[Bismuth treatment and blood bismuth levels]. / Traitement bismuthique et bismuthémie.

The authors report the results of bismuth blood levels in 41 patients treated by oral route with bismuth salts used in gastro-enterology according to the Bensaude rule (10 to 20 g/day, 20 days/month). Median bismuth blood level during the period of treatment amounts to 13 microgram/l. It decreases to 7 microgram/l during the period of therapeutic withdrawal. In patients with bismuth encephalopathies (63 cases recorded in the literature) median values range from 680 to 700 microgram/l. The authors recommend the determination of bismuth blood levels as a monitoring method in bismuth treatment and propose the following values:--normal level during treatment : less than 50 microgram/l (in Bi metal);--alarm level : 50 to 100 microgram/l : (patients to be monitored);--toxicity level less than 100 microgram/l : (treatment to be interrupted).

[Colonic cancer and diverticulitis of the large intestine]. / Cancer colique et diverticulite du gros intestin

The authors report 17 cases of colonic carcinoma associated with diverticulitis. They differentiate between carcinomas arising above and below the diverticular area and emphasise the coexistence of both diseases on the same segment of colon. The diagnosis may be made in two different circumstances depending on whether the association presents as diverticulosis or as diverticulitis with complications. Careful examination of the barium enema whenever possible is the basic factor in diagnosis. The operation is rendered more difficult by inflammatory phenomena or suppuration of the sigmoiditis and the prognosis is aggravated by cancer.

[Reflexions on the surgical treatment of diverticular sigmoiditis. Apropos of 62 cases]. / Réflexions sur le traitement chirurgical de la sigmoïdite diverticulaire. A propos de 62 observations

The authors report 62 cases of operated diverticular sigmoiditis, note the indications for surgery and the method adopted. Apart from acute complications comparison of the clinical, laboratory and radiological data permit one to decide on a cold operation for prophylactic purposes. For acute generalised or localised peritonitis, the authors remove the lesions straight away when local and general conditions permit it. They emphasis the severity of the complications and the dealy with which these patients are still too often admitted on a surgical unit, which explins the persistently poor prognosis in spite of present conditions of resuscitation.