a 21 years old man who had subacute terminal ileitis. Histopathological study showed specific lesions in those two cases: ovoïd or starry abscesses with preepithelioïd cells, rare giant Langhans cells, rare altered polynuclear cells in necrosis, massive lymphoïd hyperplasia. The third case was a 27 years woman with mild appendicitis showing masses of bacteria in the wall of appendix, surrounded by lymphocytes without polynuclear. Serological study showed anti YPST agglutinins significantly modified in all 3 cases. In the absence of bacteriological study, the role of pathological findings is discussed.