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Biomedical subjects

A Arsalane

Publications and source records attributed to A Arsalane.

6 recordsLinked to original sources

[Surgical treatment of pulmonary hydatid cysts in childhood].

OBJECTIVES: To analyse the radioclinical forms of pulmonary hydatid cyst in children, and to evaluate the results of surgical treatment. PATIENTS AND METHODS: During a period of 4 years (2002-2005), 26 surgical procedures were performed for pulmonary hydatid cyst in 23 children (16 boys and 7 girls, mean age 13, 5 years). Symptoms were chest pain (87%), broncho-pulmonary infection (32%) and hemoptysis (22%). Chest x-ray showed a non-complicated cyst in 62% of cases. The CT scan was performed in 15 cases (65%), mainly for complicated forms. Abdominal echography for all patients showed 3 hepatic localisations of hydatid cyst. All the patients underwent surgical treatment by thoracotomy. RESULTS: In a total of 34 cysts, 21 were uncomplicated, 13 complicated (intra-bronchial rupture: 11 cases, pleural rupture: 2 cases). Cystectomy or pericystectomy were performed in 91% of cases, segmentectomy in 6% and a lobectomy in 3%. Decortication was done in the 2 pleural-ruptured cases. There was no mortality. One lower left lobe atelectasis was observed post-operatively. CONCLUSION: Conservative surgical techniques for pulmonary hydatid cysts in children are preferred to parenchyma resection. In our practice the treatment of bilateral hydatidosis in 2 times decreases the complication rate.

Adolescent↗

[Sequestration of the posterobasal segment of the right lower pulmonary lobe].

Pulmonary sequestration is a rare congenital malformation that receives its blood supply from a systemic artery. We report a case of pulmonary sequestration treated by ligature of the anomalous artery without pulmonary resection. Pulmonary sequestration must be treated surgically before the occurrence of severe complications.

Adult↗

[Spontaneous hemothorax: a rare but serious complication of intralobular pulmonary sequestration].

Pulmonary sequestration is a rare congenital malformation characterized by a non-functional portion of pulmonary parenchyma devoid of any connection with the bronchial tree and pulmonary artery. If not identified antenatally or at birth, the sequestration may not be discovered until complications, mainly repeated infections, arise. Hemorrhage is another but much rarer complication which is generally severe. We report a new case of intralobular pulmonary sequestration revealed by hemoptysis then massive hemothroax with shock requiring emergency thoracotomy for hemostasis.

Adult↗

[Thoracic gossypibomas].

OBJECTIVES: Intrathoracic gossypiboma are exceptional, but diagnosis and treatment are difficult. The purpose of this study was to recall the clinical and radiological aspects of intrathoracic gosssyibomas and discuss the medicolegal consequences. MATERIAL AND METHODS: From January 1990 to June 2003, eight cases of gossypiboma were treated in our unit. The patients were aged 31 to 60 years (mean 40.5). Six had a history of thoracic surgery and two a history of biliary surgery. Clinically, the main symptom was hemoptysia (7 patients, 87.5%). Four patients (50%) presented thoracic pain and one a pleurocutaneous fistula. The chest x-ray revealed a poorly delimited opacity in six patients, a liquid effusion in one and a raised left diaphragm in one. The thoracic scan performed in two patients demonstrated an air image in one and a liquid image in the other. RESULTS: Surgical removal was difficult in all eight patients. Pulmonary parenchyma had to be sacrificed in certain patients. Two patients developed postoperative complications (one pneumothora and one thoracic wall infection). CONCLUSION: The diagnosis of intrathoracic gossypiboma should be suggested in all patients with a pulmonary mass and a history of thoracic surgery, more rarely laparotomy. Prevention remains the best treatment.

Adult↗

[Left strangulated diaphragmatic hernia: an unusual complication of gastric bypass].

The appearance of left strangulated diaphragmatic hernia doesn't seem to have been described in the past as a progressive complication after gastric bypass surgery. The authors describe the case of a 54 year old patient suffering from a strangulated gastric hernia pushing through a diaphragm defect located next to the gastric band. The gastric band had been placed two years previously in this patient suffering from morbid obesity. Strangulation of the hernia resulted in the sphacelation of the entire stomach fundus. Therefore a partial gastrectomy and removal of the band was necessary. Recovery from procedure was without complications. The past history of a major spinal trauma in this patient, could have led to a discussion regarding the etiology of this hernia, however the delay between the two events (28 years) makes this unlikely. It seems, therefore, that the placement of a gastric band was the responsible factor. The authors emphasize the importance of pre-procedure pulmonary X-ray, prior to any general anesthesia, as well as a post procedure cliché following any intervention that might have lead to diaphragmatic lesion.

Gastric Bypass↗

[In utero transfer for preterm labor: experience of a regional perinatal hotline providing a 24-hour on call service].

OBJECTIVE: Preterm labor is one of the major causes of concern for level I and II obstetricians. The purpose of this study was to determine the incidence of in utero transfer performed for preterm labor. We also aimed to evaluate the algorithm we used in case of call for preterm labor. This algorithm allowed us to study the rate of endovaginal sonography use prior to in utero transfer, to calculate its predictive value and to evaluate the risk of delivery during transfer. PATIENTS AND METHOD: We conducted an 8-months prospective study of all calls for preterm labor received at a regional call center in France (EU). All obstetrical data were entered in a computerized anonymous database. Three months after the first call midwives collected data from the receiving hospital. RESULTS: Calls for preterm labor account for 40% of calls for in utero transfer. Two hundred and sixty-five calls have been received for preterm labor; among them 50 cases were associated with a preterm rupture of membrane, a maternal or fetal pathology and 14 cases were lost for follow-up. Those 64 cases were excluded leaving 201 cases for analysis. Twenty-eight had a cervix dilated 4 cm, or more, while 173 had a cervix dilated less than 4 cm. Fifty percent of woman that had a cervical dilatation of 4 cm or more delivered more than 4 h after the call. Among the 173 patients that had a cervix dilated less than 4 cm, 71% had not delivered 7 days after the hotline call and 26% had an endovaginal ultrasonography performed before the transfer. None of the women that had a cervical length longer than 27 mm delivered in the 7 following days. None of the 176 women that were transferred delivered during the transfer. DISCUSSION AND CONCLUSION: In utero transfer for preterm labor is the leading cause of in utero transfer. Endovaginal ultrasonography prior to transfer should be performed in order to avoid unnecessary transfer. Women who have a preterm labor with a cervical dilatation of 4 cm or more are not an absolute contra-indication to in utero transfer. In those cases the transfer indication should be discussed on a case-to-case basis including the actual term and the distance between hospitals.

Female↗