Biomedical subjects
Publications and source records attributed to A Louvel.
Reporting a case of cystic dystrophy of ectopic duodenal pancreas without associated pancreatitis, the authors recall the special characteristics of this exceptional entity and conclude that cephalic duodene pancreatectomy is the only operation which in their opinion can confirm the diagnosis and cause the symptoms to disappear.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors report the case of a patient with pancreatic and parathyroid adenomatosis and discuss whether it belongs to Wermer's syndrome. After a study of the various possible endocrine involvements, the complexity of hormonal inter-relations is studied, the prognosis and classification of multiple endocrine tumours are then discussed.
Explore the source record for details and available documents.
The authors report two recent personal cases including one explored by retrograde cholangiography and discuss the main clinical, pathological characteristics of this rare disease. They emphasize the severity of the course which does not usually last more than a few weeks after the onset of the first signs.
The authors report 9 cases of painless chronic pancreatitis and review the literature on this apparently rare condition. They emphasise the contrast between absent or minimal pain and the severe pathological lesions. In the light of these cases and pathological specimens, they attempt to interpret the pain during chronic pancreatitis. Pain seems to occur when there is a downhill course.
Explore the source record for details and available documents.
Allergic granulomatous angeitis or Churg and Strauss disease, seems to form part of the disease of necrotising angeitis. Clinically, it may be considered when periarteritis nodosa is associated with asthma and marked eosinophilia. The diagnosis depends on the pathological findings including the venous and pulmonary lesions, giant cells and the presence of extra-vascular granulomas. The recognition of this disease does not, however, permit one to give a precise prognosis. In the absence of progress concerning the pathogenesis, treatment will be the same as that given in other forms of necrotising angeitis.
The author report a case of enteroid retroperitoneal cyst treated by enucleation. Such a lesion raises mainly the problem of histological recognition and embryological interpretation for which there are two possible theories: (1) Uptake, before sealing off of the embryo, of a cell group of endoblastic origin which develops some distance from the digestive tract. (2) Retroperitoneal course of a simple teratoma of enteroid type. Such a possibility of teratoma leaves open the possibility of malignant transformation.
Frequently confused with adenomas or pseudopolyps of the gall bladder, papillomas are rare tumours defined as vegetations covered with an epithelium of gall bladder type in the centre of which is a thin connective tissue axis. They are usually recognised on lyon histological examination of the operative specimen. The uncertainty concerning their course makes them a potentially malignant lesion as shown by the two cases reported here including one personal case concerning a carcinoma situated close to a benign papillomatous lesion. The frequent coexistence with lithiasis which may induce their malignant transformation reinforces the indications for surgery for gall stones.
Twenty five cases of Hodgkin disease were treated by chemotherapy and radiotherapy after staging laparotomy. The safety and the utility of staging laparotomy are discussed. Staging laparotomy seems to be usefull in stage II with involvement of at least three lymphatic territories and in stage III.
Study of as homogeneous series as possible of 72 cases of gastrointestinal haemorrhage in patients with portal hypertension showed that the major cause of bleeding, accounting for almost 70% of cases, was ulceration of oesophageal varices. The presence at autopsy of haemorrhagic or necrotic lesions of the gastric mucosa is not felt to be a definite argument in favour of a gastric origin of the bleeding. Ulceration of gastric varices is considered to be an uncommon possibility, by virtue of the absence of dystrophic changes in the overlying mucosa, in contrast to the state of affairs seen in the oesophagus. Finally, the authors noted the relatively common presence of an associated malignant tumour (more than 8% of cases). This should perhaps lead to more profound investigations in order to seek a malignant intra- or extrahepatic malignant tumour before any bypass procedure to correct portal hypertension is undertaken.
Explore the source record for details and available documents.
With reference to 115 cases of acute pancreatitis which were either operated on or confirmed, the authors stress the seriousness of the lesion to the glandular parenchyma; it is also difficult to recognise during peroperative exploration. The necrosis, which is sometimes limited to the peripheral and interstitial tissue, sparing the gland itself (its prognosis is less serious) has led many surgeons to perform surgical excision. However, the problems encountered postoperatively have given rise to doubts a posteriori as to whether this is legitimate. Reference is made to the decapsulation of the pancreas described by Romanian authors, and a method for future operative diagnosis of glandular necrosis is proposed.